Occupational therapy intervention for cancer patients following hospital discharge: How and when should we intervene? A systematic review

Abstract

Introduction Advances in cancer treatment over the last decade have led to increased survival rates. As a result, survivors are living longer with and beyond cancer, often with greater levels of morbidity. Occupational therapists, with their focus on remedial and compensatory strategies to improve function and participation, are well suited to assess and intervene with this population. Despite this, little research exists to demonstrate the efficacy of interventions and value of the occupational therapy role. This systematic review aimed to review how and when occupational therapists provide services for adult patients with cancer and identify where they add the most value. Methods A systematic search was conducted of six electronic databases. Eligible studies reported on occupational therapy interventions targeting management of cancer symptoms, rehabilitation or environmental modifications for adult cancer patients discharged from acute hospital services. Data extraction and quality assessment were undertaken by two reviewers. Narrative synthesis summarised the attributes and treatment outcomes of each intervention. Results Nine articles were included from a total of 309 articles retrieved. Eight different interventions were reported for people with cancer (n = 531). Small sample sizes and methodological quality precluded any formal analysis; however, intervention components that showed positive results were person‐centred, individualised and included regular monitoring and flexibility in care, with input from multidisciplinary health professionals. Therapists also need to reflect upon the optimal duration of interventions and selection of outcome measures that specifically match intervention components. Conclusion Despite inconclusive support of any particular type of intervention, this systematic review identified several successful intervention components for occupational therapists working with people with or beyond cancer. Overall, findings suggest that monitored tailored programmes compensating for fluctuations in a patient's condition have efficacy to improve patient outcomes and should be considered when delivering intervention with patients post hospital discharge.

Occupational Therapy After Breast Cancer Reconstructive Surgery: A Predictor for Opioid Prescriptions

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Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) for Shoulder Mobility Improvement in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Multicenter Controlled Clinical Trial

“…Current evidence agrees with the need for further research in multidisciplinary oncology rehabilitation and recommends a multidisciplinary approach in patients with BCRL, including but not limited to occupational therapy [18][19][20][21][22][23][24][25], health training/promotion [9,[26][27][28] and physical activity [29,30].…”

Outcomes and Feasibility of an Occupational Care Programme (TERRA) to Support Work Ability of Rare and Advanced Cancer Patients: A Report of 7 Cases

“…Third, regarding feasibility of TERRA, adjustments made during the course of the programme to respect the needs of participants, such as extending breaks, were valuable for tailoring. Taylor et al [14] studied occupational interventions for cancer patients and indicated that monitored tailoring of intervention programmes might improve outcomes. Implementation was, however, hindered by the heterogeneity of the participants' RRTW phase as well as their illness phase.…”