title: Patient compliance with a health care provider referral for an occupational therapy lymphedema consult.
abstract: OBJECTIVE
  Limited information exists on breast cancer patients' compliance to attend outpatient appointments with an occupational therapy (OT) lymphedema specialist. The objectives of this study were (1) to examine patient compliance with a health care provider referral for an OT lymphedema consult and (2) to identify potential barriers to compliance.
  
  
  METHODS
  A retrospective chart review of female breast cancer patients at the UC San Diego Health System was conducted. Electronic medical records were queried for breast cancer patients, who received a health care provider referral for an OT lymphedema consult between June 1, 2010 and December 31, 2011. Descriptive statistics and Fisher's exact chi-square tests were used to examine how specific participant characteristics were associated with attending an OT appointment.
  
  
  RESULTS
  A total of 210 female patients received an OT referral from a health care provider related to their breast cancer diagnosis. Forty-three (20.5%) patients did not attend an OT appointment. Non-attenders were more likely to have had fewer lymph nodes removed (P<0.01) when compared to attenders. The two most common barriers to attendance were the presence of health problems and undergoing chemotherapy and/or radiation at the time of the OT referral.
  
  
  CONCLUSIONS
  While most breast cancer patients attended recommended OT lymphedema consults, a substantial number of women might benefit from further education about OT for lymphedema prevention following breast cancer treatment. Further research to understand barriers to attendance is recommended, particularly among women with only sentinel nodes removed.
authors: Moores UCSD Cancer Center, University of California, San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0901, USA.
authors: Sally A
authors: SA
authors: Dominick
authors: Loki
authors: L
authors: Natarajan
authors: John P
authors: JP
authors: Pierce
authors: Hala
authors: H
authors: Madanat
authors: Lisa
authors: L
authors: Madlensky
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D002140:California; D005260:Female; D006282:Health Personnel; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000517:prevention & control / Q000534:rehabilitation / Q000628:therapy*; D008875:Middle Aged; D009788:Occupational Therapy / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies