Community-based outpatient cancer rehabilitation services for women with gynecologic cancer: acceptability and impact on patient-reported outcomes

Wood, Kelley C; Bertram, Jessica; Kendig, Tiffany; Hidde, Mary; Leiser, Aliza; Meritens, Alexandre Buckley de; Pergolotti, Mackenzi

doi:10.1007/s00520-022-07227-8

Cited by 3 publications

(2 citation statements)

References 45 publications

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“…GMH scores for 4/13 types (head and neck, genitourinary, leukemia, prostate) and SRA scores for 2/13 cancer types (head and neck, leukemia) met or exceeded USA norms. The magnitude of improvement in HRQOL outcomes observed in this study was similar to or greater than the findings of previous meta-analyses and our previous evaluations of practice-based evidence [26,[51][52][53]. We also observed differences in the magnitude of change across domains (see Tables 2-5).…”

Section: Discussionsupporting

confidence: 88%

Impact of Real-World Outpatient Cancer Rehabilitation Services on Health-Related Quality of Life of Cancer Survivors across 12 Diagnosis Types in the United States

Pergolotti,

Wood,

Kendig

et al. 2024

Cancers

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Compared to adults without cancer, cancer survivors report poorer health-related quality of life (HRQOL), which is associated with negative treatment outcomes and increased healthcare use. Cancer-specialized physical and occupational therapy (PT/OT) could optimize HRQOL; however, the impact among survivors with non-breast malignancies is unknown. This retrospective (2020–2022), observational, study of medical record data of 12 cancer types, examined pre/post-HRQOL among cancer survivors who completed PT/OT. PROMIS® HRQOL measures: Global Health (physical [GPH] and mental [GMH]), Physical Function (PF), and Ability to Participate in Social Roles and Activities (SRA) were evaluated using linear mixed effect models by cancer type, then compared to the minimal important change (MIC, 2 points). Survivors were 65.44 ± 12.84 years old (range: 19–91), male (54%), with a median of 12 visits. Improvements in GPH were significant (p < 0.05) for all cancer types and all achieved MIC. Improvements in GMH were significant for 11/12 cancer types and 8/12 achieved MIC. Improvements in PF were significant for all cancer types and all achieved the MIC. Improvements in SRA were significant for all cancer types and all groups achieved the MIC. We observed statistically and clinically significant improvements in HRQOL domains for each of the 12 cancer types evaluated.

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Section: Discussionsupporting

confidence: 88%

Impact of Real-World Outpatient Cancer Rehabilitation Services on Health-Related Quality of Life of Cancer Survivors across 12 Diagnosis Types in the United States

Pergolotti,

Wood,

Kendig

et al. 2024

Cancers

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“…16,17 Expanding high-level evidence 18 demonstrates that when provided to BCSs, cancer-specialized rehabilitation interventions can mitigate, [18][19][20][21] and may even prevent, 22 treatment-related impairments. Furthermore, evidence from systematic reviews 5,[23][24][25] and observational studies of cancer rehabilitation services delivered in the community 16,21,26,27 demonstrate that participation in these interventions is associated with improved HRQoL, including physical, mental, functional, and social domains. Taken together, this evidence suggests that rehabilitation interventions may enhance work ability by addressing HRQoL needs.…”

Section: Introductionmentioning

confidence: 99%

Cancer Rehabilitation: Impact on Breast Cancer Survivors’ Work Ability and Health-Related Quality of Life

Pergolotti,

Wood,

Kendig

et al. 2024

Journal of the National Comprehensive Cancer Network

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Background: Breast cancer survivors (BCSs) report persistent, diminished ability to work, and decreased health-related quality of life (HRQoL). Cancer rehabilitation interventions (physical therapy or occupational therapy [PT/OT]) aim to improve these outcomes, but little is known about their impact in the community. Methods: This retrospective, pre-post, uncontrolled study examined cases of younger BCSs (age <65 years) who attended cancer-specialized PT/OT over a 2-year period. Outcomes and covariates (age, race, US region, payer type, number of visits, length of care [weeks]) were extracted from electronic medical records. Patient-reported outcomes were overall-Work Ability Score (WASoverall), physical-WAS (WASphysical), and mental-WAS (WASmental) and PROMIS Global Physical Health (GPH), Global Mental Health (GMH), Physical Function (PF), and Ability to Participate in Social Roles and Activities (SRA). We used linear mixed effect models to examine pre- to post-rehabilitation change overall, and separately, while controlling for covariates. Results: PT/OT cases (NPT=758; NOT=140) had a mean [SD] age of 51.39 [8.49] years and attended approximately 12 visits (IQR, 8.0–19.0) over 10.71 weeks (IQR, 6.14–17.00). Overall, work ability outcomes (WASoverall: +1.79; WASphysical: +0.78; WASmental: +0.47; all P<.001) and HRQoL outcomes improved significantly (GPH: +5.38; GMH: +2.90; PF: +5.17; SRA: +5.83; all P<.001), and average change on each HRQoL outcome exceeded the minimal important change (2 points). Outcome scores were similar at each timepoint for both PT and OT cases (all P>.05) and both groups improved significantly (all P<.01). Conclusions: In this large study of the impact of cancer-specialized, community-based PT and OT, younger BCSs reported significant improvement in ability to work and HRQoL. Although more research is needed, these findings suggest improved access to PT/OT could improve work ability and HRQoL for younger BCSs.

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Understanding Patient Experience with Outpatient Cancer Rehabilitation Care

Covington¹,

Bertram

Kendig³

et al. 2023

Healthcare

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Background: Understanding patient experience is key to optimize access and quality of outpatient cancer rehabilitation (physical or occupational therapy, PT/OT) services. Methods: We performed a retrospective mixed-method analysis of rehabilitation medical record data to better understand patient experience and aspects of care that influenced experience. From the medical record, we extracted case characteristics, patient experience data (Net Promoter Survey®, NPS) and patient-reported outcome (PRO) data. We categorized cases as ‘promoters’ (i.e., highly likely to recommend rehabilitation) or ‘detractors’, then calculated NPS score (−100 [worst] to 100 [best]). We identified key themes from NPS free-text comments using inductive content analysis, then used Pearson [r] or Spearman [ρ] correlation to explore relationships between NPS, characteristics, and PRO improvement. Results: Patients (N = 383) were 60.51 ± 12.02 years old, predominantly women with breast cancer (69.2%), and attended 14.23 ± 12.37 visits. Most were ‘promoters’ (92%); NPS score was 91.4. Patients described two experiences (themes) that influenced their likelihood to recommend rehabilitation: (1) feeling comfortable with the process and (2) observable improvement in health/functioning, and described attributes of clinic staff, environment and clinical care that influenced themes. Likelihood to recommend rehabilitation was associated with achieving the minimal clinical important difference on a PRO (ρ = 0.21, p < 0.001) and cancer type (ρ = 0.10, p < 0.001). Conclusion: Patients who received specialized cancer PT/OT were highly likely to recommend rehabilitation. Feeling comfortable with the rehabilitation process and making observable improvements in health and/or functioning influenced likelihood to recommend. Rehabilitation providers should leverage the findings of this study optimize access to and quality of cancer rehab services.

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Community-based outpatient cancer rehabilitation services for women with gynecologic cancer: acceptability and impact on patient-reported outcomes

Cited by 3 publications

References 45 publications

Impact of Real-World Outpatient Cancer Rehabilitation Services on Health-Related Quality of Life of Cancer Survivors across 12 Diagnosis Types in the United States

Impact of Real-World Outpatient Cancer Rehabilitation Services on Health-Related Quality of Life of Cancer Survivors across 12 Diagnosis Types in the United States

Cancer Rehabilitation: Impact on Breast Cancer Survivors’ Work Ability and Health-Related Quality of Life

Understanding Patient Experience with Outpatient Cancer Rehabilitation Care

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