Recently, a group of clinicians and researchers in Switzerland developed a clinical decision support system to support exercise oncology standards across various sites across the country.
Dr. Anastasios Manettas at the University Hospital Zurich, led this study and published the results in the Journal of Cancer Survivorship. The researchers convened 25 experts, collecting multiple rounds of feedback, and paired this with a review of the science.
The group agreed upon three structures:
Exercise program frequency and duration: Twice weekly in a supervised setting. Maximum of 36 exercise sessions.
Exercise prescription progression. Gradual increase in exercise intensity. This allows individuals time to adapt the program to the survivors’ needs.
Face validity of the intervention. The exercise course recommended should align with the indications for the exercise. This may be a “gut check” for a provider assessing the link between the reason survivors are prescribed the exercise prescription.
The group’s clinical decision support system included guidance in the following areas of exercise oncology:
Referral from a clinician. This helps ensure survivors recognize the importance and participate in the exercise program
Prescription indication. This helps align the exercise protocol with the assessments needed to ensure the program works.
Treatment status. Understanding survivors’ treatment timing is critical to ensure their participation in an exercise program doesn’t hinder their treatment goals.
Measurement set. Using outcomes similar to patient-reported outcome measures that can demonstrate the relative success and impact of the exercise oncology routine on patient care.
The American Cancer Society provides recommendations for how cancer survivors can use exercise. These recommendations are very helpful, though they need added context. Oncology nurses can build on these recommendations to implement exercise oncology across settings and survivor groups.