Barriers and facilitators to giving prehabilitation advice by clinical nurse specialists and advanced nurse practitioners in oncology patients.

PURPOSE: This is the second article in this series on the knowledge, attitudes and beliefs of clinical nurse specialists (CNSs) and ANPs (advanced nurse practitioners) regarding prehabilitation advice in oncology patients, exploring the barriers and facilitators to giving prehabilitation advice by CNSs and ANPs in oncology patients. METHODS: A Cross-sectional online questionnaire opens for 3 months to establish the knowledge, attitudes and beliefs of ANPs and CNSs to prehabilitation disseminated through professional organisations and social media. RESULTS: The questionnaire gained (n = 415) responses. Prehabilitation advice was routinely given by 89% (n = 371) of respondents. Many (60%) identified a lack of guidance and referral processes as a barrier to giving prehabilitation advice; this corresponded between respondents' confidence to give prehabilitation advice and subsequent referrals (< 0.001). Other factors included time (61%), a lack of patient interest (44%) and limited relevance to patients (35%). CONCLUSION: The implementation of standardised nurse prehabilitation advice resources would enable CNSs and ANPs to provide personalised prehabilitation advice in their consultations.

The routine collation of health outcomes data from hospital treated subjects in the Health Outcomes Data Repository (HODaR): descriptive analysis from the first 20,000 subjects.

OBJECTIVES: Health technology assessment requires data covering many different facets of treatment. A new resource, the Health Outcomes Data Repository (HODaR), is described and evaluated for its use in the pharmaceutical research and development process. METHODS: Data were collated for subjects treated at Cardiff and Vale National Health Service (NHS) Hospitals Trust, United Kingdom. Inpatients are surveyed 6 weeks postdischarge by postal survey, whilst outpatients are handed a survey pack when they attend. Survey data cover sociodemographics, resource use, production losses, and quality of life. Electronic hospital data are available for all responders, and linked with survey returns. Sample characteristics, coverage of disease areas, and a more detailed description of data values for diabetes are described. RESULTS: Survey responses relating to 16,188 admissions and 4476 outpatient attendances were available relating to around 2000 different diagnoses. Over 5000 pharmacy items and 400,000 biochemistry test results were available. Analysis of utility data showed a broad coverage of diseases. For patients with diabetes the pattern of EQ-5D scores across subgroups is not clear. Health service resource use showed a linear relationship with respect to number of comorbidities. CONCLUSIONS: HODaR represents a new approach to accessing patient data, and gathers both routine and survey-based data. Although linking survey data to routine hospital systems is a complex task, which produces some limitations, it can produce health outcomes data at relatively low cost. Its performance within the pharmaceutical research and development process needs to be further evaluated in order to assess its most appropriate role.