Optimising stem cell transplant outcomes; home-based rehabilitation

Optimising post-transplant outcomes via the delivery of a contemporary home-based rehabilitation program for Alfred Health patients undergoing Stem Cell Transplantation

Enabled by a 2023 grant from the SMICS Funding Program, Alfred Health has successfully embedded a standardised, multidisciplinary pre-habilitation and rehabilitation program for patients undergoing stem cell transplantation (SCT). The program integrated physiotherapy and dietetic services, offering both face-to-face and telehealth modalities to enhance accessibility for those living away or with considerable appointment burden.
Key outputs included the creation of a shared-care model, development of virtual health delivery platforms, and establishment of referral pathways to support continuity of care across metropolitan and regional settings.

The program reached over 100 patients, with more than half completing post-transplant care, and demonstrated high feasibility and acceptability among patients and staff. Educational resources, assessment protocols, and a scalable care model now support continuity and quality across the cancer journey.

The outcomes have been transformative: patients reported improvements in physical function, nutritional status, and health related quality of life, with 100% of surveyed participants rating the program as acceptable or highly acceptable. The initiative has strengthened allied health integration into SCT pathways, improved referral timeliness, and empowered patients through education and self-directed care.

The findings suggest potential for broader implementation and scaling of the model to other cancer cohorts, with recommendations for co-location of services, centralised referrals, and expanded multidisciplinary collaboration.

The service is now part of Alfred Health Outpatient Allied Health suite of services. With the attainment of additional allied health EFT in outpatient cancer service, the prehab and rehab program now also includes a social work assessment (phone call) and a psychology group with opportunity for 1:1 review if required. A new digital build has further improved the referral workflow and coordination of care within our electronic medical record.

The model is primed for scale up to other cancer cohorts, for example CAR-T, pre-surgery, pre-high dose chemotherapy/treatment regimes, and other chronic disease cohorts. Offering a blueprint for adoption in regional and rural centres via telehealth.

The grant project has enabled the Alfred team to provide evidence based prehabilitation and rehabilitation to all stem cell transplant recipients. Equity of service access has also been addressed, as other providers of stem cell transplantation were already offering a MDT prehab and rehab service. Linking patients in, with local health care providers to enable care closer to home, and their support networks provided further benefit to program participants. Noting that some participants still chose to join group activity for the peer-support component.