A multi-centre investigation of delivering national guidelines on exercise training for men with advanced prostate cancer undergoing androgen deprivation therapy in the UK NHS

BOURKE, Liam, TURNER, Rebecca, GREASLEY, Rosa, SUTTON, Eileen, STEED, Liz, SMITH, Dianna, BROWN, Janet, KELLY, Ben, HULME, Claire, GREENFIELD, Diana, PERSAD, Raj, FARRIN, Amanda, HEWISON, Jenny and ROSARIO, Derek J. (2018). A multi-centre investigation of delivering national guidelines on exercise training for men with advanced prostate cancer undergoing androgen deprivation therapy in the UK NHS. PLOS ONE, 13 (7), e0197606.

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Official URL: http://journals.plos.org/plosone/article?id=10.137...
Link to published version:: https://doi.org/10.1371/journal.pone.0197606

Abstract

Background National guidelines (NICE-CG175) recommended 12 weeks of supervised exercise training for men treated with androgen deprivation therapy (ADT) for prostate cancer to counter debilitating adverse effects of castration. As with other chronic conditions where exercise is indicated, it is uncertain if these services are being delivered in the health services. The aim of this multi-centre investigation was to examine what exercise referral is currently available for men on ADT as provided by the NHS and if a supervised, individually-tailored exercise training package (as per the national NICE guidelines CG175) is embedded within prostate cancer care. Methods A multi-centre investigation of current National Health Service (NHS) care involving a web-based survey of NHS prostate cancer care, five focus groups involving 26 men on ADT and 37 semi-structured interviews with healthcare professionals (HCPs) involved in the management of prostate cancer. Descriptive statistics and thematic analysis evaluated quantitative and qualitative data, respectively. Qualitative methods followed COREQ standards. Results HCPs and men on ADT asserted that medical castration has a serious and debilitating impact on many features of men's quality of life. There is support for exercise training programmes as part of cancer care and patients would support their initiation soon after diagnosis. Involving the Multidisciplinary Team (MDT) is proposed as key to this. Critically, traditional values in oncology would need to be overcome for widespread acceptance. Specialist further training for HCPs around behaviour change support could encourage this. Given that these schemes are seen as a fundamental part of cancer care, it is felt the NHS should commission and support provision. 79 representatives of 154 NHS trusts (51%) provided survey data on current delivery: only 17% could provide supervised exercise as per CG175. Conclusions Evidence-based national exercise guidelines are not being delivered to men on ADT as intended. Traditional values in oncology and the need for NHS financial support are seen as major barriers to provision of current best practice guidelines. Despite this both HCPs and men on ADT are in favour of such programmes being a fundamental part of their cancer care.

Item Type: Article
Additional Information: ** From PLOS via Jisc Publications Router. ** History: received 11-07-2017; collection 2018; accepted 04-05-2018; epub 05-07-2018. ** Licence for this article: http://creativecommons.org/licenses/by/4.0/
Uncontrolled Keywords: Research Article, Medicine and health sciences, Biology and life sciences, Research and analysis methods
Research Institute, Centre or Group: Centre for Sport and Exercise Science
Departments: Health and Well-being > Department of Sport
Identification Number: https://doi.org/10.1371/journal.pone.0197606
Related URLs:
SWORD Depositor: Margaret Boot
Depositing User: Margaret Boot
Date Deposited: 10 Jul 2018 09:27
Last Modified: 16 Nov 2018 14:16
URI: http://shura.shu.ac.uk/id/eprint/21871

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