Physical Activity & Cancer. Macmillan Activity Promotion Programme (MAPP) South East Wales

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1 Physical Activity & Cancer Macmillan Activity Promotion Programme (MAPP) South East Wales Helen Tyler Macmillan Therapies Manager Velindre Cancer Centre

2 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)

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4 Improves health and wellbeing outcomes Effect size 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 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.

5 2 million People Living with Cancer PA levels 1.6 Million not achieving recommend level of PA 0.4 million achieving recommended level of PA 1.1 million are 65years and over

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7 Meeting Patients Needs Specific needs Additional support requirements Physiotherapy Outpatients MAPP NERS Self management 10 Top tips

8 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

9 MAPP setting up process Develop Promote Champion

10 Develop Referral pathways Stage of cancer care pathway Patient Measurement tool- EQ5D,FACIT, VAS,TUG Evaluate Identify Current PA schemes NERs /Walking groups Resources needed to run MAPP, staff, equipment Suitable facilities Establish Expand Referral pathways- Professional/self referral Gateway session Variety of PA sessions Modify/enhance dependent on patient feedback

11 Promoting Hospitalspromotional stand GP-leaflets Health and well being days for family/carer /HCP VCC patient portal Patient Family Carers MDT Health and social care staff ed Learn at lunch Intra net VCC Raise awareness NERS/activities local Seminars for GPs MAPP Written to GPs Meet them F/U regularly ed referrals Secondary care Community Collaborate CNS link in with Cancer support groups Attended support group meetings

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13 Championing Carrying pre and post MAPP assessments F/u in person/phone Sign posting Advice Education Support Behavioural change model Varied menu of PA Within sports, leisure providers, community room Facilitate sessions Welcoming, friendly Environment Facilitate peer support Physical activity Patient Centred Brief intervention HNA Motivational interviewing Right type of activity

14 MAPP 6 week course 2 hours Health & wellbeing talk + Physical activity session Beginning of the journey why now? Local opportunities & resources Confidence in moving forward with PA DIY- Home based PA Walking NERs Tai chi Relaxation Mindfulness Pacing, planning, energy diaries Healthy Eating Coping thoughts

15 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

16 Macmillan Activity Promotion Programme Exclusion criteria Many of these exclusions will only be temporary but all must be considered 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 lightheadedness 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.

17 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

18 Patient Feedback MAPP 1 Tremendous. I have been able to improve my fatigue level through planning and using some of the activities and ideas gained from the course 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 Helped me to think outside the box about physical activity and the restraints of my life made me more aware of the need for exercise reassurance to do activities I thought might be damaging or hurt Made me realize doing something a little is better than nothing at all. Something has clicked and I now feel more motivated

19 MAPP future developments Session locations Friday 11am -1pm Cwmbran Stadium Monday am Pont Newydd Medical Centre, Porth Tuesday pm Whitchurch Rugby Club

20 THANKS Diolch Any questions?