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Patient compliance with a health care provider referral for an occupational therapy lymphedema consult

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Abstract

Purpose

Limited information exists on breast cancer patients’ compliance to attend outpatient appointments with an occupational therapy (OT) lymphedema specialist. The objectives of this study were (1) to examine patient compliance with a health care provider referral for an OT lymphedema consult and (2) to identify potential barriers to compliance.

Methods

A retrospective chart review of female breast cancer patients at the UC San Diego Health System was conducted. Electronic medical records were queried for breast cancer patients, who received a health care provider referral for an OT lymphedema consult between June 1, 2010 and December 31, 2011. Descriptive statistics and Fisher’s exact chi-square tests were used to examine how specific participant characteristics were associated with attending an OT appointment.

Results

A total of 210 female patients received an OT referral from a health care provider related to their breast cancer diagnosis. Forty-three (20.5 %) patients did not attend an OT appointment. Non-attenders were more likely to have had fewer lymph nodes removed (P < 0.01) when compared to attenders. The two most common barriers to attendance were the presence of health problems and undergoing chemotherapy and/or radiation at the time of the OT referral.

Conclusions

While most breast cancer patients attended recommended OT lymphedema consults, a substantial number of women might benefit from further education about OT for lymphedema prevention following breast cancer treatment. Further research to understand barriers to attendance is recommended, particularly among women with only sentinel nodes removed.

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Acknowledgments

Research related to the development of this paper was supported by Award Number T32-GM084896 from the National Institute of General Medical Sciences and partially supported by the National Institutes of Health, grant UL1-TR000100. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of General Medical Sciences or the National Institutes of Health. Study investigators would like to thank Kenneth Nunes Jr., who provided us with the initial list of 274 patients, and Resenia Collins and Patricia Kormanik, who contributed their lymphedema expertise, time, and effort to this research project. Study investigators also thank the UC San Diego Health System medical personnel and patients who made this chart review possible.

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Authors and Affiliations

  1. Moores UCSD Cancer Center, University of California, San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0901, USA

    Sally A. Dominick, Loki Natarajan, John P. Pierce & Lisa Madlensky

  2. Institute for Behavioral and Community Health, San Diego State University, San Diego, CA, USA

    Hala Madanat

  3. Graduate School of Public Health, San Diego State University, San Diego, CA, USA

    Hala Madanat

Authors
  1. Sally A. Dominick
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  2. Loki Natarajan
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  3. John P. Pierce
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  4. Hala Madanat
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  5. Lisa Madlensky
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Corresponding author

Correspondence to Lisa Madlensky.

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Dominick, S.A., Natarajan, L., Pierce, J.P. et al. Patient compliance with a health care provider referral for an occupational therapy lymphedema consult. Support Care Cancer 22, 1781–1787 (2014). https://doi.org/10.1007/s00520-014-2145-z

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  • DOI: https://doi.org/10.1007/s00520-014-2145-z

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