ACTIOHN Study
Research type
Research Study
Full title
Activity as medicine in oncology for head and neck
IRAS ID
310827
Contact name
Jo Patterson
Contact email
Sponsor organisation
University of Liverpool
ISRCTN Number
ISRCTN82505455
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Summary of Research
We aim to increase head and neck cancer (HaNC) patients’ engagement in physical exercise. There are many proven benefits of exercise following cancer treatment, aiding recovery, reducing risk of cancer returning, improving physical and psychological well-being and quality of life (QOL). However, the vast majority of HaNC patients have low levels of physical activity both pre- and post-treatment. There are multiple reasons for this; HaNC treatment is often aggressive with severe side-effects e.g. profoundly dry mouth, breathing through a hole in the neck, shoulder dysfunction, poor swallowing making it difficult to exercise; apprehension about participating in groups due to altered facial appearance; many are from low socio-economic areas, with high risk smoking and alcohol behaviours and other health problems; HaNC services are regional, requiring long journeys to access specialist support. Our survey of 400 HaNC patients found a desire to participate in an exercise programme, if tailored to individual needs and preferences. We will develop a collaborative, flexible, patient-centred personalised programme, with tools to support HaNC-specific barriers to exercise, and test whether this is feasible and
acceptable.
Design
We will recruit 70 HaNC patients, pre-treatment and up to 2 months post-treatment, across two large HaNC units in NW and NE England. In consultation with a HaNC Physiotherapist, patients will work with a local Cancer Exercise Specialist to devise a personalised exercise programme (including options for time, frequency, intensity,
type, location, remote delivery), using support tools to overcome HaNC-specific barriers, with weekly virtual support, delivered over 8-weeks. We will assess; rates of uptake, retention and exercise completion; patient reported symptoms and QOL; physical fitness. We will interview patients and healthcare professionals to understand how acceptable they found the programme and explore any issues with integrating it into HaNC care.
Our study will determine whether further research into personalised exercise programmes is feasible and worthwhile for HaNC patients.Summary of Results
Aim
To develop a flexible, personalised exercise programme for patients with head and neck cancer (HNC) and test whether this is possible and acceptable to patients and staff.
Background
There are many benefits of exercise following cancer treatment but the majority of HNC patients are physically inactive. The treatment is often aggressive with severe side-effects. Many have high-risk smoking and alcohol behaviours, and live in low socio-economic areas.
Methods
We planned to recruit 70 HNC patients. After assessment by a Physiotherapist, patients worked with a Cancer Exercise Specialist to plan their individual programme. This was delivered over 8-weeks, with weekly virtual support.
We assessed uptake, retention and exercise completion, symptoms, quality-of-life; physical fitness. We interviewed patients and staff.
Findings
Seventy-six patients agreed to participate, but 18 did not start the programme. The average age was 61yrs, the majority were male from a range of socio-economic backgrounds. Forty out of the 58 patients completed the programme; reasons for drop-out included poor physical or mental health and additional caring responsibilities.
We interviewed 18 patients and 12 staff. Most patients were active and understood the benefits. Inactive patients found it harder to know what to expect. Everyone valued the flexible, personalised nature of the programme. Staff held differing views about the value and appropriateness of exercise during HNC treatment.
Dissemination
We have presented at conferences, workshops and produced scientific articles. Findings will be distributed to charities and circulated via our website and social media.
Public and patient involvement
Our PPI group met regularly to develop the design, assessments, resources and delivery of the programme. They commented and shared our findings.
Conclusions and future plans
Patients and staff found the programme acceptable, suggesting minor changes. We will hold workshops to refine plans and test whether the programme is beneficial for patients.REC name
West of Scotland REC 1
REC reference
22/WS/0058
Date of REC Opinion
30 May 2022
REC opinion
Further Information Favourable Opinion