Physiotherapy Triage Service for Cancer Patients – a service evaluation.

Purpose

Individuals with cancer experience a plethora of symptoms from diagnosis, through treatment and beyond into survivorship. Allied Health Professionals are uniquely placed to impact upon these symptoms by engaging individuals in rehabilitation. Scoping of rehabilitation services amongst individuals with cancer undergoing haematological and oncological treatment highlighted various issues with fatigue, loss of function, pain and breathlessness. A pilot programme was implemented to address these unmet needs.

Approach

In an acute teaching trust in the South West of England, individuals with cancer were highlighted by health care professionals and referred into the Therapy Treatment Support Service (TTSS). Included individuals had a cancer diagnosis and were adults aged 16 years and over, exclusion criteria specified those under 16 years of age and those without a cancer diagnosis. Telephone triage carried out by a physiotherapist provided appropriate interventions including fatigue management, musculoskeletal treatment, exercise programmes and breathlessness advice for individuals. The Functional Assessment of Cancer Therapy - General (FACT-G) was used as a quality of life outcome measure on initial and final contact.

Outcomes

Between March 2017 and March 2018 220 individuals were referred to TTSS with the following numbers specifying the primary reason for referral, 81 for fatigue, 71 for musculoskeletal issues, 42 for physical activity issues, 20 for mobility issues and 6 for breathlessness.

In total 44 of 53 completed datasets demonstrated positive outcomes in terms of quality of life using the FACT-G. Of 23 completed datasets with fatigue as the primary reason for referral, 21 demonstrated an improvement.

Cost and savings

Currently no data is available on project costs and savings.

Implications

Fatigue is the primary reason for referral to TTSS and its interventions have shown a positive impact upon quality of life. A more detailed enquiry is required to investigate this service model.

There is discrepancy in service provision for fatigue management amongst the population of those living with and beyond cancer. A cost-effective intervention that can provide equitable access is required to meet the aims stated in the Recovery Package. A standardised intervention delivered via a telephone clinic could reach a significant population of those living with and beyond cancer improving cancer-related fatigue symptoms.

Top three learning points

  1. Many cancer patients underreport their symptom burden to health care professionals.
  2. Specific interventions relating to cancer-related fatigue management can be provided via a telephone clinic.
  3. Establishing and maintaining the awareness of a pilot amongst health care professionals is essential to the overall success of a project.

 

Fund acknowledgements

Macmillan Cancer Support provided funding for this pilot programme. The authors report no affiliations or conflicts of interest in the subject matter of this abstract.

Additional notes

This work was presented at Physiotherapy UK 2018.

For further information about this work contact Thomas Cave