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Long-term effectiveness and cost-effectiveness of an 18-week supervised exercise program in patients treated with autologous stem cell transplantation: results from the EXIST study.
- Source :
-
Journal of cancer survivorship : research and practice [J Cancer Surviv] 2019 Aug; Vol. 13 (4), pp. 558-569. Date of Electronic Publication: 2019 Jul 08. - Publication Year :
- 2019
-
Abstract
- Purpose: To evaluate the long-term effectiveness and cost-effectiveness of a supervised 18-week high-intensity exercise program compared with usual care in patients treated with autologous stem cell transplantation.<br />Methods: One hundred nine patients were randomly assigned to the exercise intervention (n = 54) or the usual care control group (n = 55). Data on cardiorespiratory fitness (VO <subscript>2</subscript> peak), handgrip strength, general fatigue, and health-related quality of life (quality-adjusted life years [QALYs]) were collected at baseline (T0), after completion of the exercise intervention or at a similar time point in the control group (T1) and 12 months later (T2). Cost questionnaires were used to assess societal costs. Long-term effectiveness (at T2) was evaluated using linear mixed model analyses. For the economic evaluation, missing data were imputed using multiple imputation, and data were analyzed using linear mixed models.<br />Results: At T2, no statistically significant differences were found between the intervention and control group for VO <subscript>2</subscript> peak (0.12; 95%CI - 1.89; 2.14 ml/min/kg), handgrip strength (- 1.08; 95%CI- 2.47; 2.31), and general fatigue (- 0.69; 95%CI - 2.52; 1.14). During 12-months follow-up, no significant between-group differences in QALYs and societal costs were found (QALYs - 0.07; 95%CI - 0.17; 0.04; costs 529; 95%CI - 3205;4452). Intervention costs were €1340 per patient. For all outcomes, the probability of the intervention being cost-effective was low at reasonable values of willingness-to-pay.<br />Conclusion: We found no evidence for the exercise intervention being effective on physical fitness and fatigue, nor cost-effective from a societal perspective.<br />Trial Registration: The study was prospectively registered on 27 May 2010 at the Netherlands Trial Register ( NTR2341 ).<br />Implications for Cancer Survivors: The current exercise intervention should not be recommended to patients recently treated with autologous stem cell transplantation.
- Subjects :
- Adult
Cardiorespiratory Fitness physiology
Cost-Benefit Analysis
Fatigue epidemiology
Female
Follow-Up Studies
Hand Strength physiology
Hematologic Neoplasms economics
Hematologic Neoplasms epidemiology
Hematologic Neoplasms mortality
Humans
Male
Middle Aged
Netherlands epidemiology
Physical Fitness physiology
Quality of Life
Quality-Adjusted Life Years
Surveys and Questionnaires
Transplantation, Autologous statistics & numerical data
Treatment Outcome
Cancer Survivors statistics & numerical data
Exercise Therapy economics
Exercise Therapy methods
Hematologic Neoplasms therapy
Hematopoietic Stem Cell Transplantation statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1932-2267
- Volume :
- 13
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of cancer survivorship : research and practice
- Publication Type :
- Academic Journal
- Accession number :
- 31286387
- Full Text :
- https://doi.org/10.1007/s11764-019-00775-9