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T. Fynmore



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    OA14 - Nurses in Care for Lung Cancer and in Research (ID 398)

    • Event: WCLC 2016
    • Type: Oral Session
    • Track: Nurses
    • Presentations: 1
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      OA14.06 - The Role of a Multi-Disciplinary Team Approach to Early Rehabilitation and Symptom Management in Thoracic Oncology (ID 5013)

      16:55 - 17:05  |  Author(s): T. Fynmore

      • Abstract
      • Presentation
      • Slides

      Background:
      In the United Kingdom thoracic cancer is mainly diagnosed in an older population, who generally have significant co-morbidities, and advanced stage disease. Due to this, they experiences high levels of disease burden, both physical and psychological, impacting on individuals’ functional independence and quality of life (QoL). The national governing bodies, such as NICE and LCA, recommend that all patients should have access to an Holistic Needs Assessment (HNA) and rehabilitation services. At Guy's And St Thomas' NHS Foundation Trust (GSTFT) we have developed a multi-disciplinary team (MDT), consisting of Dietetics, Occupational Therapy (OT) and Physiotherapy (PT), who are present within the outpatient thoracic oncology clinics and aim to address the rehabilitation and supportive care needs of all patients.

      Methods:
      All new thoracic oncology patients attending outpatient consultant lead clinics at GSTFT were offered an HNA, in order to identify their individual concerns/needs. The assessments are completed by the MDT and individual intervention plans created. Over a three-month period, January to March 2015, data was collected on patient's diagnosis, treatment offered, treatment intent, symptom concerns, QoL indicators, onward MDT referrals and mortality.

      Results:
      82 patients completed the assessments, of these 85% reported unmet needs/concerns. The main tumour types seen were Adenocarcinoma, Squamous cell carcinoma, mesothelioma and small cell lung cancer. Of those reporting symptoms the most common were; breathlessness (55%), fatigue (52%), reduced appetite (43%), weight loss (41%), pain (37%), emotions/mood (33%). sleep concerns (33%), and reduced mobility (32%). 69 patients had onward referrals to supportive care services. The most common referrals were; OT (65%), PT (60%), Dietitian (43%), and patient information (38%). 66% of patients were provided with on the spot MDT intervention.

      Conclusion:
      Providing thoracic oncology patients access to an MDT service on their initial oncology visit, has enabled early identification of the key symptoms this patient group experience, as well as the need for allied health services. This has supported the role of early rehabilitation as being integral to improving patient's level of symptom burden and QoL. Moving forward it would be beneficial to do a comparative study of the symptoms and intervention needs of this patient group over a longitudinal analysis, with the aim of showing the impact of early rehabilitation on patient's QoL, survivorship, and life expectancy.

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