REJOIN Trial for Older Breast Cancer Survivors (REJOIN)
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|ClinicalTrials.gov Identifier: NCT03955627|
Recruitment Status : Recruiting
First Posted : May 20, 2019
Last Update Posted : June 18, 2021
|Condition or disease||Intervention/treatment||Phase|
|Breast Cancer Female||Behavioral: Relieving Joint Pain and Improving AI Adherence in Older Breast Cancer Survivors (REJOIN)||Not Applicable|
To improve AIA and AI Adherence in older survivors, it will: first, adapt an evidence-based intervention (AIM 1) and then; test the adapted intervention with breast cancer survivors ≥65 years. The Investigators will educate survivors about possible AI-related side effects and teach survivors ways to use PA to self-manage AIA (AIM 2), and support adherence to hormonal therapy recommendations (AIM 3). Given evidence that survivors experience AIA soon after initiating hormonal therapy, potentially eligible participants would be identified early in the treatment process. By identifying potential participants after diagnosis or during active treatment, survivors would have a minimal delay in beginning the exercise intervention after initiating hormonal therapy (i.e. AIs). All participants will have completed surgery, radiation and/or chemotherapy, which is consistent with current ASCO guidelines for AI use.
Two groups will be randomized to either an information-only group (enhanced standard care) or an education plus exercise group (treatment). At the initial clinical visit during the intervention, participants in both groups will receive printed information along with their AI medication prescription. The treatment group will subsequently receive a one-on-one exercise consultation with a certified exercise trainer (e.g ACSM or similar), followed by a modified version of the Fit & Strong! program, which includes bi-weekly supervised exercise (60 minutes) and educational sessions (30 minutes).
The exercise sessions will include light weights or resistance bands plus low-impact aerobic exercise, in which movements will be explained, demonstrated and modified based on the needs of participants. The exercise protocol will be reviewed and revised based on recommendations from clinical advisers. Educational materials will provide information about the purpose of AI medications (e.g., to reduce cancer recurrence) in layperson language and basic information about potential side effects. As part of in-person sessions, participants will develop a plan to continue exercise at home. Participants can do an activity of their choice (e.g., walking) and use resistance bands which will be provided for the at-home program which will begin after 8 weeks and will include follow up phone calls to assess progress and reinforce the program. Educational sessions will be modified to reflect relevant content and advice for older survivors beginning AIs. Assessments will be taken at 4 and 6 months, with follow up at 12 months.
All supervised exercise sessions will be conducted remotely to accommodate recommended COVID safety protocols.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||76 participants|
|Intervention Model:||Parallel Assignment|
|Intervention Model Description:||Randomized Clinical Pilot. Enhanced Standard Care v. Treatment (education plus exercise).|
|Masking:||Triple (Participant, Care Provider, Outcomes Assessor)|
|Masking Description:||Masked parties will not be told the arm to which the participant is assigned. Patient study records will indicate if they are in the study, but not the arm assignment. All participants will receive standard information about AI use and participate in four assessments.|
|Primary Purpose:||Supportive Care|
|Official Title:||Using Exercise to Relieve Arthralgia (Joint Pain) and Improve AI Adherence in Older Survivors (REJOIN): A Pilot Study|
|Actual Study Start Date :||June 15, 2021|
|Estimated Primary Completion Date :||June 2022|
|Estimated Study Completion Date :||December 2022|
No Intervention: Enhanced Standard Care
Participants will receive standard care, plus a brochure about hormonal therapy use.
Experimental: Treatment (Education plus Exercise)
Participants will receive the same materials as the standard care group, plus participate in group exercise and group discussion sessions.
Behavioral: Relieving Joint Pain and Improving AI Adherence in Older Breast Cancer Survivors (REJOIN)
Self-management program which includes supervised exercise sessions in groups and group discussions for 8 weeks conducted by Zoom video, followed by an 8-week home-based version of the same program participants do on their own with bi-weekly coaching calls.
Other Name: REJOIN
- Brief Pain Inventory (Modified for Joint Pain) [ Time Frame: Change in pain experience from baseline at 12 months ]The Brief Pain Inventory - Short Form (BPI-sf) is a 9 item self-administered questionnaire used to evaluate the severity of a patient's pain and the impact of this pain on the patient's daily functioning. The patient is asked to rate their worst, least, average, and current pain intensity, list current treatments and their perceived effectiveness, and rate the degree that pain interferes with general activity, mood, walking ability, normal work, relations with other persons, sleep, and enjoyment of life on a 10 point scale. The BPI-sf is a modification of the Brief Pain Inventory - Long Form, which includes additional questions on demographics (date of birth, marital status, education, employment), pain history, aggravating and easing factors, treatment and medication, pain quality, and response to treatment.
- Toronto Informational Needs Questionnaire (TINQ) -- Breast Cancer [ Time Frame: Baseline to 12 months ]Self-report questionnaire about knowledge of breast cancer, its treatment and its side effects. Responses to questions about informational needs are reported using a Likert Scale -- 1 is "not important" to 5 "extremely important." Higher score indicate greater informational needs. Individual subscales may be calculated using percentages.
- The Exercise Self-efficacy Scale [ Time Frame: Baseline to 12 months ]The Exercise Self-Efficacy Scale assesses an individual's beliefs in their ability to continue exercising on a three time per week basis at moderate intensities for 40+ minutes per session in the future. For each of 8 items, participants indicate their confidence to execute the behavior on a 100-point percentage scale comprised of 10-point increments, ranging from 0% (not at all confident) to 100% (highly confident). Total strength for each measure of self-efficacy is then calculated by summing the confidence ratings and dividing by the total number of items in the scale, resulting in a maximum possible efficacy score of 100.
- AI Medication Adherence [ Time Frame: Percent taken based on what was prescribed over the last 30 days ]Medication Possession Ratio (MPR). Percent of days medication taken as prescribed, as self-reported by patient and verified with prescription refill records.
- Modified Cancer and Aging Research Group (CARG) plus National Health and Nutrition Examination Survey (NHANES) and Patient-Reported Outcomes Measurement Information System (PROMIS) Geriatric Assessment Study Patient Questionnaire [ Time Frame: Baseline to 12 months ]Aggregated assessment of self-reported information about demographic data, daily activities, nutritional status, medication use and health behaviors.
- Community Healthy Activities Model Program for Seniors (CHAMPS) Questionnaire for Older Adults [ Time Frame: Baseline to 12 months ]This self-report questionnaire assesses weekly frequency and duration of a variety of lifestyle physical activities that are meaningful and appropriate for older adults. It includes activities of various intensities (from light to vigorous) such as walking, running, hiking, swimming, bicycling, dancing, tennis, aerobics, yoga/tai chi, gardening, and housework. Intensity is reflected in the item stem (e.g., light and heavy gardening are separate items).
- Blood draw for inflammatory biomarkers [ Time Frame: Baseline to 12 months ]Fasting blood sample (2 tsp) to assess inflammatory biomarkers (IL-6, TNFα, C-reactive protein [CRP])
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03955627
|Contact: Robinn Moyer, BS||717-531-0003 ext email@example.com|
|Contact: Eileen Flores, MPHfirstname.lastname@example.org|
|United States, Pennsylvania|
|Penn State Cancer Institute||Recruiting|
|Hershey, Pennsylvania, United States, 17033|
|Contact: Robinn Moyer, BS 717-531-0003 email@example.com|
|Principal Investigator: Shirley M Bluethmann, PhD, MPH|
|Principal Investigator:||Shirley M. Bluethmann, PhD, MPH||Milton S. Hershey Medical Center|