A qualitative evaluation of a multi-modal cancer prehabilitation programme for colorectal, head and neck and lung cancers patients

BackgroundGrowing evidence indicates patients survivorship outcomes can be enhanced through active engagement in a multi-modal cancer prehabilitation programme (MCPP), although this intervention is not uniformly embedded as a standard of care. MCPP aims to optimise patients physiologically and psychologically for cancer treatments, shorten recovery time, reduce complications, promote healthier lifestyles and improve quality of life. South Eastern Health and Social Care Trust (SET) developed and evaluated a system-wide collaborative approach to MMCP across three tumour groups (colorectal, lung, head and neck cancer). Addressing the lack of qualitative evaluation of MCPPs, this paper explores mechanisms promoting feasibility and acceptability of MCPP from patients and interdisciplinary professionals perspectives. MethodsSemi-structured virtual one-to-one interviews were conducted with 24 interdisciplinary professionals and nine patients. Transcripts were recorded, transcribed verbatim and themes developed using Framework Analysis. ResultsAnalysis of findings identified four themes providing an in-depth understanding of key elements required to develop and deliver a MCPP: 1) Planning: Building the team, 2) Shared vision to develop and tailor the MCPP to meet patient needs, 3) Delivering the MCPP and 4) Moving forward - improving the MCPP. ConclusionThe system-wide collaborative approach to developing a MCPP at SET was deemed both feasible and acceptable. Success was attributed to visionary leadership, alongside a diverse group of interdisciplinary professionals being engaged, motivated and committed to improving patient outcomes. Iterative, responsive troubleshooting during delivery facilitated successful implementation. Greater adherence to provision of prescriptive high intensity exercise within the programme may further promote enhanced patient outcomes. O_TEXTBOXKey elements required to deliver a successful multimodal cancer prehabilitation programme O_LINecessity of visionary, strategic leadership C_LIO_LICommitted interdisciplinary stakeholders to include patient and public involvement C_LIO_LISkilled, trained multi-disciplinary multi-sectoral team to deliver programme C_LIO_LIScreening of patients to tailor referrals to multimodal elements C_LIO_LIEffective and efficient referral processes C_LIO_LIPatient-centred pathways, delivered across universal, targeted and specialist stepped-care model based on patients needs C_LIO_LIPromote tailored intense exercise prescriptions C_LIO_LIData collection parameters agreed and implemented to enable robust evaluation C_LIO_LIEffective and regular communication with professionals operationally delivering the programme C_LIO_LISustainable funding C_LI C_TEXTBOX