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Post operative exercise guidance app (BAPSApp Wales) for breast cancer patients empowers patients and reduces problems with positioning for radiotherapy


Donna Egbeare

Cardiff & Vale UHB, GB
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The BAPS App was designed following patient feedback, to guide patients who have had breast or axillary surgery for breast cancer through exercises aiming to maintain shoulder function and allow them to get into position for radiotherapy.

Prior to the use of the App, there was disparity in information given to patients, who gave the information and at what point within the Health Board’s that refer patients for oncological treatment to Velindre Cancer Centre (VCC) in Cardiff.  Increasing numbers of patients were unable to maintain correct position for radiotherapy planning and required urgent and intensive physiotherapy input to achieve this.

Economically this has an impact on planned cancer care – CT scanner time wasted, rearranging appointments, intensive physiotherapy sessions needed, but most importantly, delayed adjuvant treatment has a psychologically negative impact on the patient.

Our aim was to standardise information given to patients in a more interactive fashion, empowering patients with an understanding of why the exercises are important, motivating them to achieve their goals and optimising patient care pathway from surgery to radiotherapy. 

The problem was initially highlighted by a patient who became an important member of the team in the design, development and testing of the App.  The multidisciplinary team worked together with an industry partner to film and develop the App and then identified key stakeholders to engage before launching the App.  This was enabled by taking part in the Bevan Commission Health Hack and being one of the successful bidders for funding.  Our App evolved in a pro-active way and we have added in a section on deep inspirational breath hold which is being used for some patients with left sided breast cancer requiring radiotherapy, but also as a relaxation technique within the App.

The App has links to common questions, reliable sources of evidence-based information and our YouTube channel:

Initially the Health Boards that refer patients to Velindre were targeted and breast care nurses, physiotherapists and surgeons in these areas were contacted to promote use of the App and engage in order to have good uptake of the technology.

The App was launched in February 2019. In six months, we have achieved:

•           583 app downloads

•           440 direct downloads using link or QR code

•           313 Sessions (physio sessions 1-4) have been completed.

The VCC physiotherapy department have noticed a downward trend in urgent referrals.  

Questionnaires for patient feedback and healthcare professional feedback are underway and data collection is ongoing.  We aim to roll out use of BAPSApp across Wales this year as an integrated component of the breast cancer care pathway. 

The App is sustainable as the information is unlikely to change and is sufficiently generic for all cancer centres to use.  It is transferable and indeed has been downloaded in many international locations, not just within Wales.  It is available in Welsh and English language, thus no Welsh first language patient is disadvantaged.  Health economists will help evaluate the App in terms of financial impact once longer term data is available.

How to Cite: Egbeare D. Post operative exercise guidance app (BAPSApp Wales) for breast cancer patients empowers patients and reduces problems with positioning for radiotherapy. International Journal of Integrated Care. 2021;21(S1):87. DOI:
Published on 01 Sep 2021.


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