Patient‐Reported Usefulness of Acute Cancer Rehabilitation

Ng, Amy; Gupta, Ekta; Fontillas, Rhodora C.; Bansal, Shruti; Williams, Janet L.; Park, Minjeong; Liu, Diane; Fu, Jack B.; Yadav, Rajesh; Bruera, Éduardo

doi:10.1016/j.pmrj.2017.04.006

Cited by 16 publications

(18 citation statements)

References 26 publications

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“…Ninety-four percent of patients rated their stay as either extremely good or very good. 5 Metastasis to the spine is a common problem. It is found in 30% of cancer patients at autopsy.…”

Section: Discussionmentioning

confidence: 99%

The impact of inpatient rehabilitation on outcomes for patients with cancer

Forrest¹

2016

JCSO

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The impact of inpatient rehabilitation on outcomes for patients with cancer T he American Cancer Society reports that 1.6 million people are diagnosed with cancer each year, of whom 78% are aged 55 years or older. The 5-year survival rate for cancer is 68%. 1 Almost 15.5 million living Americans have been diagnosed with cancer. 2 Many patients with cancer have difficulty walking and with activities of daily living. Patients with primary brain tumors or tumors metastatic to the brain may present with focal weakness or cognitive deficits similar to patients with stroke. Patients with tumors metastatic to the spine may have the same deficits as a patient with a traumatic spinal cord injury. Patients with metastasis to bone may have pathologic fractures of the hip or long bones. Patients may develop peripheral neuropathy associated with a paraneoplastic syndrome, chemotherapy, or critical illness neuropathy. Lehmann and colleagues evaluated 805 patients admitted to hospitals affiliated with the University of Washington Medical School with a diagnosis of cancer and found that 15% had difficulty walking and 20% had difficulty with activities of daily living. 3 Many patients with cancer can benefit from inpa-tient rehabilitation. 4,5 Study findings have shown that patients with impairments in function related to cancer are often not referred for rehabilitation. Among the reasons mentioned for that are that oncologists are more focused on treating the patients' cancer than on their functional deficits and that specialists in rehabilitation medicine do not want to be involved with patients with complex medical problems. Rehabilitation facilities may not want to incur the costs associated with caring for patients with cancer. 6 The present paper looks at the outcomes of 61 consecutive patients with cancer who were admitted to an inpatient rehabilitation facility (IRF) and received radiation therapy concurrent with rehabilitation. It compares the outcomes of the cancer patients with the outcomes of patients without cancer who were admitted with stroke or spinal cord injury, conditions more commonly treated at an IRF. Methods We reviewed electronic medical records of all patients with cancer admitted to the IRF from 2008 through 2013 who received radiation ther

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“…Ninety-four percent of patients rated their stay as either extremely good or very good. 5 Metastasis to the spine is a common problem. It is found in 30% of cancer patients at autopsy.…”

Section: Discussionmentioning

confidence: 99%

The impact of inpatient rehabilitation on outcomes for patients with cancer

Forrest¹

2016

JCSO

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“…Existing research suggests that both referring providers and cancer survivors may be ambivalent or disinterested in rehabilitation services, although those who experience rehabilitation generally report perceptions that it was beneficial . As such, national research or public opinion surveys to capture public attitudes and preferences regarding cancer rehabilitation and guide the development of educational campaigns to increase the uptake of cancer rehabilitation care for patients in need of these interventions are important next steps.…”

Section: Strategy 4: Ascertaining and Responding To Public Opinionmentioning

confidence: 99%

“…Existing research suggests that both referring providers 102,103 and cancer survivors may be ambivalent or disinterested in rehabilitation services, 104,105 although those who experience rehabilitation generally report perceptions that it was beneficial. 102,106 As such, national research or public opinion surveys to capture public attitudes and preferences regarding cancer rehabilitation and guide the development of educational campaigns to increase the uptake of cancer rehabilitation care for patients in need of these interventions are important next steps. Professional organizations such as the ACS, the American Physical Therapy Association, the American Academy of Physical Medicine and Rehabilitation, the American Occupational Therapy Association, the American College of Sports Medicine, and ASCO (in their patient-facing cancer.net site; accessed May 14, 2018) have patient-focused cancer rehabilitation materials on their respective Web sites.…”

