Rehabilitation in Oncology Care Guidelines: A Gap Analysis.

IF 14.8 2区 医学 Q1 ONCOLOGY
Cristina Kline-Quiroz, Cody Andrews, Patrick Martone, James Thomas Pastrnak, Katherine Power, Sean R Smith, Eric Wisotzky
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引用次数: 0

Abstract

Background: Cancer survivors experience a high prevalence of functional impairments. Rehabilitation interventions include an expansive array of services that can help optimize function, address pain, decrease symptom burden, and improve quality of life. Nonetheless, rehabilitation services remain underutilized. Thus, it is important to enhance the understanding of and establish guidelines for specific rehabilitation disciplines and interventions.

Methods: This is a gap analysis of rehabilitation recommendations in published oncology guidelines from selected nationally recognized organizations. Symptom-specific guidelines and cancer type-specific guidelines were analyzed for inclusion of common functional impairments (fatigue, pain, peripheral neuropathy, cognitive dysfunction, and lymphedema) and the rehabilitation discipline recommendations.

Results: The prevalence of recommendations for rehabilitation in cancer type-specific guidelines was 29%, and was higher in symptom-specific guidelines at 60%. However, the frequency of specific rehabilitation disciplines (physiatry, physical therapy, occupational therapy, speech-language pathology, and rehabilitation psychology/neuropsychology) was notably lower. Overall rehabilitation was mentioned in 33% and physiatry in 18%. Nonrehabilitation specialties were recommended in 18% of the guidelines. No specialty referral was endorsed in 53% of guidelines in which 1 of 5 symptoms were discussed. This highlights the relative paucity of recommendations for specific rehabilitation disciplines in oncology guidelines. The more general term "rehabilitation" was included more frequently but lacks critical guidance for oncology providers. Other crucial rehabilitation services may be underrecognized and underutilized. Rehabilitation specialists must work to improve patient access and the presence of indicated specific rehabilitation disciplines and goals within guidelines.

Conclusions: Most oncology guidelines do not include specific recommendations for rehabilitation disciplines. However, including specific rehabilitation disciplines is more common in symptom-specific guidelines. With a stronger evidence base and increased involvement of rehabilitation specialists in guideline development, rehabilitation recommendations in oncologic guidelines may be more precise, leading to improved utilization of rehabilitation services to optimize function and quality of life.

肿瘤治疗中的康复指南:差距分析。
背景:癌症幸存者普遍存在功能障碍。康复干预包括一系列广泛的服务,有助于优化功能、解决疼痛、减轻症状负担和提高生活质量。然而,康复服务仍未得到充分利用。因此,加强对特定康复学科和干预措施的了解并制定相关指南非常重要:方法:这是对部分国家认可的组织已发布的肿瘤指南中的康复建议进行的差距分析。分析了针对特定症状的指南和针对特定癌症类型的指南,以纳入常见功能障碍(疲劳、疼痛、周围神经病变、认知功能障碍和淋巴水肿)和康复学科建议:结果:针对癌症类型的指南中康复建议的比例为 29%,针对症状的指南中康复建议的比例更高,为 60%。然而,特定康复学科(物理治疗、物理治疗、职业治疗、言语病理学和康复心理学/神经心理学)的频率明显较低。33% 的人提到过整体康复,18% 的人提到过物理治疗。18%的指南推荐了非康复专科。有 53% 的指南在讨论 5 个症状中的 1 个症状时,没有推荐任何专科。这突显出肿瘤指南中对特定康复学科的推荐相对较少。康复 "这一较为笼统的术语被纳入的频率较高,但却缺乏对肿瘤服务提供者的重要指导。其他重要的康复服务可能未被充分认识和利用。康复专家必须努力提高患者获得康复服务的机会,并在指南中指明具体的康复学科和目标:结论:大多数肿瘤指南都不包括康复学科的具体建议。然而,在针对特定症状的指南中,包含特定康复学科的情况更为常见。随着证据基础的加强和康复专家更多地参与指南的制定,肿瘤指南中的康复建议可能会更加精确,从而提高康复服务的利用率,优化功能和生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
20.20
自引率
0.00%
发文量
388
审稿时长
4-8 weeks
期刊介绍: JNCCN—Journal of the National Comprehensive Cancer Network is a peer-reviewed medical journal read by over 25,000 oncologists and cancer care professionals nationwide. This indexed publication delivers the latest insights into best clinical practices, oncology health services research, and translational medicine. Notably, JNCCN provides updates on the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research, and case reports that spotlight molecular insights in patient care. Guided by its vision, JNCCN seeks to advance the mission of NCCN by serving as the primary resource for information on NCCN Guidelines®, innovation in translational medicine, and scientific studies related to oncology health services research. This encompasses quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN boasts indexing by prominent databases such as MEDLINE/PubMed, Chemical Abstracts, Embase, EmCare, and Scopus, reinforcing its standing as a reputable source for comprehensive information in the field of oncology.
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