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Evaluation of pedometry as a patient-centered outcome in patients undergoing hematopoietic cell transplant (HCT): a comparison of pedometry and patient reports of symptoms, health, and quality of life

  • Special Section: PROs in Non-Standard Settings (by invitation only)
  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Aims

We evaluated pedometry as a novel patient-centered outcome because it enables passive continuous assessment of activity and may provide information about the consequences of symptomatic toxicity complementary to self-report.

Methods

Adult patients undergoing hematopoietic cell transplant (HCT) wore pedometers and completed PRO assessments during transplant hospitalization (4 weeks) and 4 weeks post-discharge. Patient reports of symptomatic treatment toxicities (single items from PRO-CTCAE, http://healthcaredelivery.cancer.gov/pro-ctcae) and symptoms, physical health, mental health, and quality of life (PROMIS® Global-10, http://nih.promis.org), assessed weekly with 7-day recall on Likert scales, were compared individually with pedometry data, summarized as average daily steps per week, using linear mixed models.

Results

Thirty-two patients [mean age 55 (SD = 14), 63 % male, 84 % white, 56 % autologous, 43 % allogeneic] completed a mean 4.6 (SD = 1.5, range 1–8) evaluable assessments. Regression model coefficients (β) indicated within-person decrements in average daily steps were associated with increases in pain (β = −852; 852 fewer steps per unit increase in pain score, p < 0.001), fatigue (β = −886, p < 0.001), vomiting (β = −518, p < 0.01), shaking/chills (β = −587, p < 0.01), diarrhea (β = −719, p < 0.001), shortness of breath (β = −1018, p < 0.05), reduction in carrying out social activities (β = 705, p < 0.01) or physical activities (β = 618, p < 0.01), and global physical health (β = 101, p < 0.001), but not global mental health or quality of life.

Conclusions

In this small sample of HCT recipients, more severe symptoms, impaired physical health, and restrictions in the performance of usual daily activities were associated with statistically significant decrements in objectively measured daily steps. Pedometry may be a valuable outcome measure and validation anchor in clinical research.

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Funding

This study was supported by the University of North Carolina Cancer Research Fund.

Author information

Authors and Affiliations

  1. Department of Health Policy and Management, University of North Carolina at Chapel Hill, Campus Box 7411, Chapel Hill, NC, 27599, USA

    Antonia V. Bennett & Bryce B. Reeve

  2. Department of Medicine, University of North Carolina at Chapel Hill, Campus Box 7305, Chapel Hill, NC, 27599, USA

    Ethan M. Basch, Mathew Meeneghan, Thomas C. Shea & William A. Wood

  3. Division of Cancer Control and Population Sciences, Outcomes Research Branch, National Cancer Institute, 9609 Medical Center Drive, East Tower, Room 3-448, Rockville, MD, 20850, USA

    Sandra A. Mitchell

  4. Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Campus Box 8700, Chapel Hill, NC, 27599, USA

    Claudio L. Battaglini & Abbie E. Smith-Ryan

  5. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Campus Box 7295, Chapel Hill, NC, 27599, USA

    Antonia V. Bennett, Bryce B. Reeve, Ethan M. Basch, Mathew Meeneghan, Claudio L. Battaglini, Brett Phillips, Thomas C. Shea & William A. Wood

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  1. Antonia V. Bennett
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Correspondence to Antonia V. Bennett.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the Ethical Standards of the Institutional and/or National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Bennett, A.V., Reeve, B.B., Basch, E.M. et al. Evaluation of pedometry as a patient-centered outcome in patients undergoing hematopoietic cell transplant (HCT): a comparison of pedometry and patient reports of symptoms, health, and quality of life. Qual Life Res 25, 535–546 (2016). https://doi.org/10.1007/s11136-015-1179-0

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