20/142 Prehabilitation: Living with and beyond cancer commissioning brief
Deadline for submission: 30 March 2021, 1pm
The National Institute for Health Research (NIHR) is interested in receiving applications for applied health research studies to increase the evidence base to support health and care services for people with a new cancer diagnosis and the role of prehabilitation in their treatment pathway.
Prehabilitation enables people with cancer to prepare for treatment through promoting healthy behaviours and through needs based prescribing of exercise, nutrition and psychological interventions. Cancer prehabilitation has been defined by Sliver and Baima (2013) as “a process on the cancer continuum of care that occurs between the time of cancer diagnosis and the beginning of acute treatment.” It has the potential to offer significant benefits to the long term health and wellbeing of patients with cancer. However, the evidence base to support the role of prehabilitation is variable and research is required to evaluate the benefits across different cancer types, cancer treatments, modes of delivery and also understanding the patient experience.
A recent report developed through a partnership of the NIHR Cancer and Nutrition Collaboration with the Royal College of Anaesthetists and Macmillan Cancer Support has highlighted prehabilitation areas that require further evidence.
There are four key areas in which it is felt that research is needed most:
- The mechanisms by which poor nutrition, being physically unfit and stress act separately and together to impair response to treatment and outcomes, and in turn, the mechanism by which improvements through prehabilitation interventions may act.
- How best to identify those most at risk and the efficacy of the interventions themselves (dose intensity/effect, timing, by cancer, and by treatment).
- The effectiveness and implementation of interventions.
- Organisation of services.
Please refer to the following reports and accompanying systematic review for further information:
- An evidence table that summarises published work in the field
- Prehabilitation evidence and insight review (MacMillan Cancer Support): Pages 46 of the review lays out the need for developing a research base in this area.
- NCRI/JLA research priorities
- A BMJ editorial highlighted some potential concerns with delivering prehabilitation and it would be important to consider these concerns in any application.
How to apply
Research proposals must be within the remit of at least one participating NIHR Programme. The Programmes involved in this call are:
- Efficacy and Mechanism Evaluation (EME)
- Health Services and Delivery Research (HS&DR)
- Health Technology Assessment (HTA)
- Public Health Research (PHR)
Applicants should note that:
- Applications which span the remit of one or more of the participating NIHR Programmes will be welcomed.
- Applicants should justify the importance of their proposed research and its potential impact on patient care.
- Applicants should clearly state how their proposed research addresses an explicit evidence gap and how the research adds value to the existing NIHR research portfolio
- Research proposals must pay attention to the need to make research relevant to all members of our community; in who does the research, who takes part in the research and who advises and co-creates the research. Useful resources include the Increasing BAME Participation toolkit produced by the NIHR East Midlands ARC.
- Patient and public involvement should be included within the application and study design.
- The call represents an ongoing area of interest for the NIHR and following this opportunity, the NIHR research programmes would still be interested in receiving applications in this area to their researcher-led workstreams.
- Studies which investigate prehabilitation outside of cancer should apply through individual Programmes researcher-led opportunities
Applicants who require further guidance about the call should contact their local NIHR Research Design Service (RDS) or equivalent in the first instance.
For any general enquiries regarding this call, please contact email: firstname.lastname@example.org