PMID- 35840361
OWN - NLM
STAT- MEDLINE
DCOM- 20230103
LR  - 20230127
IS  - 1471-6771 (Electronic)
IS  - 0007-0912 (Print)
IS  - 0007-0912 (Linking)
VI  - 130
IP  - 1
DP  - 2023 Jan
TI  - Feasibility and outcomes of a real-world regional lung cancer prehabilitation 
      programme in the UK.
PG  - e47-e55
LID - S0007-0912(22)00295-1 [pii]
LID - 10.1016/j.bja.2022.05.034 [doi]
AB  - BACKGROUND: Prehabilitation, or multimodality patient optimisation before major 
      treatment, has demonstrated meaningful improvements in patients' outcomes. In the 
      setting of lung cancer surgery, postoperative complications and length of 
      hospital stay are reduced, but there is currently limited access to 
      prehabilitation. Prehab4Cancer (P4C) is an innovative regional programme serving 
      all areas of Greater Manchester (GM). METHODS: The lung cancer P4C service 
      commenced in 2019 as a collaboration between the GM Cancer alliance and 12 
      leisure and community organisations. Patients planning surgical resection could 
      be referred to receive exercise, nutrition, and well-being assessment and 
      interventions before surgery. We evaluated the programme's feasibility, uptake, 
      and outcomes during the 11 months before COVID-19 restrictions. RESULTS: In 
      total, 377 patients were referred to the lung cancer P4C service from all 11 
      hospitals in GM. Of the patients reached by telephone, 80.0% (n=280/348) attended 
      initial P4C assessment, which occurred a median of 8 days (inter-quartile range 
      [IQR]: 4-14) after referral. In addition, 74.3% (n=280/377) attended for baseline 
      assessment and 47.7% (n=180/377) completed prehabilitation, attending a median of 
      six sessions (IQR: 4-9). Statistically significant improvements in all objective 
      physiological and subjective functional assessments were observed preoperatively, 
      including a mean increase in the incremental shuttle walk test of 50 m (95% 
      confidence interval: 25-74; P<0.001). CONCLUSIONS: The P4C programme demonstrated 
      feasibility at scale, high uptake, and promising impact on the status of patients 
      with lung cancer before surgery. P4C is the first regional prehabilitation 
      service internationally, and this evaluation provides a framework for 
      implementing similar services in other regions.
CI  - Copyright (c) 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
FAU - Bradley, Patrick
AU  - Bradley P
AD  - Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University 
      NHS Foundation Trust, Manchester, UK; Division of Infection, Immunity and 
      Respiratory Medicine, University of Manchester, Manchester, UK. Electronic 
      address: patrickbradley@nhs.net.
FAU - Merchant, Zoe
AU  - Merchant Z
AD  - Greater Manchester Cancer Prehab4Cancer and Recovery Programme, Manchester, UK.
FAU - Rowlinson-Groves, Kirsty
AU  - Rowlinson-Groves K
AD  - Greater Manchester Cancer Prehab4Cancer and Recovery Programme, Manchester, UK.
FAU - Taylor, Marcus
AU  - Taylor M
AD  - Department of Thoracic Surgery, Manchester University NHS Foundation Trust, 
      Wythenshawe Hospital, Manchester, UK.
FAU - Moore, John
AU  - Moore J
AD  - Greater Manchester Cancer Prehab4Cancer and Recovery Programme, Manchester, UK; 
      Division for Anaesthesia, Peri-Operative Medicine and Critical Care Services, 
      Manchester Royal Infirmary, Manchester University NHS Foundation Trust, 
      Manchester, UK.
FAU - Evison, Matthew
AU  - Evison M
AD  - Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University 
      NHS Foundation Trust, Manchester, UK; Greater Manchester Cancer Prehab4Cancer and 
      Recovery Programme, Manchester, UK.
LA  - eng
PT  - Journal Article
DEP - 20220713
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
SB  - IM
MH  - Humans
MH  - Preoperative Exercise
MH  - Feasibility Studies
MH  - Preoperative Care
MH  - *COVID-19/complications
MH  - *Lung Neoplasms/surgery
MH  - Postoperative Complications/epidemiology/prevention & control/etiology
MH  - United Kingdom/epidemiology
PMC - PMC9875904
OTO - NOTNLM
OT  - exercise therapy
OT  - lung cancer
OT  - prehabilitation
OT  - quality of healthcare
OT  - thoracic surgery
EDAT- 2022/07/16 06:00
MHDA- 2023/01/04 06:00
PMCR- 2022/07/13
CRDT- 2022/07/15 22:03
PHST- 2021/12/20 00:00 [received]
PHST- 2022/05/03 00:00 [revised]
PHST- 2022/05/18 00:00 [accepted]
PHST- 2022/07/16 06:00 [pubmed]
PHST- 2023/01/04 06:00 [medline]
PHST- 2022/07/15 22:03 [entrez]
PHST- 2022/07/13 00:00 [pmc-release]
AID - S0007-0912(22)00295-1 [pii]
AID - 10.1016/j.bja.2022.05.034 [doi]
PST - ppublish
SO  - Br J Anaesth. 2023 Jan;130(1):e47-e55. doi: 10.1016/j.bja.2022.05.034. Epub 2022 
      Jul 13.