Section: Cancer Rehabilitationmentioning

confidence: 99%

Follow the trail: Using insights from the growth of palliative care to propose a roadmap for cancer rehabilitation

Lyons

Padgett

Marshall

et al. 2018

CA A Cancer J Clinicians

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Despite research explicating the benefits of cancer rehabilitation interventions to optimize physical, social, emotional, and vocational functioning, many reports document low rates of referral to and uptake of rehabilitation in oncology. Cancer rehabilitation clinicians, researchers, and policy makers could learn from the multidisciplinary specialty of palliative care, which has benefited from a growth strategy and has garnered national recognition as an important and necessary aspect of oncology care. The purpose of this article is to explore the actions that have increased the uptake and integration of palliative care to yield insights and multimodal strategies for the development and growth of cancer rehabilitation. After examining the history of palliative care and its growth, the authors highlight 5 key strategies that may benefit the field of cancer rehabilitation: 1) stimulating the science in specific gap areas; 2) creating clinical practice guidelines; 3) building clinical capacity; 4) ascertaining and responding to public opinion; and 5) advocating for public policy change. Coordinated and simultaneous advances on these 5 strategies may catalyze the growth, utilization, and effectiveness of patient screening, timely referrals, and delivery of appropriate cancer rehabilitation care that reduces disability and improves quality of life for cancer survivors who need these services.

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“…Now a part of the oncology care continuum, rehabilitation professionals diagnose and treat patients' physical, psychological, and cognitive impairments in an effort to maintain or restore function, reduce symptom burden, maximize independence, and improve quality of life 2 . Oncologists increasingly refer patients to cancer rehabilitation providers, and patients report inpatient rehabilitation helps with independence with mobility and activities of daily living 3 …”

Section: Introductionmentioning

confidence: 99%

Cancer Rehabilitation Providers and Oncology Patient Expectations for Functional Outcomes after Inpatient Rehabilitation

Gupta

et al. 2020

PM&R

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Background Cancer rehabilitation is a valued resource for patients and oncologists. Cancer rehabilitation providers are seeing increasing numbers of referrals for inpatient rehabilitation as the number of cancer survivors grows. However, cancer rehabilitation providers, oncologists, therapists, patients, and caregivers may not always clearly communicate the goals of care, which can lead to different expectations for inpatient rehabilitation. Objective To determine the difference in expectations of function after an acute inpatient rehabilitation stay between cancer patients and cancer rehabilitation providers and how they align with achieved goals after treatment. Design Prospective survey study. Setting Quaternary academic medical center inpatient rehabilitation unit. Participants Out of 194 eligible patients, 132 were enrolled and completed admission surveys, and 110 completed the discharge survey. Twelve cancer rehabilitation providers completed the surveys. Interventions Not applicable. Main Outcome Measures Barthel Index. Results Patients estimated their expected functional status as a median (interquartile range) score of 19 points (18, 20) using the Barthel Index, compared to cancer rehabilitation providers, who estimated a median score of 17 points (15, 19) (P < .001). Actual functional status upon discharge was a median score of 16 points (13, 18) using the Barthel Index, which was three points lower than expected by patients (P < .001). Conclusions Oncology patients and cancer rehabilitation providers significantly overestimate functional goals for acute inpatient rehabilitation. This overestimation was clinically significant for oncology patients and statistically but not clinically significant for cancer rehabilitation providers. Increased communication may allow for a more realistic expectation of functional status upon discharge.

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Patient‐Reported Usefulness of Acute Cancer Rehabilitation

Abstract: IV.

Cited by 16 publications

References 26 publications

The impact of inpatient rehabilitation on outcomes for patients with cancer

The impact of inpatient rehabilitation on outcomes for patients with cancer

Follow the trail: Using insights from the growth of palliative care to propose a roadmap for cancer rehabilitation

Cancer Rehabilitation Providers and Oncology Patient Expectations for Functional Outcomes after Inpatient Rehabilitation

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