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EX-MED Cancer: A Best Practice Exercise Medicine Program for People with Cancer

Asia-Pacific journal of clinical oncology(2018)

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摘要
Aim: COSA considers the level of evidence sufficient to recognise exercise as an adjunct therapy but only one in 10 people with cancer adhere with exercise guidelines. This project aims to develop, implement and evaluate a sustainable and scalable model of care for population‐wide implementation of affordable, accessible and effective exercise medicine for people with cancer. Methods: EX‐MED Cancer is a patient centred model of care involving a coordinated pathway between the multidisciplinary cancer team, general practitioners and exercise physiologists. The model capitalises on existing health‐care and community‐based workforce, services and resources. EX‐MED Cancer provides people with any type of cancer access to personalised exercise medicine using evidence‐based practice delivered in the community by upskilled allied health professionals. Participants receive three individual sessions and 36 group‐based exercise sessions delivered over a 4‐month period. Behaviour change theories guiding the content and delivery of EX‐MED Cancer. Participants receive an individualised plan developed by their exercise physiologist including a detailed strategy for transition to self‐management. Results: Preliminary analyses were conducted to evaluate the level of engagement with EX‐MED Cancer. 680 patient enquiries have been received over the ∼9 months of operation, equating to ∼20 referrals weekly. Referrals came from patients (74%), nurses (8%), specialists (6%) and family/carers (4%). Patients were informed about EX‐MED Cancer primarily through their hospital (50%) or word‐of‐mouth/social media (20%). Patients were diagnosed with over 20 different types of cancer, primarily breast (48%), haematological (15%), prostate (9%) and lung (5%) cancers. The majority of patients are women (72%). The main motivators to contact EX‐MED Cancer were to improve well‐being (54%) and to comply with their doctors/nurses advice (27%). Initial contact/referral through the website (72%) was preferred over phone (23%) or email (5%). Conclusions: The engagement with EX‐MED Cancer demonstrates a significant demand for exercise to be integrated into cancer care.
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