Abstract
AIM: Central nervous system (CNS) tumours are associated with debilitating physical and psychological sequlea resulting in reduced functional independence and quality of life (QoL). Nationally access to support and rehabilitation services should be offered to all patients with a CNS tumour throughout their treatment pathway (LCA 2014, NICE 2004). The aim was to develop an integrated rehabilitation model of care that optimises patient care through an active and planned approach; reviewing symptoms, rehabilitation and support needs at all stages of disease. METHOD: All new neuro-oncology patients attending outpatient consultant clinics at Guy’s Cancer Centre were offered a holistic rehabilitation assessment to identify their individual concerns. The assessments were completed by a specialist Physiotherapist and or Occupational therapist and individual intervention plans were created. Over a 6 month period, July to December 2016, data was collected on patient characteristics, symptom concerns, QoL indicators, onward referrals and patient experience. RESULTS: 64 patients completed the assessments with 92% reporting unmet concerns. Of those reporting concerns the most common symptoms highlighted were; fatigue (83%), emotions/mood (72%), limb weakness (67%) difficulties managing daily activities (65%), mobility and falls (63%), sleep concerns (54%), memory/concentration (52%), appetite/weight (39%) and pain (18%). 59 patients went on to receive rehabilitation interventions. The most common referrals were to specialist cancer rehabilitation services (71%). Other referrals included social services (26%) and rapid response home teams (44%). Case reviews demonstrated; optimisation of mobility and physical function and admission avoidance. Patient outcomes have included improved symptom control, ability to work and satisfaction in managing activities of daily living. CONCLUSION: Providing neuro-oncology patients with early assessment of their rehabilitation concerns has enabled timely implementation of their rehabilitation care plan. This has been integral in reducing avoidable admissions and improving patient’s level of symptom burden and QoL.