What do patients undergoing androgen deprivation therapy think about exercise interventions and the use of wearable activity monitors?

Abstract

e17091 Background: Exercise is critical for the prevention of functional decline and maintaining overall health, especially among patients with prostate cancer (PC) undergoing androgen deprivation therapy (ADT). Despite the well-established benefits of exercise intervention, the most acceptable exercise programs for PC patients receiving ADT remain unclear. Thus, this qualitative study sought to understand patient perspectives regarding exercise preferences and barriers to inform tailoring of exercise interventions for this population. Methods: Patients undergoing ADT were recruited from two sites: a large academic medical center and a Veterans Affairs (VA) medical center and were enrolled in the DigiPRO trial (NCT04575402) which integrates 12 weeks of wearable activity monitors with patient-reported outcomes to model functional decline. As an optional sub-study, virtual semi-structured qualitative interviews were conducted with enrolled patients, exploring patient preferences for exercise interventions, perceptions of functional changes, and views on wearables using a semi-structured interview guide. Interview transcripts were analyzed using content analysis. Results: Among the 30 interviewed participants in the sub-study (Median age: 68 years, SD; 8.8), resistance and aerobic training guided by an instructor were favored, with preferences for small groups, one-on-one, or solo workouts in gym or outdoor settings. As participants reported ADT-related fatigue, muscle loss, and fluctuating energy levels, they emphasized the need for flexible pacing and recovery days, expressing the need for adaptable and personalized programming that accommodates treatment side effects. Patients reported that wearables enhanced their motivation to be active, noting that the self-monitoring encouraged exercise goal completion (such as meeting daily step count targets) and helped them counteract treatment-related lethargy. Reported additional benefits of the wearables included activity reminders, sleep and heart rate tracking, and guided breathing, which patients found useful for managing the side-effects of ADT. Conclusions: These findings support the integration of wearable activity monitors as a motivational tool to enhance adherence to future prescribed exercise regimens, improving physical function and survivorship among PC survivors on ADT. Given ADT-associated fluctuations in physical function, patient input also highlighted the benefits of instructor-guided exercise interventions, such as aerobic and resistance training, tailored to individual needs and energy levels. Clinical trial information: NCT04575402 .