Issue Focus, Aims, and Objectives
The HICO project targeted the treatment disparities faced by older women (aged 65 and over) with ovarian cancer in two healthcare trusts, focusing on a holistic approach to reduce inequalities. Through the integration of physiotherapy, psychological support, quality-of-life assessments, and management of nutritional risks, the project sought to improve physical function, mental well-being, and overall patient experience. Specific objectives included the use of optimal treatment regimens such as surgery and specialised chemotherapy, education for healthcare teams, cost-efficacy analysis, and sharing lessons with other cancer centres nationally and internationally.
Successes, Challenges, and Mitigations
The project's success was marked by full integration into patient pathways, evident improvement in quality of life, and a cultural shift in treatment. Online resources were developed, and the continuous HICO approach even after project cessation underscored its sustainable impact. Challenges such as limited stakeholder engagement, understaffing, recruitment difficulties, and data analysis were met with thoughtful mitigations, including more time for planning, support and funding, larger studies, and separate project managers. The failure to increase the surgery rate was recognised as an area for further investigation.
Conclusion and Broader Impact
Conclusively, the HICO project stands as a pioneering model in the treatment of older women with ovarian cancer, with a distinct focus on holistic healthcare. Achieving its aims and objectives, the project significantly enhanced patient well-being and established a new standard of care. Despite challenges, the lessons learned have shaped future practices and fostered collaboration and research. The HICO team's work now guides national discourse on prehabilitation in gynaecological cancers, with planned presentations at major conferences, journal submissions, and a collaboration for a national conference on prehabilitation, emphasising the project's far-reaching influence.
Project Title: Holistic Integrated Care in Ovarian Cancer (HICO) - Reducing inequalities due to age, frailty, poor physical and mental health
Project Lead & Pilot location: Jonathan Frost - Consultant Gynaecological Oncologist & Project Lead Lead Centre: Royal United Hospitals Bath
Inequality Criteria: Age
Objective Criteria: Improve patient experience and quality of life
Improve physical functioning, nutritional status, and psychological wellbeing