Importance of an interdisciplinary approach to terminal pediatric cancer patients

Research Objectives: To investigate the effects of an interdisciplinary approach to the pediatric patients with advanced cancer.

Design: This is a case series descriptive study looking at three pediatric patients diagnosed with advanced cancer at a pediatric hospital admitted for an inpatient rehabilitation course. An interdisciplinary team consisting of speech therapy, occupational therapy,
physical therapy and rehabilitation medicine identified patients that had participated in acute rehabilitation in past five years, were 18 years or younger, and had a cancer diagnosis thought to be terminal. Electronic medical records of patients were reviewed.

Setting: The study setting is a pediatric acute rehabilitation unit within a large academic pediatric hospital.

Participants: The participants were pediatric patient 18 years or younger, requiring inpatient rehabilitation, and diagnosed with advanced cancer.

Interventions: Each patient in the case series was determined to have acute rehabilitation goals by a rehabilitation physician, the patient and patient’s caregiver agreed with rehabilitation course, and the patient was admitted to a comprehensive inpatient rehabilitation. Following course of rehabilitation, an interdisciplinary team reviewed their course in electronic medical record.

Main Outcome Measures: The main outcome measures were functional status at discharge including mobility, communication, feeding, and ADL level. Secondary outcomes were the patient discharge location, length of stay, and any ethical considerations the team identified.

Results: The results showed that all three patients benefited from an interdisciplinary rehabilitative approach evidenced by significant improvement in functional status in multiple domains, two of the three discharged home, and average length of stay 5 weeks 4 days. The team identified several ethical considerations that had the potential to affect patient outcomes.

Conclusions: Pediatric patients with advanced cancer diagnoses benefit from an interdisciplinary approach to transitioning home and optimizing functional recovery. Larger case controlled prospective studies should be done to determine more about the benefit including patient and caregiver experience, therapeutic window and timeline, and differences between the vast cancer diagnoses.

Author(s) Disclosures: The authors have no disclosures.