Predictors of Cancer Rehabilitation Medicine Referral and Utilization among Cancer Survivors

Research Objectives To examine patient-level predictors of referral to cancer rehabilitation medicine services following a physical activity screening assessment among cancer survivors. Design Secondary analysis of individuals that completed My Wellness Check Program (MWC), an electronic health record-integrated symptom screening and referral system for cancer survivors, between April 2021 and January 2022. Multivariable logistic regression models were fit to calculate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI). Setting Ambulatory oncology clinics in an urban academic medical center. Participants 1,174 cancer survivors who completed the Moving Through Cancer physical activity assessment and at least one MWC assessment battery. Interventions Not applicable. Main Outcome Measures Positive screening for physical inactivity (yes/no). Completed referral to cancer rehabilitation medicine services following a positive screen (yes/no). Results Forty-six percent of survivors screened positive as being physically inactive. Individuals with moderate-severe physical dysfunction compared to none-to-mild (aOR: 1.750; 95%CI: 1.137 - 2.693; p=0.0109) had higher odds and self-reporting Hispanic/Latino ethnicity compared to non-Hispanic/Latino ethnicity (0.720; 0.556, 0.932; p=0.0126) had lower odds of positive screening for physical inactivity. Only 31% of survivors with physical inactivity received a completed referral to cancer rehabilitation medicine services. There were no significant predictors associated with referral completion. Conclusions Self-reported physical function and ethnicity may help clinicians identify cancer survivors at risk for physical inactivity. Additional research on provider- and organizational-level variables are needed to determine the relationship between referral completion to cancer rehabilitation medicine services following physical activity assessments. Author(s) Disclosures This study was funded in part by grant P30CA240139 (Nimer, S: PI; Penedo, F: Cancer Control Co-Leader). P.I.M. was supported by a National Cancer Institute career development award (K01CA258955). We acknowledge the Miami Clinical & Translational Science Institute for their help with data collection on the primary study (UL1TR002736). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the National Institutes of Health.