Impact of an allied health prehabilitation service for haematologic patients receiving high-dose chemotherapy in a large cancer centre
- Author(s)
- Crowe, J; Francis, JJ; Edbrooke, L; Loeliger, J; Joyce, T; Prickett, C; Martin, A; Khot, A; Denehy, L; Centre for PrehabilitationPeri-operative Care (CPPOC);
- Details
- Publication Year 2022-02,Volume 30,Issue #2,Page 1841-1852
- Journal Title
- Supportive Care in Cancer
- Publication Type
- Research article
- Abstract
- PURPOSE: Evaluate the impact of a new multidisciplinary allied health prehabilitation service in haematologic cancer patients receiving high-dose chemotherapy with autologous stem cell transplant (AuSCT). METHODS: In a tertiary cancer centre, 12 months of prospectively collected data was retrospectively analysed. Patients were referred to an allied health service for individualised exercise prescription, nutrition intervention and, if indicated through screening, psychological intervention. Impact and operational success were investigated using the RE-AIM framework: patient uptake of the service and sample representativeness (reach); effectiveness in terms of changes in outcomes from initial to pre-transplant assessment; adoption of the service by key stakeholders; fidelity of the prescribed exercise program (implementation); and the extent to which the new service had become routine practice (maintenance). RESULTS: One hundred and eighty-three patients were referred to the AuSCT service over 12 months, of whom 133 (73%) were referred into the prehabilitation service, 128 (96%) were eligible and 116 (91%) participated. Patients were representative of Australian AuSCT patients. Eighty-nine patients reached pre-transplant assessment by data censoring; 6-min walk distance (n = 45/89, 51%) improved a mean (95% CI) of 39.9 m (18.8 to 61.0, p = < 0.005) from baseline. Fidelity of exercise prescription was moderate with 72% of eligible patients receiving the intended exercise interventions. The referral trend over time (maintenance) was high after the initiation period. CONCLUSION: The prehabilitation service was well adopted by clinicians. Clinically relevant improvements in outcomes were demonstrated. Recommendations, including development of well-integrated discipline-specific assessment intervention and measurement protocols, are highlighted for service improvement. Prehabilitation should be routinely considered to support patients undergoing AuSCT.
- Keywords
- Australia; Exercise; Humans; *Neoplasms; Preoperative Care; *Preoperative Exercise; Retrospective Studies; Allied health; Autologous stem cell transplant; High-dose chemotherapy; Implementation; Prehabilitation
- Department(s)
- Physiotherapy; Allied Health; Health Services Research; Nutrition and Speech Pathology; Psychosocial Oncology; Haematology
- PubMed ID
- 34609585
- Publisher's Version
- https://doi.org/10.1007/s00520-021-06607-w
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-10-18 05:06:14
Last Modified: 2024-10-18 05:07:17