The 'Cancer Home-Life Intervention': A randomised controlled trial evaluating the efficacy of an occupational therapy-based intervention in people with advanced cancer

Marc Sampedro Pilegaard, Karen la Cour, Lisa Gregersen Oestergaard, Anna Thit Johnsen, Line Lindahl-Jacobsen, Inger Højris, Åse Brandt, Marc Sampedro Pilegaard, Karen la Cour, Lisa Gregersen Oestergaard, Anna Thit Johnsen, Line Lindahl-Jacobsen, Inger Højris, Åse Brandt

Abstract

Background: People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the 'Cancer Home-Life Intervention'.

Aim: To evaluate the efficacy of the 'Cancer Home Life-Intervention' compared with usual care with regard to patients' performance of, and participation in, everyday activities, and their health-related quality of life.

Design and intervention: A randomised controlled trial ( ClinicalTrials.gov NCT02356627). The 'Cancer Home-Life Intervention' is a brief, tailored, occupational therapy-based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities.

Setting/participants: Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were assessed at baseline, and at 6 and 12 weeks of follow-up. The primary outcome was activities of daily living motor ability. Secondary outcomes were activities of daily living process ability, difficulty performing prioritised everyday activities, participation restrictions and health-related quality of life.

Results: A total of 242 participants were randomised either to the intervention group ( n = 121) or the control group ( n = 121). No effect was found on the primary outcome (between-group mean change: -0.04 logits (95% confidence interval: -0.23 to 0.15); p = 0.69). Nor was any effect on the secondary outcomes observed.

Conclusion: In most cases, the 'Cancer Home-Life Intervention' was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants' everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing.

Keywords: Activities of daily living; controlled clinical trial; independent living; neoplasms; occupational therapy; palliative care; quality of life.

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart
Figure 2.
Figure 2.
Change over time and between-group differences. ADL=Activities of Daily Living; AMPS=Assessment of Motor and Process Skills; IPPA=Individually Prioritised Problem Assessment; HRQoL=Health-related Quality of Life; QLQ-C30=European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C-30.

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