Subgroup effects of occupational therapy-based intervention for people with advanced cancer

Abstract

Background: Many people with advanced cancer have decreased ability to perform activities of daily living (ADL). We recently performed a randomized, controlled trial (RCT) assessing the efficacy of an occupational therapy-based program, the ’Cancer Home-Life Intervention’ in people with advanced cancer (N = 242) and found no overall effects on ADL ability. However, heterogeneity of treatment effect may disguise subgroup differences.

Objective: To investigate whether subgroups of people with advanced cancer gain positive effects from the ‘Cancer Home-Life Intervention’ on ADL ability.

Material and method: An exploratory subgroup analysis including 191 participants from a RCT. The outcome was ADL motor ability measured by the Assessment of Motor and Process Skills (AMPS). Subgroups were defined by age, gender, years of education, type of primary tumor, functional level, and activity problems.

Results: The ‘Cancer Home-Life Intervention’ had no statistically significant effect in the six subgroups. Modifying effects of age (0.30 [95% CI: −0.05 to 0.64]) and gender (0.23 [95% CI: −0.11 to 0.57]) were not found.

Conclusion: There were no subgroup effects of the ‘Cancer Home-Life Intervention’on ADL motor ability. Some indications suggest greater effects for those aged below 69 years; however, this result should be interpreted with caution.

Keywords:

• Activities of daily living
• neoplasms
• occupational therapy
• randomized controlled trial
• moderator variables

Acknowledgements

We wish to thank all the participants who took part in the study, the OTs, and statistician Professor Jakob Hjelmborg, University Southern Denmark, for statistical consultancy on the analyzes.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The trial was supported financially by TrygFonden, the Danish Cancer Society (R53-A2783), the University of Southern Denmark, the Danish Association of Occupational Therapists (FF 2 14 – 3), and the Region of Southern Denmark (15/23775).