Scottish Government in conjunction with Macmillan Cancer Support have recently convened a short life working group (SLWG) on Prehab(ilitation) in Scotland. Rehabilitation programmes have been well established for many conditions but there is now growing evidence that providing support to people with cancer as soon after diagnosis as possible and prior to treatment can be beneficial for short and long term health outcomes. Current evidence suggests that three key factors should be considered within the design of prehabilitation programmes: physical activity/exercise, nutrition (individualised requirements in relation to under nutrition, otherwise keeping to a healthy balanced diet) and psychological support. However, we know little about prehab practices in Scotland. To remedy this the SLWG undertook a nationwide survey to identify the availability of relevant services.
A total of 295 responses were obtained from people working in a variety of professional backgrounds and care settings including primary and secondary care, local authority and third sector. The responses indicated that less than one-third of respondents (28%, n=81) could identify prehabilitation activities within their local area. None of the identified services offered a multi-modal, multi-phasic, multi-professional intervention with clear access routes and embedded outcome measures. However, many respondents indicated further interest in developing this area with requests for support, guidance on approach and mentions of sharing practice. Perceived challenges in delivery, funding and resources, pathway redesign and timing, evidence and willingness of patients to participate were highlighted. On the other hand, it was reported that clinical and managerial support could clearly facilitate action.
This work forms the basis of future action in this area – watch this space.
More details on this work are available here:-