Implementation and Effectiveness of a Veterans Affairs-Based Comprehensive Lung Cancer Survivorship Program
| Autor: | Harry S Swartzwelder, Brian J Rabe, Alisa D Hassinger, Jordan W Stafford, Scott Shofer |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Survivorship Hospital Anxiety and Depression Scale Pulmonary Disease Chronic Obstructive Quality of life Cancer Survivors Survivorship curve Medicine Humans Veterans Affairs Lung Veterans business.industry Rehabilitation Mental health Dyspnea Physical therapy Quality of Life Smoking cessation Anxiety medicine.symptom Cardiology and Cardiovascular Medicine business Body mass index |
| Zdroj: | Journal of cardiopulmonary rehabilitation and prevention. 42(3) |
| ISSN: | 1932-751X |
| Popis: | PURPOSE Few programs exist to address persistent impairment in functional status, quality of life, and mental health in lung cancer survivors. We aimed to determine whether a 12-wk multimodal survivorship program imparts clinical benefit. METHODS Any patient at the Durham Veterans Affairs Medical Center with lung cancer and a Karnofsky score of ≥60 could participate. Chronic obstructive pulmonary disease medications were optimized at the enrollment visit. Participants with a Hospital Anxiety and Depression Scale (HADS) score of >8 were offered pharmacotherapy and mental health referral. Participants did home-based exercise with a goal of 1 hr/d, 5 d/wk. They were called weekly to assess exercise progress and review depression/anxiety symptoms. Participants were offered pharmacotherapy for smoking cessation. RESULTS Twenty-three (50%) of the first 46 enrollees completed the full 12-wk program. Paired changes from enrollment to completion (mean ± SD) were observed in 6-min walk test (73.6 ± 96.9 m, P = .002), BODE (Body mass index, airflow Obstruction, Dyspnea, and Exercise) index (-1.45 ± 1.64 points, P < .001), Duke Activity Status Index (3.84 ± 7.12 points, P = .02), Fried Frailty Index (-0.588 ± 0.939 points, P = .02), modified Medical Research Council dyspnea scale (-0.619 ± 1.284 points, P = .04), Functional Assessment of Cancer Therapy-Lung Emotional subscale score (1.52 ± 2.96 points, P = .03), HADS total score (-2.63 ± 4.34 points, P = .02), and HADS Anxiety subscale score (-1.47 ± 2.29 points, P = .01). CONCLUSIONS A comprehensive Lung Cancer Survivorship Program provides clinically meaningful improvements in functional status, quality of life, and mental health. |
| Databáze: | OpenAIRE |
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