3312 - The Broader Impact of Specialized Outpatient Cancer Rehabilitation on Functioning and Health Outcomes during Radiation Treatment

K. C. Wood¹, J. Bertram², S. Mayo¹, and M. Pergolotti^1,3; ¹Select Medical, Mechanicsburg, PA, ²Baylor Institute for Rehabilitation, Grapevine, TX, ³University of North Carolina, Chapel Hill, NC

Purpose/Objective(s): Many patients experience diminished health-related quality of life (HRQOL) during treatment. Without targeted intervention, these declines can persist long-term and have negative effects, including morbidity and mortality. Outpatient rehabilitation (physical and occupational therapy [PT/OT]) interventions are shown to enhance HRQOL outcomes. However, the impact of real-world community-based rehabilitation services is understudied. We performed a retrospective study of rehabilitation medical record data to evaluate the impact of cancer-specialized outpatient rehabilitation services on HRQOL outcomes during radiation treatment. Materials/

Methods: From the EMR, we extracted case characteristics and HRQOL outcome measures collected from patients who were referred to PT/OT by their radiation oncologist (single institution, 3-year period). HRQOL outcomes included PROMIS global physical and mental health, physical function, and ability to participate in social roles and activities. We used one-sample t-tests to compare baseline PROMIS t-scores to U.S. population norms (50 ± 10), then used paired t-tests to examine change from baseline to discharge for those who attended at least two rehabilitation visits.
Results: Patients (N=120) were 58.78±.89 years old, mostly female (65%), white (68%), and had private (62%) versus federally funded (34%) insurance. Interventions were primarily delivered by a PT (64%); 9% were multidisciplinary (PT and OT). At baseline global physical health (p<.001), physical functioning (p<.001), and ability to participate in social roles and activities (p=.018) were below population norms. After attending a median of 11 visits (IQR: 6 to 18), all outcomes improved significantly (Table 1). The average improvement exceeded the minimally important change of two points for all outcomes.
Conclusion: Patients with cancer receiving radiation therapy presented to outpatient rehabilitation with below-average HRQOL. After rehabilitation, significant improvement was observed in global physical and mental health, physical functioning, and ability to participate in social roles and activities. Although additional research is needed, these results can be used to increase awareness of the benefits of cancer rehabilitation during radiation treatment and support referral for these services.

Abstract 3312 – Table 1

HRQOL outcome	Baseline T-score (SE)	Discharge T-score (SE)	Average change (SE)	p-value
Global physical health	42.63 (0.72)	45.59 (0.92)	+3.44 (0.77)	<.001
Global mental health	48.84 (0.81)	51.49 (1.00)	+2.66 (0.75)	<.001
Physical functioning	40.28 (0.85)	43.79 (0.94)	+3.48 (0.75)	<.001
Ability to participate in social roles and activities	47.93 (0.86)	50.95 (1.00)	+3.26 (1.06)	.003