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Influence of a Home-based Nutrition and Exercise Program on Quality of Life of Palliative Cancer Outpatients

Not Applicable
Completed
Conditions
Cancer, Gastrointestinal
Cancer, Lung
Malnutrition
Interventions
Dietary Supplement: Whey protein supplement high in leucine and β-hydroxy-β-methylbutyrate (HMB)
Behavioral: Standardized nutritional program
Behavioral: Standardized exercise program
Registration Number
NCT04859400
Lead Sponsor
Kantonsspital Winterthur KSW
Brief Summary

The main purpose of the study is to investigate whether a tailor-made nutritional and exercise program including home-based sessions and regular monitoring using an application on the smartphone is effective in improving Quality of Life in patients with advanced lung or gastrointestinal tract cancer.

Detailed Description

Cachexia is highly prevalent among cancer patients and has substantial impact on the Quality of Life (QoL) and the functional status of patients.Therefore, the main purpose of this study is to investigate whether a mainly home-based nutritional and exercise program including regular monitoring using an application on the smartphone is effective in improving QoL in patients with advanced lung or gastrointestinal tract cancer.

The study desing is a randomized, two-arm and multicenter international trial and advanced lung or gastrointestinal cancer patients not eligible for curative treatment make up the patient population.

Patients in the intervention group receive a nutrition and exercise program in combination with an electronic application for data collection and monitoring.

The nutritional program comprises an extensive nutritional assessment and an individual nutritional recommendation. In addition, patients receive a whey protein supplement high in leucine and β-hydroxy-β-methylbutyrate (HMB) to support an optimal protein intake in combination with physical activity. The nutritional situation is reassessed at 2 -3 weeks.

Exercise counselling includes at least two visits with an extensive first baseline assessment. On this basis, an individual training program for 12 weeks in a home-based setting is compiled, with mainly strength and endurance exercises. At week 2-3, the patient and the study physiotherapist have a follow-up meeting.

The application Swiss NutriAct is mainly used for data collection (nutritional, exercise and QoL data). Since the study coordinator, dietician and physiotherapist can see the information entered by the intervention group patients, they can contact patients and offer help regarding the nutrition and exercise program, where deemed appropriate. Vice versa, patients can use the help button to contact the study team to ask questions regarding the nutrition and exercise program.

Patients in the control group receive standard of care and a limited version of the application.

Both arms will be assessed at baseline (0 weeks), after the 12 weeks intervention phase and at a follow up assessment after 24 weeks.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
72
Inclusion Criteria
  • Advanced lung or gastrointestinal cancer patients not eligible for curative treatment
  • WHO performance status of ≤ 2
  • Able to perform physical exercise estimated by the treating physician
  • Estimated life expectancy of ≥ 6 months
  • Patient must give written informed consent
Exclusion Criteria
  • Intake of supplements with high-dose branched-chain amino acids within one month
  • Enteral (except oral nutritional supplements) and/or parenteral nutrition within one month
  • History of ileus within previous month
  • Milk protein allergy
  • The patient cannot understand the trial-specific content due to linguistic, psychological or disease reasons
  • Age < 18 years

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionStandardized nutritional programstandardized nutritional program including a nutritional supplement standardized exercise program app for monitoring.
InterventionWhey protein supplement high in leucine and β-hydroxy-β-methylbutyrate (HMB)standardized nutritional program including a nutritional supplement standardized exercise program app for monitoring.
InterventionStandardized exercise programstandardized nutritional program including a nutritional supplement standardized exercise program app for monitoring.
Primary Outcome Measures
NameTimeMethod
QoL3 Months

Questionnaire Functional Assessment of Cancer Therapy - General (FACT-G)

Secondary Outcome Measures
NameTimeMethod
Physical function3 months

6 minute walk test (in m)

Energy- and protein intake3 months

Data collected with application, Harris-Benedict formula

Fatigue3 months

Questionnaire Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue)

Adherence to the nutritional and exercise program3 months

According to data collected with application

Usability of the new application3 months

Questionnaire mHealth App Usability (MAUQ)

Success of recruitment rate in comparison to former studiesThrough study completion (24 months)

Number of eligible patients, participants, rejections as compared to similar past studies

Nutritional status3 months

Sarcopenia screening questionnaire SARC-F

Clinical data3 months

Survival

Trial Locations

Locations (3)

Klinikum Konstanz

🇩🇪

Konstanz, Germany

Spital STS (Simmental-Thun-Saanenland) AG

🇨🇭

Thun, Switzerland

Kantonsspital Winterthur

🇨🇭

Winterthur, Switzerland

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