Experiences, adherence and satisfaction with a combined exercise and dietary intervention for patients with ovarian cancer undergoing chemotherapy: A mixed-methods study

• Published in: Gynecologic oncology 2022-06, Vol.165 (3), p.619-628
• Main Authors: Stelten, S., van Lonkhuijzen, L.R.C.W., Hartman, Y.A.W., van Driel, W.J., Winkels, R.M., Kenter, G.G., Buffart, L.M., Hoedjes, M.
• Format: Article
• Language: English
• Subjects: Adherence; Carcinoma, Ovarian Epithelial - drug therapy; Dietary intervention; Exercise intervention; Experiences; Female; Humans; Ovarian cancer; Ovarian Neoplasms - drug therapy; Patient Satisfaction; Personal Satisfaction; Quality of Life; Satisfaction
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2022.03.011

This study examined experiences, adherence and satisfaction with a combined exercise and dietary intervention in patients with ovarian cancer and their healthcare professionals (HCPs) as part of the randomized PADOVA trial. A mixed-methods approach was used in 24 patients with ovarian cancer receiving first-line chemotherapy who were randomly allocated to a combined exercise and dietary intervention or usual care with counseling sessions post-treatment. Qualitative data on intervention experiences, adherence and satisfaction was collected using semi-structured interviews with patients and their HCPs (n = 18 physical therapists; n = 5 dietitians). Quantitative data on adherence and satisfaction was collected to provide context to qualitative data. Exercise relative dose intensity ranged from 36 to 100% (median 72%) and patients attended 33–133% (median 100%) of the prescribed dietary counseling sessions. Patients appreciated guidance on exercise and nutrition and perceived benefits including improved physical fitness, quality of life, peer support and recovery after surgery and/or chemotherapy cycles. Both patients and HCPs were satisfied with the intervention and perceived that participation exceeded prior expectations. Median patient satisfaction score with the intervention was 8.5 out of 10. Suggestions for improving the intervention included further personalization of the number, content and scheduling of the sessions to preferences of patients and HCPs. Patients in the usual care group reported counseling sessions post-chemotherapy to be too little too late. Patients with ovarian cancer adhered well to the intervention. Numerous perceived benefits of the intervention were reported by patients and HCPs. Good adherence and positive experiences support successful implementation in clinical practice. •Patients with ovarian cancer adhered well to a combined exercise and dietary intervention during chemotherapy.•Participation in the intervention improved patients' fitness, quality of life and recovery after chemotherapy and surgery.•Patients were generally satisfied with the combined intervention.•Good intervention adherence, high satisfaction and perceived benefits support successful clinical implementation.