Introduction Colorectal cancer (CRC) accounts for 1.23 million new colorectal cancer cases in 2008 worldwide. 57% of adults diagnosed with CRC in 2010–2011 in England and Wales are predicted to survive ten or more years. Addressing the post-treatment needs of this group is therefore a public health priority. This is the first study to examine the use of cardiac rehabilitation to aid the recovery of CRC patients.1The study is funded by NIHR – HS-DR.
Design pilot RCT with nested qualitative study. Participants: 3 UK hospitals; 41 patients. Sample size: A pilot so we did not have a formal sample size calculation.Intervention and control: Referral of patients with CRC after surgery to cardiac rehabilitation comprising weekly exercise classes for approximately 10 weeks (intervention); usual care (control). Randomisation:Patients stratified by site and randomly allocated to intervention/control groups. Measures: Physical activity (accelerometer and self-report); quality of life (EQ-5D and FACT-C); fatigue (FACIT-Fatigue), anxiety and depression (HADS), self-efficacy and risk perception.Data collection points: Baseline assessment pre-intervention; follow-up assessments 1 and 3 months post-intervention. Qualitative study: interviews with patients with CRC (n = 26), cancer and cardiac clinicians (n = 8) and focus groups with cardiac patients (n = 3). Analysis: Descriptive statistics of recruitment and attrition rates, missing data; Inferential statistics for outcomes; thematic analysis of qualitative data.
Results 62% of the recruitment target was reached. Sample attrition varied by site; 35%, 22% and 50% of patients who agreed to participate dropped out before consenting to be randomised at Sites 1, 2 and 3, respectively. Barriers to participation were poor recovery from surgery, adjuvant therapy and transport/travel difficulties. Patients and clinicians viewed this model of rehabilitation positively and found main trial components acceptable. In this presentation we will report analysis of baseline and follow up assessments (physical activity level, quality of life, fatigue, anxiety and depression) for intervention and control groups. We will also discuss plans for a future large-scale effectiveness trial of the intervention.
Conclusion Referral of patients with CRC to cardiac rehabilitation and conducting a RCT of the intervention is feasible and acceptable and a full effectiveness trial should be conducted.
Disclosure of interest None Declared.
Munro J et al. CRIB—the use of cardiac rehabilitation services to aid the recovery of patients with bowel cancer: a pilot randomised controlled trial (RCT) with embedded feasibility study. BMJ Open 2014;4:e004684. doi:10.1136/bmjopen-2013-004684