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Poster Display session

200P - The value of holistic assessment and rapid intervention: The lung cancer outpatient occupational therapy service (LCOOTS)

Date

03 Apr 2022

Session

Poster Display session

Topics

Tumour Site

Thoracic Malignancies

Presenters

Jenny Welford

Citation

Annals of Oncology (2022) 33 (suppl_2): S117-S121. 10.1016/annonc/annonc858

Authors

J. Welford

Author affiliations

  • NUTH - Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne/GB
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Abstract 200P

Background

Frailty is a complex syndrome which can be accelerated by lung cancer, its symptoms and treatments. Lung cancer presents unique challenges within this population, which can significantly impact upon function and quality of life. We aimed to ascertain whether a specialist occupational therapist could provide timely assessment and intervention to manage frailty, symptoms such as fatigue and breathlessness, reduce social admissions to hospital, maintain function and increase the frequency of future planning conversations.

Methods

The Newcastle upon Tyne Hospitals NHS Foundation Trust funded a one-year pilot with charity funds to recruit x1 full-time specialist occupational therapist to design and run the Lung Cancer Outpatient Occupational Therapy Service from April 2021. Data collected included patient demographics, socioeconomic deprivation, clinical frailty scores, admission avoidance, bed days in hospital, clinical interventions and future planning conversations.

Results

98 patients (43 male, 55 female) with a mean age of 72 received an occupational therapy assessment over a 40 week period. 571 contacts took place and 569 interventions were delivered (mean: 5.8 per patient). Patients scored 5.3 on average using the Clinical Frailty Scale at initial assessment (range 4-7), presenting a mild/moderate level of frailty. 35% (n=34) engaged in future planning conversations and as a result 75% of patients achieved their preferred place of death. To date 43 patients are deceased (median 52 days between assessment and date of death). 26 visits to the emergency department/admissions to hospital were avoided as a result of rapid intervention and there were no admissions for social reasons. Bed days in hospital were reduced by 4.85 days (12.25 VS 7.40). Feedback from patients and the multidisciplinary team was positive.

Conclusions

Patients with lung cancer have high levels of physical, psychological and social need due to their disease and its symptoms. Occupational therapists specialising in oncology possess an array of clinical skills that can tackle frailty, symptom management, functional disruption and future planning early in the clinical pathway.

Legal entity responsible for the study

The author.

Funding

Charlie Bear for Cancer Care funds this post (The Newcastle upon Tyne Hospitals NHS Foundation Trust's Cancer Charity).

Disclosure

The author has declared no conflicts of interest.

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