Evaluating telephone versus face-to-face modes of exercise intervention delivery to women during and following treatment for breast cancer (#7)
Abstract: Exercise for Health was a randomised, controlled trial designed to evaluate two modes of delivering (face-to-face [FtF] and over-the-telephone [Tel]) an 8-month translational exercise intervention, commencing 6-weeks post-breast cancer surgery (PS). The FtF mode of delivery reflects the traditional approach used for exercise prescription, while Tel delivery represents a mode with wide reach and potential cost-savings. Physical function (fitness and upper-body), treatment-related side effects (fatigue, lymphoedema, body mass index, menopausal symptoms, anxiety, depression and pain) and quality of life were evaluated pre-intervention (5-weeks PS), mid-intervention (6-months PS) and two months post-intervention (12-months PS). 194 women representative of the breast cancer population were randomised following baseline assessment to the FtF (n=67), Tel (n=67) and UC (n=60) groups. Generalised estimating equation modelling determined time, group (FtF, Tel, Usual Care [UC]) and time-by-group effects. Findings from the FtF and Tel groups were similar, with the treatment groups reporting improved QoL, fitness and fatigue over time. In contrast, the UC group experienced no change, or worsening QoL, fitness and fatigue, mid-intervention. Although improvements in the UC group occurred by 12-months post-surgery, change did not meet the clinically relevant threshold. This translational intervention trial, delivered either face-to-face or over-the-telephone, supports exercise as a form of adjuvant breast cancer therapy that can prevent declines in fitness and function during treatment and optimise recovery post-treatment. Demonstrating that delivery of the intervention face-to-face or over-the-telephone has similar effect is a particularly novel and exciting finding with significant implications for the integration of exercise into the standard of breast cancer care provided to all women, irrespective of place of residence and access to specialist care.