New project pilots a new model of rehabilitation for adults living with advanced cancer across Europe to improve function and quality of life.
Funded by Horizon Europe and Innovate UK, INSPIRE (Integrated Short-term Palliative Rehabilitation) is a four-year project that seeks to address disability, declining mobility, and related palliative care needs for individuals with cancer.
The project was created with and for people with incurable cancer, along with their main caregivers. It responds to each person's concerns, priorities and goals and can be delivered by a range of different healthcare professionals.
The launch of INSPIRE has come at an opportune time. According to the World Health Organization (WHO), individuals are living longer with cancer-related disability, which is increasing the demand for integrated palliative care and rehabilitation services. The WHO recently called for greater integration of palliative care and rehabilitation services to provide for this growing demand.
As lead partners for the Intervention Readiness work package of the trial, researchers from the University of Edinburgh and King's College London have been designing an intervention structure, materials, and resources to fill current gaps in palliative care and rehabilitation services for cancer.
By testing a new model of palliative rehabilitation in a randomised controlled trial, a range of healthcare professionals will work with individuals with cancer to target their debilitating symptoms and to devise a unique rehabilitation plan to support their goals.
Goal setting is one of several behaviour change techniques that underpin the intervention and will enable participants and INSPIRE professionals to co-develop a rehabilitation plan that works for them. Directing rehabilitation through goal-setting pairs with guidelines from the WHO, who indicate that intervention effectiveness can be bolstered by centering the intervention on what matters to the participant; their needs, wants, and wishes.
Practitioners will engage participants in evidence-based rehabilitation strategies, working towards goals that matter to them in everyday life. INSPIRE includes interventions to optimise self-management of symptoms, physical fitness and engagement in daily activities. Interventions support individuals to participate in their family and community networks, navigating the constraints of their condition.
Researchers from the University of Edinburgh, Professor Barry Laird and Clinical Fellow Amy McLuskie, and from King's College London, Dr Joanne Bayly, have been instrumental in preparing the trial manual and in delivering the training to rehabilitation practitioners.
With preparation for the INSPIRE trial now complete, recruitment for this major trial is set to start in six European countries (Denmark, England, France, Norway, Italy and Scotland).
INSPIRE will generate key learnings on designing and implementing an integrated service based on WHO recommendations. As well as assessing how the intervention was delivered, trial results will be examined on both clinical and cost-effectiveness as a potential integration model for health services to tackle the growing need for palliative rehabilitation.
The results of INSPIRE will be compelling for healthcare systems across Europe seeking better integration between healthcare professionals and departments delivering palliative and oncology care.
"This is the first multi-national randomised controlled trial to test a tailored and individualised multi-modal palliative rehabilitation intervention. If found to be effective, the INSPIRE intervention is designed to be scalable, to facilitate sustainable integration into palliative care services across a range of clinical settings and health care systems."
Dr Joanne Bayly, Scientific Project Manager, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care
"Goals for everyday life should be person-centered. I think we all do goal setting to a degree as health professionals but we don't necessarily label them in this way. We wanted this built into INSPIRE so that the individual's goal is what directs the palliative rehabilitation sessions."
Amy McLuskie, Clinical Fellow, University of Edinburgh
