Impact of Real-World Outpatient Cancer Rehabilitation Services on Health-Related Quality of Life of Cancer Survivors across 12 Diagnosis Types in the United States

Abstract

Compared to adults without cancer, cancer survivors report poorer health-related quality of life (HRQOL), which is associated with negative treatment outcomes and increased healthcare use. Cancer-specialized physical and occupational therapy (PT/OT) could optimize HRQOL; however, the impact among survivors with non-breast malignancies is unknown. This retrospective (2020-2022), observational, study of medical record data of 12 cancer types, examined pre/post-HRQOL among cancer survivors who completed PT/OT. PROMIS^® HRQOL measures: Global Health (physical [GPH] and mental [GMH]), Physical Function (PF), and Ability to Participate in Social Roles and Activities (SRA) were evaluated using linear mixed effect models by cancer type, then compared to the minimal important change (MIC, 2 points). Survivors were 65.44 ± 12.84 years old (range: 19-91), male (54%), with a median of 12 visits. Improvements in GPH were significant (p < 0.05) for all cancer types and all achieved MIC. Improvements in GMH were significant for 11/12 cancer types and 8/12 achieved MIC. Improvements in PF were significant for all cancer types and all achieved the MIC. Improvements in SRA were significant for all cancer types and all groups achieved the MIC. We observed statistically and clinically significant improvements in HRQOL domains for each of the 12 cancer types evaluated.

Keywords: cancer; cancer rehabilitation; cancer survivors; health-related quality of life; occupational therapy; patient-reported outcomes; physical therapy.

Figure 1

Percentage of cases reporting impairments in HRQOL domains at baseline, overall, and by cancer type. Abbreviations HRQOL, health-related quality of life. HRQOL impairment was determined using established cut points for each PROMIS^® measure: (a) global physical health (T-score ≤ 41), (b) global mental health (T-score ≤ 39), (c) physical function (T-score ≤ 45), and (d) ability to participate in social roles and activities (T-score ≤ 45) [40]. * The within-group percentage of impairment was significantly different than the percentage of impairment observed overall, p < 0.05.