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The Feasibility of Prehabilitation as Part of the Breast Cancer Treatment Pathway
Author(s) -
Wu Fiona,
LazaCagigas Roberto,
Pagarkar Aalia,
Olaoke Adeola,
El Gammal Mohsen,
Rampal Tarannum
Publication year - 2021
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1002/pmrj.12543
Subject(s) - prehabilitation , medicine , psychosocial , physical therapy , breast cancer , perioperative , rehabilitation , psychological intervention , patient satisfaction , anxiety , cancer , surgery , nursing , psychiatry
Background There is compelling support for implementing prehabilitation to optimize perioperative risk factors and to improve postoperative outcomes. However, there is limited evidence studying the application of multimodal prehabilitation for patients with breast cancer. Objective To determine the feasibility of multimodal prehabilitation as part of the breast cancer treatment pathway. Design This was a prospective, cohort observational study. Breast cancer patients undergoing surgery were recruited. They were assigned to an intervention or control group according to patient preference. Setting UK prehabilitation center. Participants A total of 75 patients were referred during the study period. Forty eight patients (64%) did not participate; 20 of those opted to be in the control group. Twenty four patients engaged with prehabilitation and returned completed questionnaires. In total, 44 patients were included in the analysis. Interventions The program consisted of supervised exercise, nutritional advice, smoking cessation, and psychosocial support. Outcome Measures Feasibility was determined by the center's ability to deliver the program. This was measured by the number of patients who wanted to access the service, compared with those able to. Service uptake, patient satisfaction, and project costs were recorded. Patient‐reported outcomes (PROs) and the use of healthcare resources were also evaluated. Results A total of 61 patients (81%) wanted to participate; 24 (32%) were able to partake and return questionnaires. Reasons for nonparticipation included surgery within weeks, full‐time commitments, and transportation difficulties. A total of 25 (93%) prehabilitation patients recorded high satisfaction with the program. There was a significant reduction in anxiety among prehabilitation patients. There were no significant improvements in the other PROs. There were no changes to hospital length of stay, readmissions, and complications. Conclusions Multimodal prehabilitation is a feasible intervention. Logistical challenges need to be addressed to improve engagement. These results are limited and would require a larger sample to confirm the findings. Work on a thorough cost‐benefit analysis is also required.