by Marian Jones, Prehabilitation Pharmacist, Cardiff South West cluster
It’s crucially important to prepare patients for the beginning of the cancer pathway, particularly to help with their mental health and wellbeing. Patients who present any red flag symptoms are referred via the urgent suspected cancer pathway for further investigation. At this stage they are also referred for a prehabilitation review, which is where I come in.
As a prehabilitation pharmacist, I consult with patients and give them an optimisation bundle which consists of medication reviews, screening checks and any lifestyle interventions that I need to make, particularly regarding smoking cessation, alcohol detoxification and weight management. Prehabilitation encompasses both physical and holistic needs for a patient to ensure maximum benefit for their treatment and recovery.
It is always exciting to deliver a new patient service and especially within cancer services where patients are going through a very difficult period. As pharmacists, we play a key role in optimising patient therapy and by targeting high risk patients promptly, this means we can have a huge impact at increasing their health status whatever the outcome of their investigations. As with every new service, there are always challenges, the pandemic has proved to be our biggest challenge as patients are not presenting early enough with red flag symptoms.
Having moved to virtual consultations, we’ve adapted our ways of working and changed protocols to ensure we can deliver the objectives of prehabilitation. This allows us to review bloods and alter treatments as well as requesting further examinations on an individual basis. Feedback from patients has been very positive and the opportunity to have a consultation prior to their investigations addresses their concerns as well as providing support and a point of contact for future follow up once discharged back to primary care.
The cluster is already set up with an integrated care hub and therefore has a lot of established services ready for patients to be referred to. It has been a great advantage to be able to refer patients promptly for social prescribing, wellbeing services and address issues early on to improve future outcomes. Working in a proactive and pro-pharmacy cluster has been key to capturing patients at the start of their journey in order to maximise their rehabilitation status.
The prehabilitation programme is made up of a wide network of allied healthcare professionals, so it’s encouraging to see engagement from GP practices and patients as well as the organisations patients are being referred to. We have set up links to ensure patients are prioritised through these services based on the fast track approach of the cancer pathway. I am extremely fortunate to be part of this multidisciplinary team and am very excited to be part of the prehabilitation team, working alongside colleagues that are making a difference to patients going through an exceptionally difficult process.