The acceptability and feasibility of a physical activity and metformin supplementation intervention in men with prostate cancer


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Megan Denne, Luke Robles, Lucy Hackshaw-McGeagh, Sally Adams, Richard Martin, Athene Lane

Abstract

Background

Whilst survival rates for localised prostate cancer are generally high, limiting the possibility of biochemical recurrence and treatment side effects is important for improving survivors’ outcomes and quality of life. Low-toxicity interventions may be beneficial adjuncts to a patients’ primary treatment. This ongoing qualitative study aims to understand the acceptability and feasibility of a brisk walking and metformin supplementation intervention in men diagnosed with localised prostate cancer.

Method

This qualitative study was nested within the Prostate cancer: Exercise and Metformin Trial (Pre-EMpT), a factorial feasibility randomised controlled trial in which participants were randomised to either one or a combination of the interventions following radical prostatectomy. Purposive sampling was used to recruited participants following their participation in the 6-month interventions. The sample represents all intervention groups. Semi-structured interviews were conducted, audio-recorded and transcribed for reflexive thematic analysis.

Results

In preliminary findings, three themes have been identified: (1) acceptability of interventions; (2) acceptability and impact of physical activity trackers, and (3) trial logistics. The brisk walking and metformin interventions were both largely accepted. Participants incorporated their brisk walking and metformin intake into their daily activities (i.e. setting specific times in the day to walk, taking metformin along with other medicines).  Acceptance of physical activity trackers was mixed. Some participants appreciated the quantification of their brisk walking whilst others regarded devices as an unnecessary adjunct to their exercise engagement. Longer-term adherence and barriers were discussed.  Interventions being routinely integrated and made time convenient were identified as important factors for maintenance. All participants gave positive feedback about the instructions they were given about the trial’s requirements and these were clear for all aspects of the trial (i.e. attending appointments, intervention instructions, and completing questionnaires).

Conclusion

The findings so far indicate acceptance of brisk walking and metformin interventions in men newly diagnosed with localised prostate cancer. However, longer-term upkeep of the interventions might be dependent on certain participant characteristics. Further qualitative data will inform on the feasibility of physical activity trackers and intervention acceptance for participants who have undergone other treatment types.

Impact statement

The findings could help inform metformin and physical activity interventions in larger randomised controlled trials.