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Abstract
Introduction/Background The aim of the All Wales Ovarian Cancer Prehabilitation Project (AWOCPP) was to develop and deliver a standardised, personalised, multimodal framework of prehabilitation to all patients being offered surgery for advanced ovarian cancer in Wales.
The benefits of prehabilitation prior to surgery are well documented. Collaborative guidance from Macmillan, the Royal College of Anaesthetists and the NIHR states that ‘prehabilitation should be integral in the management and support of patients diagnosed with cancer’.
Methodology The objectives were to, develop an evidence based framework of prehabilitation to standardise delivery and provide equality of care to all patients across Wales and to assess the impact the program had on patient outcomes, specifically; length of stay in hospital, post operative complications and surgery to chemotherapy interval (SCI).
All patients with stage 3 or 4 ovarian cancer were identified at MDT who were to be scheduled for primary cyto-reductive surgery or interval cyto-reductive surgery and were invited to take part in AWOCPP.
Prehabilitation Patient Pathway
The programme consisted of a baseline appointment prior to commencement of treatment, to assess patients requirements and refer to appropriate AHPs. There were additional follow up appointments, at pre-operative time point and at the end of treatment. Please see attached image for prehabilitation pathway.
Results On average the length of hospital stay following surgery in Wales reduced from 7.8 days (National Ovarian Cancer Audit 2019) to 5.6 days. 2 out of 3 cancer sites in Wales saw a reduction in surgery to chemotherapy interval time. There was no change in complications rates. Patient feedback forms demonstrated patients found AWOCPP acceptable and a manageable part of their treatment plan.
Conclusion We have demonstrated a significant reduction in hospital stay for patients who participated in AWOCPP when compared to historical data, that the programme is feasable and will mean significant cost saving and improved patient experience.
Disclosures None