Prep-4-RT
The WCMICS Grants Program 2021–22 funded a project at the Peter MacCallum Cancer Centre, in collaboration with consumers and clinicians from Bendigo Health and Melbourne Health, to develop a stepped multimodal prehabilitation model of care for patients with head and neck cancer.
Radiotherapy (RT) is a primary treatment modality for patients with a diagnosis of head and neck cancer but can induce significant physical impacts and high rates of distress. Prehabilitation interventions have demonstrated improved clinical outcomes and are becoming common practice prior to surgery. This initiative sought to replicate this approach by developing a prehabilitation model of care for patients undergoing RT for head and neck cancer. The model involved 3 steps:
- Screening patients for risk of psychological distress, malnutrition, sarcopenia, dysphagia, and poor functional capacity
- Offering all patients self-management resources
- Offering specialist prehabilitation to patients identified as being at risk.
Co-design by patients, carers and clinicians is an effective means to create highly acceptable resources. 18 new resources developed including:
- webpages
- factsheets
- videos
- postcard with QR code directing to resources.
Impacts
61% of patients reported using the self-management resources and 100% of patients who used the resources reported high satisfaction.
Prep-4-RT addressed care and information gaps for HNC patients prior to radiotherapy, leading to early intervention. The Prep-4-RT model is a feasible and acceptable model of prehabilitation for HNC patients prior to radiotherapy across metropolitan and regional health services.
- 54% of screened patients were eligible for specialist prehabilitation. Nearly all patients adhered to specialist treatment recommendations and 100% were satisfied with the treatment they received.
- 90% of healthcare professionals found Prep-4RT acceptable
- 100% of clinicians believed Prep-4-RT improved how patients prepared for the impact of radiotherapy.
Next steps
This project has shown that the Prep-4-RT model of care is a feasible and acceptable model of prehabilitation for HNC patients prior to radiotherapy. Recommendations include:
- minor changes to the program and further testing of the model into clinical practice
- further evaluation of efficacy in terms of clinical and health service outcomes, and ability to improve equity and access for patients and carers in regional areas.