gms | German Medical Science

Background and state of research: There is strong evidence on multiple positive and clinically relevant effects of exercise programs in cancer patients. However, studies show that cancer patients do not sufficiently exercise without systemic support. Thus, there is an increasing demand for the integration of exercise counseling and service as supportive care measure during cancer treatment.

Research question and objectives, hypothesis: Therefore, the aim of the MOVE-ON(KO) project is to implement an interdisciplinary and multi-professional exercise oncology care pathway to identify, counsel, triage and refer cancer patients to adequate local quality-assured exercise programs. The pathway builds on advanced education curricular developed jointly with and for health care professionals (exercise oncology navigators, EON) and for exercise physiologists/sports physicians (cancer exercise specialist, CES). A telemedicine database and platform will act as a key element for communication and process flow of the pathway. In a first step, the pathway of exercise oncology care will be established at 7 Comprehensive Cancer Center (CCCs) in 3 model regions in Germany. Secondly, outreach to local Cancer Centers (CCs) and resident oncologists will follow.

Method: Using a mixed-method approach, the project will be continuously evaluated. Besides the effectiveness of the implemented program (summative evaluation), structures and processes will be focused, being prerequisites for sustainable implementation (process evaluation).

Results: We expect that educating central oncology health care professionals as EONs is a key element to implement exercise oncology as standard procedure in routine cancer care. Even the project involves a complex intervention, the support of EONs by a modern telemedicine database and platform as well as the coordinating support of CCC-based CESs will help to serve a broad variety of cancer patients. The feasibility of MOVE-ON(KO) is expected as high due to the cooperative planning with relevant stakeholders (professional societies, patient representatives, insurance companies and scientist) and the commitment of the CCCs involved.

Discussion: There are various challenges to implement the suggested pathway. The most critical could be to find suitable persons for the role of EON and CES. Even the project will pay for such a position; the existing staff at the treatment center have to find a person with available work capacity and interest in doing such work. Facing personal shortcomings in the health care system, this could be critical but also an advantage by offering a perspective for professional development.

Implication for care: If the exercise oncology care pathway can be implemented successfully, this will be a first key milestone (implementation model) in the complex journey to establish/incorporate exercise oncology care as standard in cancer treatment. From the patient and oncology perspective, a successful implementation might contribute substantially to reduce side effects, improve outcomes and therefore enhance patient health during and after cancer treatment.

Funding: Individual funding (BMG, DRV, BMBF, DFG, etc); DKH 70114693