Aim
The COSA clinical practice guideline recommends exercise to be part of standard practice in cancer care. However, patient participation in adequate exercise remains suboptimal. The aim of the study is to assess the knowledge of the COSA guideline and to understand the barriers and facilitators to an exercise program in breast cancer patients.
Methods
A cross-sectional study was performed in the South Eastern Sydney Local Health District (SESLHD) between June and September 2020. Study population included adults with breast cancer, their general practitioners (GPs) and breast cancer healthcare professionals (BCHPs). Consented participants were asked to complete a standardised survey.
Results
The study included 62 breast cancer patients, 7 GPs and 9 BCHPs. The median age of breast cancer patients was 55 years (range 30-78). All had non-metastatic disease. 74% had hormone receptor positive breast cancer. Familiarity with the COSA guideline was reported in 39% and 29% of patients and healthcare professionals (p=0.79), respectively. Patients aged ≤ 55 years were more likely to be compliant with COSA guidelines (13.3% vs 0%; p=0.056). Interestingly, patients who endorsed knowing the COSA guidelines performed significantly fewer minutes of exercise per week compared to those who were unfamiliar with the guidelines (172 vs 286; p = 0.036). Healthcare workers predicted significantly more barriers to exercise than patients reported (5 vs 2; p <0.001). The most highly endorsed barrier to exercise by patients and healthcare professionals was low energy (48% and 82%, respectively). Facilitators to exercise endorsed by patients included convenience (49%), cost (37%), and group exercise (29%).
Conclusions
The familiarity of the COSA clinical guidelines on exercise was low among breast cancer patients and healthcare professionals. Younger patients appeared more likely to be compliant with the COSA guidelines. The study results inform potential interventions to improve exercise compliance by addressing the barriers and facilitators.