Psycho-Educational and Rehabilitative Intervention to Manage Cancer Cachexia (PRICC) for Advanced Patients and Their Caregivers: Lessons Learned from a Single-Arm Feasibility Trial

Cancers (Basel). 2023 Mar 30;15(7):2063. doi: 10.3390/cancers15072063.

Abstract

Background: Key elements in cancer cachexia (CC) management are personalized and multimodal interventions, but it is hard for some patients to follow programs based on several components. We examined the feasibility of a bimodal intervention, including a psycho-educational component and exercises, to support patients and their caregivers in managing CC; Methods: Prospective mixed-methods pilot study explored feasibility data, changes in patient-reported outcomes, and performance outcomes over time in a convenient sample of 30 consecutive CC patients and their caregivers.

Results: Twenty-four dyads consented to participate. Twenty dyads received at least two psycho-educational sessions, so the psycho-educational component was feasible for 83.3% of the sample. Six dyads participated in at least fourteen out of twenty-seven rehabilitation sessions, so the exercise program was feasible for 25.0% of the sample. Six dyads showed compliance greater than 50% for both components of the bimodal intervention.

Conclusions: While we did not meet our primary feasibility endpoint and had mixed acceptability, our experience provides insight into the challenges and lessons learned in implementing a primary palliative care intervention for CC. More robust studies are needed to help clinicians understand the best exercise program for CC patients, to be included in a multimodal intervention.

Keywords: cancer cachexia; cancer rehabilitation; exercise; non-pharmacologic treatment; palliative medicine; psycho-educational treatment; psycho-social treatment.

Grants and funding

This work was supported by Azienda USL-IRCCS of Reggio Emilia, within the Call for Oncological Research Value 2018 (5 per Mille 2016 Funds)-Bando per la Valorizzazione della Ricerca Istituzionale in ambito oncologico 2018 (Fondi 5 per Mille 2016), it was selected throughout a competitive evaluation process which involved external referees. This study was partially supported by Italian Ministry of Health–Ricerca Corrente Annual Program 2024.