Feasibility and acceptability of the Comprehensive Oncology Rehabilitation and Exercise (CORE) clinical workflow algorithm in patients with newly diagnosed stage I–III breast cancer who undergo surgery as first-line treatment

IF 6.1 2区医学 Q1 ONCOLOGY

Cancer Pub Date : 2025-04-28 DOI:10.1002/cncr.35798

Lea Haverbeck Simon PhD, MA, Carson Saviers-Steiger BS, Emily R. Dunston PhD, MS, Patrick Galyean BS, Elisabeth R. Kimball MS, Justine Mendez BS, Susan L. Zickmund PhD, Pamela A. Hansen MD, Cornelia M. Ulrich PhD, MS, Paul C. LaStayo PhD, PT, David Steinberg MD, Christopher S. Noren MS, A’Lisha Finch BS, Leanne Seckinger OT, Emma Braun MS, Jonathan Chipman PhD, Kirstyn E. Brownson MD, Sonal Oza MD, Adriana M. Coletta PhD, MS, RD

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Abstract

Background

This pilot, mixed-methods, randomized controlled trial determined the feasibility and acceptability of the Comprehensive Oncology Rehabilitation and Exercise (CORE) clinical workflow algorithm. CORE was designed to connect patients with newly diagnosed breast cancer to exercise and rehabilitation services from the time of diagnosis throughout cancer care.

Methods

In total, 72 patients with newly diagnosed, stage I–III breast cancer who required surgery as first-line treatment were randomized 2:1 to CORE or standard of care. CORE included a triaging tool of two questionnaires regarding self-reported exercise (the Godin Leisure Time physical activity questionnaire) and functional status (the Patient-Reported Outcomes Measurement Information System physical function questionnaire), which were administered at the check-in desk for routine breast surgical oncology clinic visits at the initial surgical consultation, postoperatively, and 24 weeks after surgery. Responses to questionnaires in the triaging tool triaged participants to one of three pathways within the algorithm: exercise service, rehabilitation service, or exercise self-management (not a service). Service pathways required referral by clinic staff. Feasibility was determined based on completing the triaging tool (≥66%) and referral completion (≥50%) at the initial surgical consultation visit. Acceptability was determined by four study participant focus groups and one clinic team focus group (≥50% positive response).

Results

Ninety-three percent of participants in CORE (n = 40) completed the triaging tool. Among those triaged to a service pathway (n = 29), 62% completed their referral. Focus group feedback was primarily positive.

Conclusions

The CORE clinical workflow algorithm is feasible and acceptable among women who have newly diagnosed stage I–III breast cancer with plans for surgery as first-line treatment. CORE was also acceptable among clinic staff.

Clinical Trials Registration

NCT04594473

Abstract Image

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肿瘤学综合康复与运动（CORE）临床工作流程算法在新诊断I-III期乳腺癌手术一线治疗中的可行性和可接受性

本试验采用混合方法，随机对照，确定了肿瘤综合康复与运动（CORE）临床工作流程算法的可行性和可接受性。CORE旨在将新诊断的乳腺癌患者与从诊断到癌症治疗的运动和康复服务联系起来。方法共72例新诊断的I-III期乳腺癌患者，需要手术作为一线治疗，按2:1随机分为CORE组或标准护理组。CORE包括两份关于自我报告运动（Godin闲暇时间体力活动问卷）和功能状态（患者报告结果测量信息系统体力功能问卷）的调查问卷，这两份调查问卷在首次外科会诊、术后和术后24周的常规乳房外科肿瘤诊所就诊时在登记台进行管理。在分诊工具中，对问卷的回答将参与者分为算法中的三种途径之一：锻炼服务、康复服务或锻炼自我管理（不是服务）。服务途径需要诊所工作人员转诊。可行性根据初次外科会诊时完成分诊工具（≥66%）和转诊完成（≥50%）来确定。可接受性由4个研究参与者焦点组和1个临床团队焦点组确定（≥50%的积极反应）。结果93%的CORE参与者（n = 40）完成了分诊工具。在那些被分类到服务途径的人中（n = 29）， 62%完成了他们的转诊。焦点小组的反馈基本上是积极的。结论CORE临床工作流程算法在新诊断的I-III期乳腺癌患者中是可行且可接受的，这些患者计划将手术作为一线治疗。临床工作人员也接受CORE。临床试验注册NCT04594473

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来源期刊

Cancer 医学-肿瘤学

CiteScore

13.10

自引率

3.20%

发文量

480

审稿时长

2-3 weeks

期刊介绍： The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research