PALL-06. IMPROVING PATIENT OUTCOMES THROUGH A MULTIDISCIPLINARY NEURO-ONCOLOGY REHABILITATION CLINIC

Abstract

BACKGROUND: Patients with brain tumors often exhibit significant functional deficits and have multiple rehabilitation needs. Early access to rehabilitation services may reduce morbidity particularly associated with falls. Multidisciplinary clinics have been shown to optimize health care delivery, improve survival and quality of life in patients with other chronic neurological diseases. METHOD(S): Patients with immediate complex rehabilitation needs were identified from the Neuro-Oncology clinic. Patients were evaluated by their Neuro-Oncologist followed by a Physical Therapist and Occupational Therapist during one appointment. Patients completed the EORTC QLQ-30 and BN-20 questionnaires, the Activities-specific Balance Confidence scale (ABC) and 3-question fall risk assessment. Therapists completed the Functional Reach test (FRT) and Timed up and go test (TUG) and provided therapy and education. Patient satisfaction was assessed following each appointment. RESULT(S): 8 patients (5 male) were seen and evaluated. Median age was 52 years (range, 34-71); 6 patients had primary brain tumors, median KPS was 75% (range, 50%-80%). Median global health status/QOL score was 67% (range, 0-83%). Median ABC scale was 28% (range, 0-70%), median TUG of 14.5s [range, 8-160s], and median FRT of 12.25in (range, 11-15in). Five patients reported a fall in the prior 3 months; 4 patients reported fear of falls; 6 patients reported difficulty ambulating. At follow-up, 1 patient reported prior fall, 3 patients reported fear and 4 patients reported difficulty ambulating. Universally, patients reported the experience as positive, convenient and helpful. DISCUSSION: This multidisciplinary approach was developed to increase timely rehabilitation services to patients with complex needs. Treated patients were highly debilitated with substantial functional deficits and reduced quality of life. Patients reported high levels of satisfaction with the intervention and felt well educated. There was a trend towards improved answers on the fall questionnaires post-intervention over time. Further evaluation investigating quality of life impact is ongoing.