Physical activity levels and barriers to exercise referral among patients with cancer
1University of Cambridge School of Clinical Medicine, Cambridge, UK,2Macmillan Cancer Support, London, UK,3Coventry University, Coventry, UK,4Addenbrookes Cambridge University Hospitals NHS Trust, Cambridge, UK,5Bedford Hospital NHS Trust, Bedford, UK
Physical activity after cancer is linked to a lower rate of adverse effects and better survival.
The purpose of this study was to record the current physical activity levels of People Living With and Beyond Cancer (PLWBC) attending a typical UK community hospital, and assess their barriers to supervised exercise referral.
Of the entire cohort of patients attending our unit over a 2 month period, only 12 of 114 (11%) were classed as active according to the General Practice Physical Activity Questionnaire (GPPAQ). 68% were overweight or obese, but only 7% smoked. Despite receiving written and verbal explanations about the benefits of exercise, 47% of eligible patients declined formal exercise referral, with health safety concerns, time pressures, and the perception that they were already adequately exercising, being stated as the three most common reasons. Overall, 82% met one or more of the current indications for the National Exercise Referral Scheme, so even in regions where the inclusion criteria have not been broadened to include cancer, this is a practical option for most.
Unfortunately, it is clear from this data that we are failing to motivate patients into healthier lifestyles after cancer. Furthermore, physical activity levels have not improved since a similar previous evaluation1. This study suggests that further research should evaluate whether information materials should be changed to emphasise the safety of exercise, what level is appropriate, and how to incorporate it into a busy lifestyle.