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Should healthcare organisations offer ongoing rehabilitation services for patients undergoing haematopoietic cell transplant? A narrative review

Jaleel Mohammed (Physical Therapy Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia) (Rehabilitation Association for Hematopoietic Cell Transplant, Gloucester, UK)
Russell Kabir (Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK)
Hadeel R. Bakhsh (Department of Rehabilitation, College of Health and Rehabilitaion Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia)
Diana Greenfield (Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK) (Rehabilitation Association for Hematopoietic Cell Transplant, Gloucester, UK)
Volkova Alisa Georgievna (First Pavlov State Medical University of St. Petersburg, Saint-Petersburg, Russia) (Rehabilitation Association for Hematopoietic Cell Transplant, Gloucester, UK)
Aleksandra Bulińska (Hematology and Transplantology Clinic, University Clinical Centre, Gdańsk, Poland) (Rehabilitation Association for Hematopoietic Cell Transplant, Gloucester, UK)
Jayanti Rai (Kent and Canterbury Hospital, Canterbury, UK) (Rehabilitation Association for Hematopoietic Cell Transplant, Gloucester, UK)
Anne Gonzales (Nationwide Children’s Hospital, Columbus, Ohio, USA) (Rehabilitation Association for Hematopoietic Cell Transplant, Gloucester, UK)
Shahrukh K. Hashmi (Mayo Clinic, Rochester, Minnesota, USA) (Rehabilitation Association for Hematopoietic Cell Transplant, Gloucester, UK)

International Journal of Health Governance

ISSN: 2059-4631

Article publication date: 6 January 2021

Issue publication date: 4 June 2021

140

Abstract

Purpose

Hematopoietic stem cell transplant (HSCT) patients can suffer from long-term transplant-related complications that affect their quality of life and daily activities. This study, a narrative review, aims to report the impact of HCT complications, the benefits of rehabilitation intervention, the need for long-term care and highlights the research gap in clinical trials involving rehabilitation.

Design/methodology/approach

A comprehensive search strategy was performed on several databases to look for relevant articles published from 1998 to 2018. Articles published in English with the following terms were used: hematopoietic stem cell transplant, chronic graft-versus-host disease, rehabilitation, exercise, physical therapy, occupational therapy. A patient/population, intervention, comparison, and outcomes (PICO) framework was employed to ensure that the search strategies were structured and precise. Study year, design, outcome, intervention, sample demographics, setting and study results were extracted.

Findings

Of the 1,411 records identified, 51 studies underwent title/abstract screening for appropriateness, 30 were reviewed in full, and 19 studies were included in the review. The review found that, for the majority of patients who underwent HSCT and developed treatment-related complications, rehabilitation exercises had a positive impact on their overall quality of life. However, exercise prescription in this patient group has not always reflected the scientific approach; there is a lack of high-quality clinical trials in general. The review also highlights the need to educate healthcare policymakers and insurance companies responsible for rationing services to recognise the importance of offering long-term follow-up care for this patient group, including rehabilitation services.

Practical implications

A large number of HSCT patients require long-term follow-up from a multidisciplinary team, including rehabilitation specialists. It is important for healthcare policymakers and insurance companies to recognise this need and take the necessary steps to ensure that HSCT patients receive adequate long-term care. This paper also highlights the urgent need for high-quality rehabilitation trials to demonstrate the feasibility and importance of rehabilitation teams.

Originality/value

Healthcare policymakers and insurance companies need to recognise that transplant patients need ongoing physiotherapy for early identification of any functional impairments and appropriate timely intervention.

Keywords

Acknowledgements

Authorship contributions: JM and RK worked on the first draft of the manuscript. All authors contributed substantially to the analysis and interpretation of the data for the work.The corresponding author would like to thank the Deanship of Scientific Research at Princess Nourah bint Abdulrahman University for funding this research through the Fast-track Research Funding Program.Funding: The corresponding author was supported by funds from the Deanship of Scientific Research at Princess Nourah bint Abdulrahman University through the Fast-track Research Funding Program.

Citation

Mohammed, J., Kabir, R., Bakhsh, H.R., Greenfield, D., Georgievna, V.A., Bulińska, A., Rai, J., Gonzales, A. and Hashmi, S.K. (2021), "Should healthcare organisations offer ongoing rehabilitation services for patients undergoing haematopoietic cell transplant? A narrative review", International Journal of Health Governance, Vol. 26 No. 2, pp. 114-134. https://doi.org/10.1108/IJHG-05-2020-0045

Publisher

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Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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