Abstract
Introduction:
Patient implementation of breast cancer-related lymphoedema treatment recommendations is often considered suboptimal. This study explored patient implementation of occupational therapy breast cancer-related lymphoedema treatment recommendations and identified barriers and enablers.
Method:
An observational retrospective cohort study was conducted using clinical data from a tertiary hospital’s prospective surveillance model of care for early breast cancer-related lymphoedema detection and intervention. Patients who received occupational therapy were included, and implementation levels were compared above and below a 70% threshold.
Results:
Among 63 patients (median age = 60 years, interquartile range 47.0–70.0), 73% (n = 46) implemented over 70% of recommendations and 29% achieved full implementation. Pain (54%, n = 34) was the main barrier, while strong support networks (63.5%, n = 40) were the leading enabler. Lower implementation was associated with receipt of taxane chemotherapy (p = 0.030), fewer therapy interventions provided (p < 0.001), type of tumour (p = 0.014), lymphoedema management not seen as a patient priority (p = 0.001) and receiving nicotine treatment (p = 0.038). Sentinel node biopsy (p = 0.024) and understanding the risks of poor lymphoedema management (p = 0.019) were associated with increased patient implementation.
Conclusion:
Most patients implemented >70% of breast cancer-related lymphoedema treatment recommendations; however, understanding and addressing clinical and psychosocial factors could optimise implementation and improve outcomes.
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