Remote activity monitoring to detect physical function decline and unexpected medical events in patients with prostate cancer undergoing androgen deprivation therapy.

Abstract

5084 Background: Among patients with prostate cancer (PC), treatment with androgen deprivation therapy (ADT) is associated with reduced physical function, which can result in diminished quality of life and the occurrence of adverse medical events. The use of wearable activity monitors allows for remote monitoring of daily activity to potentially detect early functional decline and predict significant medical events such as hospitalization, serious adverse events, and premature death. This study evaluated whether wearable activity monitoring could serve as an early indicator of functional decline and impending adverse events in patients with PC undergoing ADT. Methods: PC patients receiving ADT at Cedars-Sinai and Durham VA who enrolled in the DigiPRO trial (NCT04575402) wore a Fitbit Charge over 12 weeks to track quantitative physical activity and sleep data for prediction of the occurrence of unexpected medical events (composite of hospitalization, premature death, or fall) and significant patient-reported physical function decline (> 5 NIH PROMIS T score points) within 6-months follow-up. Results: 40 patients were included in the analysis (median age 70, range 51-87, 37% Black and 63% White; 10% identified as Hispanic). On average, PC patients walked 5,189 steps/day, were sedentary 16 hours/day, and slept 5.8 hours/night. A clinically meaningful decline in daily steps (> 500 steps) within the first 3 months of initiating ADT was associated with higher odds of experiencing an unexpected medical event (hospitalization, death, fall) (OR = 3.03; 95% CI 1.6-5.9, p = 0.001 ) and clinically meaningful decline in patient-reported physical function (> 5 PROMIS T score points) occurring within 6 months from study completion (OR = 5.2, 95% CI; 1.3-11.7, p = 0.02 ). Conclusions: These findings suggest remote activity monitoring may serve as a novel early warning system to identify patients who are at increased risk of unexpected medical events and clinically meaningful physical function decline in PC patients undergoing ADT. Use of this early warning system could lead to targeted interventions in high-risk patients to reduce morbidity and perhaps even prolong survival in patients undergoing ADT. Clinical trial information: NCT04575402 .