Document Detail


Multimodal exercise improves quality of life of women being treated for breast cancer, but at what cost? Randomized trial with economic evaluation.
MedLine Citation:
PMID:  20734132     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the efficacy and economic efficiency of a multimedia, multimodal physical activity program for women undergoing adjuvant therapy following surgery for breast cancer. We conducted a randomized trial with concurrent incremental cost-effectiveness analysis and blinded baseline, 3, 6 and 12-month follow-up assessments amongst women undergoing adjuvant therapy following surgery for breast cancer (n = 89). The intervention was a multimedia, multimodal exercise program comprising strength, balance and endurance training elements. The control was sham flexibility and relaxation program delivered using similar materials. The primary outcome was health-related quality of life (EQ-5D & VAS, EORTC C30, BR23). Economic outcomes included direct health care costs and productivity gains and losses. Participants in the intervention group demonstrated greater improvement in health-related quality of life between baseline and the 3-month assessment [mean (sd) EQ-5D VAS (0-100) baseline: 72.6 (15.6), 3 month: 80.6 (11.6)] when compared to control group participants [baseline: 77.5 (13.5), 3 month: 74.1 (20.6), P = 0.006] and also improved more in terms of physical function [mean (sd) EORTC C30 physical function scale intervention (0-100) baseline: 84.9 (14.8), 3 month: 86.9 (10.7), control baseline: 91.3 (9.6), 3 month: 86.7 (14.9), P = 0.02]. These improvements were not sustained beyond this point. Upper limb volumes were also lower amongst intervention group participants. However, there was low probability that the intervention would be both less costly and more effective than the control condition (range probability = 0.05-50.02% depending on approach). Provision of multimodal exercise programs will improve the short-term health of women undergoing adjuvant therapy for breast cancer but are of questionable economic efficiency.
Authors:
Terry P Haines; Patricia Sinnamon; Neil G Wetzig; Margot Lehman; Euan Walpole; Tony Pratt; Amanda Smith
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-08-24
Journal Detail:
Title:  Breast cancer research and treatment     Volume:  124     ISSN:  1573-7217     ISO Abbreviation:  Breast Cancer Res. Treat.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8111104     Medline TA:  Breast Cancer Res Treat     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  163-75     Citation Subset:  IM    
Affiliation:
Allied Health Clinical Research Unit, Kingston Centre, Southern Health, Cheltenham, Victoria 3192, Australia. terrence.haines@med.monash.edu.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Breast Neoplasms / economics,  psychology,  therapy*
Chemotherapy, Adjuvant
Cost-Benefit Analysis
Exercise Therapy / adverse effects,  economics*
Female
Health Care Costs*
Humans
Linear Models
Logistic Models
Middle Aged
Quality of Life*
Quality-Adjusted Life Years
Queensland
Questionnaires
Radiotherapy, Adjuvant
Recovery of Function
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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