Accepted for/Published in: JMIR Research Protocols
Date Submitted: Apr 27, 2025
Date Accepted: Aug 29, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Frailty Trajectories and Influencing Factors in Patients with Non-Hodgkin Lymphoma during Chemotherapy: A retrospective Longitudinal mixed-methods study protocol
ABSTRACT
Background:
Long-term disease status and susceptibility to disease recurrence lead to an increasing disease burden in patients with non-Hodgkin's lymphoma (NHL). Although adverse influence of frailty in physical symptoms has been repeatedly reported, little attention has been paid to NHL patients and with the very limited studies, mostly are cross-sectional in nature. Our protocol provide a detailed mothods to explore the trajectory type and risk factors for frailty in NHL patients, to provide a panorama about how frailty affects NHL patients over time.
Objective:
The research aims to explore the frailty trajectories and influencing factors. It could offer healthcare professionals dynamic insights into frailty progression and facilitate the early identification and intervention of high-risk populations through systematic screening of contributing factors, thereby preventing the onset of frailty.
Methods:
This longitudinal mixed-methods study will recruit 240 patients newly diagnosed with NHL from five large public hospitals in China. Quantitative data will be collected at three time points: before chemotherapy, during the third cycle of chemotherapy, and at the end of chemotherapy. We will use validated questionnaires (i.e Tilburg Frailty Indicator) to gather information on sociodemographic data, frailty, cognition, physical condition, health literacy, anxiety and nutrition. Qualitative data will be collected via semi-structured interviews and observations at the end of chemotherapy. The growth mixture model and logistic regression analysis will be used to analyse quantitative data, and the diachronic analysis method and the directed content analysis method will be used to analysis qualitative data. Both types of data will be analyzed in parallel and separately. Finally, we will integrate the data sets to identify areas of confirmation, complementation or discordance.
Results:
The research protocol and informed consent form were approved by the Medical Ethics Committee of the First Affiliated Hospital of Henan University of Science and Technology (2024-03-K171). Participant recruitment began in Sep 2024. The data collection and analysis processes are expected to be finalized by November 2025. Data management is still ongoing; therefore, data analysis has not yet been performed.
Conclusions:
As a pilot trial, the research could offer healthcare professionals dynamic insights into frailty progression and facilitate the early identification and intervention of high-risk populations through systematic screening of contributing factors, thereby preventing the onset of frailty. Clinical Trial: ChiCTR2500097921
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