Physical Activity & Cancer Macmillan Activity Promotion … · 2015. 7. 23. · Made me realize...
Transcript of Physical Activity & Cancer Macmillan Activity Promotion … · 2015. 7. 23. · Made me realize...
Physical Activity & Cancer
Macmillan Activity Promotion Programme (MAPP)
South East Wales
Helen Tyler
Macmillan Therapies Manager Velindre Cancer Centre
Acknowledgements
• Siobhan Harkin
– Macmillan Physical Activity Lead (0.5 wte)
• Claire Jones
– Macmillan Physical Activity Physiotherapist (0.6 wte)
• Margretta Davies
– Macmillan Physical Activity Physiotherapist (O.4 wte)
• Patrick Palmer
– Macmillan Physical Activity Support Worker (1 wte)
Improves health and wellbeing outcomes Effect size
Helping people take control
‘Keeping active has helped me, and my family, through a really difficult time. It’s helped me return to a more normal way of life and has
given me a real sense of achievement’.
Reduction in the relevant risk of recurrence of breast cancer: •Adjuvant physical activity 40- 50% •Adjuvant radiotherapy 59% •Adjuvant hormone treatment 29% (after 10 years of treatment)
Physical activity guidelines
2 million People Living with Cancer PA levels
1.6 Million not achieving
recommend level of PA
1.1 million are
65years and over
0.4 million achieving recommended level of PA
Meeting Patients Needs
Specific needs
Additional support
requirements
Self management 10 Top tips
NERS
MAPP
Physiotherapy Outpatients
MAPP Aims
Promote Physical Activity
Promote Healthy Living
Promote Self management of
Cancer related side effects
To promote peer support
To empower patients to use
NERS/independent
Activity
MAPP setting up process
Promote
Champion
Develop
Develop
• Variety of PA sessions
• Modify/enhance dependent on patient feedback
• Referral pathways-
• Professional/self referral
• Gateway session
• Current PA schemes
• NERs /Walking groups
• Resources needed to run MAPP, staff, equipment
• Suitable facilities
• Referral pathways
• Stage of cancer care pathway
• Patient Measurement tool- EQ5D,FACIT,
• VAS,TUG
Evaluate Identify
Expand Establish
Promoting
• Collaborate CNS link in with Cancer support groups
• Attended support group meetings
• Seminars for GPs MAPP
• Written to GPs
• Meet them
• F/U regularly
• Emailed referrals
• Health and social care staff emailed
• Learn at lunch
• Intra net VCC
• Raise awareness NERS/activities local
• Hospitals-promotional stand
• GP-leaflets
• Health and well being days for family/carer /HCP
• VCC patient portal
Patient
Family
Carers
MDT
Community Secondary
care
Championing
• Brief intervention
• HNA
• Motivational interviewing
• Right type of activity
• Facilitate sessions
• Welcoming, friendly
• Environment
• Facilitate peer support
• Varied menu of PA
• Within sports, leisure providers, community room
• Carrying pre and post MAPP assessments
• F/u in person/phone
• Sign posting Advice
Education
Support
Behavioural change model
Patient Centred
Physical activity
MAPP 6 week course 2 hours Health & wellbeing talk +
Physical activity session
DIY-
Home based PA
Walking
NERs
Tai chi
Relaxation
Mindfulness
Beginning of the journey” – why now?
Pacing, planning,
energy diaries
Healthy Eating
Coping thoughts
Confidence in moving
forward with PA
Local opportunities & resources
Macmillan Activity Promotion Programme Inclusion criteria
• All patients will be screened by a physiotherapist prior to commencement on the MAPP.
• All tumour sites
• All ages 18+
• All stages of the cancer care pathway
• Patient has identified a desire to improve their physical activity levels
Macmillan Activity Promotion Programme Exclusion criteria
• Patients who are already physically active (we will refer directly on to NERS)
• Acute infection • Febrile illness with
temperature >38 °c • Symptomatic severe aortic
stenosis • Acute myocarditis/pericarditis • Acute uncontrolled psychiatric
illness • Diarrhoea and vomiting • Acute chest pain • Dizziness and light-
headedness • Disorientation
• Blurred vision • Unstable angina • Unstable/ Acute heart failure • Unstable diabetes • New/ Uncontrolled arrhythmias • Hypertension with a resting SBP > 180mmHg or DBP > 100mmHg • Symptomatic hypotension • <24 hrs since last chemotherapy session • Low blood counts (neutropenia or thrombocytopenia) • Acute PE • Acute MI/ Cardiac event • On antibiotics for active cellulitis • Patients with known MSCC to be discussed with MAPP team on an individual basis.
Many of these exclusions will only be temporary but all must be considered
MAPP Aims/Evaluation
Promote Physical Activity
90% attendance
1 non starter due to illness
Promote Healthy Living
Patients completed ‘Move More’ packs reporting
additional activity
Promote Self management of Cancer related side
effects
Health and wellbeing talk
To promote peer support
See patient feedback
To empower patients to use NERS/independent
Activity
All patients referred to NERS
Patient Feedback – MAPP 1
It has motivated me to examine how active I am. To realize that just increasing normal daily activities count too.
Given me help to do more exercise and advice on other activities that could help me
made me more aware of the need for exercise
Made me realize doing something a little is better than nothing at all. Something has clicked and I now feel more motivated
reassurance to do activities I thought might be damaging or hurt
Helped me to think outside the box about physical activity and the restraints of my life
“Tremendous. I have been able to improve my fatigue level through planning and using some of the activities and ideas gained from the course
Session locations
MAPP future developments
Tuesday 2 – 3.30pm Whitchurch Rugby Club
Friday 11am -1pm Cwmbran Stadium
Monday am Pont Newydd Medical Centre, Porth
THANKS Diolch
Any questions?