title: The prevalence of potentially modifiable functional deficits and the subsequent use of occupational and physical therapy by older adults with cancer.
abstract: BACKGROUND
  Occupational and physical therapy (OT/PT) services seek to reduce morbidity, mortality, and improve the quality of life of individuals; however, little is known about the needs and use of OT/PT for older adults with cancer. The goal of this study was to describe the functional deficits and their associations with other factors, and to examine the use of OT/PT after a noted functional deficit.
  
  
  METHODS
  This study analyzed data from an institution-based registry that included geriatric assessments of older adults with cancer linked to billing claims data. Logistic regression was used to model predictors of functional deficits. Use of OT/PT was determined and validated with medical chart review.
  
  
  RESULTS
  529 patients with cancer, a median age of 71, 78% were female, 87% Caucasian, 57% married, 53% post-secondary education, and 63% with breast cancer were included. In a multivariable model, the odds of having any functional deficits increased with age [5 year OR: 1.31, 95% CI: (1.10, 1.57)] were higher for those with a high school diploma versus those with advanced degrees [OR: 1.66, 95% CI: (1.00, 2.77)] and were higher for patients with comorbidities [OR: 1.15, 95% CI: (1.10, 1.21)]. Of patients with functional deficits only 9% (10/111) received OT/PT within 12 months of a noted deficit.
  
  
  CONCLUSIONS
  The odds of having any potentially modifiable functional deficit were higher in patients with increasing age, comorbid conditions, and with less than a college degree. Few were referred for OT/PT services suggesting major underutilization of these potentially beneficial services.
authors.affiliation: Cancer Care Quality Training Program, Department of Health Policy and Management, 1102G McGavran-Greenberg Hall, CB# 7411, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Electronic address: pergolot@email.unc.edu.
authors.forename: Mackenzi
authors.initials: M
authors.lastname: Pergolotti
authors.affiliation: Biostatistics and Clinical Data Management Core, University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, 450 West Drive, CB#7295, Chapel Hill, NC 27599, USA. Electronic address: Allison_Deal@med.unc.edu.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Deal
authors.affiliation: Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY 10032, USA. Electronic address: jalavery1123@gmail.com.
authors.forename: Jessica
authors.initials: J
authors.lastname: Lavery
authors.affiliation: Department of Health Policy and Management, 1101D McGavran-Greenberg Hall, Campus Box 7411, UNC Gillings School of Global Public Health, 135 Dauer Drive, Chapel Hill, NC 27599, USA. Electronic address: bbreeve@email.unc.edu.
authors.forename: Bryce B
authors.initials: BB
authors.lastname: Reeve
authors.affiliation: Department of Geriatric Oncology, University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, 170 Manning Drive, Chapel Hill, NC 27599, USA. Electronic address: hyman_muss@med.unc.edu.
authors.forename: Hyman B
authors.initials: HB
authors.lastname: Muss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy; D009657:North Carolina; D009788:Occupational Therapy / Q000706:statistics & numerical data*; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors
keywords: Cancer rehabilitation; Functional status; Geriatric assessment; Geriatric oncology; Health services research; Occupational therapy; Physical therapy