Exploring facilitators and barriers to the implementation of prehabilitation for individuals with pancreatic cancer: a survey of healthcare professionals.

People with pancreatic cancer experience poor survival, low quality of life and limited treatment options compared to those with other cancers; interventions that can improve outcomes and quality of life are urgently required. Pancreatic Cancer UK recently released 'optimal care guidelines' for pancreatic cancer, which recommends that all patients, no matter the treatment route, should be offered prehabilitation (typically exercise, nutrition and psychosocial intervention) at the point of diagnosis. We investigated the facilitators and barriers to implementing prehabilitation for individuals with pancreatic cancer, from the perspective of healthcare professionals. A mixed methods cross-sectional survey on the facilitators and barriers to implementing prehabilitation and engaging individuals with pancreatic cancer in prehabilitation was designed and circulated to healthcare professionals (n = 138). Responses were analysed using a thematic approach. Key factors highlighted by healthcare professionals that could support the implementation of a prehabilitation intervention included multidisciplinary team cohesion and collaboration and dedicated prehabilitation champions, resources and National Health Service trust engagement, accessibility and avoiding exacerbating health inequalities, community support, and clinical guidelines. Key factors that could overcome barriers to the participation of individuals with pancreatic cancer included educational support, clear aims and information, understanding of the disease-related burden and individualised programmes. Considering each of these factors in the design and delivery of services could inform future research and the implementation of prehabilitation for individuals with pancreatic cancer.