Rehabilitation and Exercise Oncology Program: Translating Research into a Model of Care

Dalzell, Mary-Ann; Smirnow, Nadia; Sateren, Warren B.; Sintharaphone, A.; Ibrahim, Marize; Mastroianni, L.; Zambrano, Lascano; O’Brien, Suzanne

doi:10.3747/co.24.3498

Cited by 53 publications

(127 citation statements)

References 38 publications

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“…Periodic, structured evaluation of processes and outcomes (uptake, adherence, waiting lists) of HCP‐supervised exercise programs would be undertaken to ensure continuous improvement of services. Finally, explicit attention would be paid to the timely, appropriate, and successful transition from HCP‐supervised exercise programs to community‐based or home‐based services . Transitions between HCP‐supervised exercise programs and community programs are notoriously challenging.…”

Section: Care Coordination: Transitioning Into and Between Hcp‐supervmentioning

confidence: 99%

“…This underscores the need for the development of validated, evidence‐based, clear, safe, and acceptable 2‐way triage guidelines that clarify who is not able to go directly to a community program run by trained fitness instructors, as well as symptoms that community‐based fitness instructors should monitor for referral back to health care professionals. There is programming in Canada and the Netherlands that has achieved many of these aspirational goals . To expand the availability of such high‐quality, multidisciplinary, integrated exercise oncology care will require addressing reimbursement and workforce development issues, as reviewed below.…”

Section: Care Coordination: Transitioning Into and Between Hcp‐supervmentioning

confidence: 99%

“…An example of best practice in HCP‐supervised exercise programs includes the ActivOnco program in Quebec, Canada. Common to these programs are a well‐defined, multidisciplinary cancer care team; a person who guides the cancer survivor through the evaluation and treatment process; defined screening and evaluation processes that triage patients according to their medical status, rehabilitation needs, and exercise eligibility; and well‐defined referral pathways to guide patient care and communications between all parties involved.…”

Section: Types Of Programmingmentioning

confidence: 99%

“…Finally, explicit attention would be paid to the timely, appropriate, and successful transition from HCP-supervised exercise programs to communitybased or home-based services. [51][52][53] Transitions between HCP-supervised exercise programs and community programs are notoriously challenging. This underscores the need for the development of validated, evidence-based, clear, safe, and acceptable 2-way triage guidelines that clarify who is not able to go directly to a community program run by trained fitness instructors, as well as symptoms that community-based fitness instructors should monitor for referral back to health care professionals.…”

Section: Care Coordination: Transitioning Into and Between Hcp-supervmentioning

confidence: 99%

“…There is programming in Canada and the Netherlands that has achieved many of these aspirational goals. 51,52 To expand the availability of such high-quality, multidisciplinary, integrated exercise oncology care will require addressing reimbursement and workforce development issues, as reviewed below. In particular, it is currently unclear who should be in charge of the referral and triage process; who should begin the process; or who should be reimbursed or rewarded for actions related to assessment, advice, and referral to exercise and rehabilitative programming.…”

Section: Care Coordination: Transitioning Into and Between Hcp-supervmentioning

confidence: 99%

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Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Schmitz

Campbell

Stuiver

et al. 2019

CA A Cancer J Clinicians

503

465

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Multiple organizations around the world have issued evidence‐based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health‐related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home‐based or community‐based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.

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Section: Care Coordination: Transitioning Into and Between Hcp‐supervmentioning

confidence: 99%

Section: Care Coordination: Transitioning Into and Between Hcp‐supervmentioning

confidence: 99%

Section: Types Of Programmingmentioning

confidence: 99%

Section: Care Coordination: Transitioning Into and Between Hcp-supervmentioning

confidence: 99%

Section: Care Coordination: Transitioning Into and Between Hcp-supervmentioning

confidence: 99%

See 3 more Smart Citations

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Schmitz

Campbell

Stuiver

et al. 2019

CA A Cancer J Clinicians

503

465

View full text Add to dashboard Cite

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An exercise oncology clinical pathway: Screening and referral for personalized interventions

Stout

Brown

Schwartz

et al. 2020

Cancer

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INTRODUCTIONThere are approximately 17 million cancer survivors living in the United States, and by 2040, this estimate is predicted to increase to 26.1 million. 1 Exercise provides a myriad of health benefits to individuals during and after cancer treatment by reducing treatment-related symptoms, improving functional status and quality of life, and lowering the risk of disease recurrence. 2,3 Despite the established benefits, an individual's level of physical activity often decreases during treatment and does not return to prediagnosis levels after treatment completion. 4,5 Although exercise is regarded as safe and beneficial for individuals with cancer, promoting exercise for this population is complex. A patient-centered pathway is needed that can guide oncology and primary care professionals in the efficient assessment of an individual's condition and enable personalized referrals for exercise interventions that promote physical activity. The purpose of this article is to provide a framework for clinical decision making that enables personalized condition assessment, risk stratification, and referral to optimal settings for exercise promotion for cancer survivors. Implementation strategies are also offered to support the integration of this model into an oncology clinical workflow.With guidance from their medical provider, individuals are more likely to engage in exercise and maintain levels of physical activity during cancer treatments. 6 However, the number of individuals with cancer who report receiving exercise-specific guidance from their health care providers is low. 7 Of particular concern is the lack of knowledge and training among health care professionals about exercise prescription for this complex population. 8

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Factors influencing engagement in hospital‐based exercise oncology programs: A narrative review

Dunston

Mulibea

Chipman

et al. 2022

PM&R

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Among cancer survivors, there are numerous health benefits of exercise engagement; however, less than 15% of survivors meet current aerobic and strength physical activity guidelines. Exercise programs provided by a cancer hospital are commonly noted as a facilitator and preference to exercise engagement. The study aimed to review the evidence and describe the barriers, facilitators, preferences, and factors associated with cancer survivors' engagement in hospital-based exercise oncology programs. Electronic databases (PubMed and Scopus) were searched to identify relevant papers published before July 1, 2021. Original research papers reporting on barriers, facilitators, preferences, or factors associated with participation in hospitalbased exercise oncology programs were included. A total of 300 potentially relevant articles were identified, of which 10 met eligibility criteria. Barriers to participation in hospital-based exercise oncology programs included program accessibility, treatment-related side effects, and uncertainty about exercise. Program individualization, peer support, and staff support were reported as facilitators. Survivors also expressed that they preferred flexibility in the time, location, and mode of exercise programming. Baseline quality of life, fitness, and marital status were all identified as potential factors associated with engagement in hospital-based exercise oncology programs. These findings are useful for the development and implementation of hospital-based exercise oncology programs to optimize exercise program engagement.

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Rehabilitation and Exercise Oncology Program: Translating Research into a Model of Care

Abstract: IntroductionThe Rehabilitation and Exercise Oncology model of care (ActivOnco) was established to optimize

Cited by 53 publications

References 38 publications

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

An exercise oncology clinical pathway: Screening and referral for personalized interventions

Factors influencing engagement in hospital‐based exercise oncology programs: A narrative review

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