Background: COSA guidelines clearly state that care providers should discuss, recommend, and refer people with cancer to appropriate exercise services; however, this rarely happens in practice. Various reasons are given as to why referrals do not occur including: (1) lack of time to offer exercise advice; (2) lack of knowledge about appropriate exercise guidance; and (3) lack of a referral pathway. Solutions are needed to overcome these barriers. This pilot study aimed to test the feasibility of offering brief consultations by an exercise physiologist as part of standard care in a radiation therapy (RT) clinic within a private hospital system to improve the provision of exercise.
Methods: An accredited exercise physiologist (AEP) experienced in cancer care was hired at a private RT clinic in Perth, WA. A workflow was established that ensured all new out-patients were scheduled for a brief (~15 minute) consultation with the AEP and offered a chance for a follow-up appointment to create a personalised exercise program. We tracked the reach of the service (ie % of people who received exercise consultations compared to those eligible), the number of follow-up appointments, and reasons for declining follow-up. Prior to the study, no exercise guidance was offered to patients.
Results: Between 1 April 2022 and 1 April 2024, 574 eligible patients came to the clinic. Attendance (reach) at the initial appoint with AEP was 75% (n=410). Of those, 85% (n=343) attended a follow-up consultation. Primary reasons for declining the initial exercise appointment included decision not to commence RT treatment at the clinic or feeling exercise guidance was not necessary because confident with current exercise program.
Conclusions: Embedding a brief AEP consultation as part of routine cancer care is a promising solution to align with COSA exercise guidelines. Future work should investigate the cost and effectiveness of this care model.