[Guideline development for rehabilitation of breast cancer patients - phase 2: findings from the classification of therapeutic procedures, KTL-data-analysis].
BACKGROUND
Aim of this project is the development of an evidence based guideline for the rehabilitation of breast cancer patients, funded by the German Pension Insurance scheme. The project consists of four phases. This paper is focused on the 2nd phase, i.e., analysis of procedures in rehabilitation based on evidence based therapeutic modules.


METHODS
As a result of a systematic literature review 14 therapeutic modules were defined. From a total of 840 possible KTL Codes (Klassifikation Therapeutischer Leistungen, Classification of therapeutic procedures), 229 could be assigned to these modules. These analyses are based on 24685 patients in 57 rehabilitation clinics, who had been treated in 2003. For these modules the number of patients having received those interventions as well as the duration of the modules were calculated. The data were analysed with respect to the influence of age and comorbidity. Moreover, differences between rehabilitation clinics were investigated according to the category of interventions.


RESULTS
Our findings show great variability in the use of the therapeutic modules. Therapeutic modules like Physiotherapy (91.6%), Training Therapy (85.2%) and Information (97.8%) are provided to most of the patients. Younger patients receive more treatments than older patients, and patients with higher comorbidity receive more Physiotherapie, Lymphoedema Therapy and Psychological Interventions than patients without comorbidities.


CONCLUSIONS
Data analysis shows wide interindividual variability with regard to the therapeutic modules. This variability is related to age and comorbidity of the patients. Furthermore, great differences were found between the rehabilitation clinics concerning the use of the various interventions. This variability supports the necessity of developing and implementing an evidence based guideline for the rehabilitation of breast cancer patients. The next step will be discussing these findings with experts from science and clinical practice.
Domann
U
U
Klinik für Tumorbiologie, Klinik für onkologische Rehabilitation und Nachsorge, Freiburg. ursula.domann@t-online.de
Brüggemann
S
S
Klosterhuis
H
H
Weis
J
J
D001943:Breast Neoplasms / Q000534:rehabilitation*; D019317:Evidence-Based Medicine; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D009313:National Health Programs; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic