National Survey of Lymphedema Therapists’ Dosing of Complete Decongestive Therapy in Breast Cancer Survivors with Lymphedema

Purpose: The purpose of this study was to identify dosing levels of complete decongestive therapy (CDT) with survivors with Breast Cancer-Related Lymphedema (BCRL) and describe factors related to how occupational therapists, occupational therapy assistants, physical therapists, and physical therapists assistants with advanced lymphedema training determine dosing. Methods: An electronic survey was sent to 598 occupational therapists, occupational therapy assistants, physical therapists, and physical therapists assistants with training in lymphedema. Respondents completed questions regarding demographics, dosing practices, and factors related to dose determination in complete decongestive therapy of survivors with Breast Cancer-Related Lymphedema. Results: 107 surveys were returned (18% response rate). Most of the respondents (95.1%) reported providing less than the recommended daily dosing (7x/wk) of complete decongestive therapy to their survivors with Breast Cancer-Related Lymphedema. The mean dosing of complete decongestive therapy from respondents was approximately half of the recommended daily dosing (M=3.71). A statistically significant Pearson’s correlation was noted among frequency of dosing and treatment adherence (r=.275) and frequency of dosing and treatment readiness (r=.242). A multiple regression analysis found adherence accounted for a significant proportion of variability in dosing frequency (R²=.077; F change p Conclusions: A majority of therapists treating survivors with Breast Cancer-Related Lymphedema in an outpatient setting are not following daily recommended dosing of complete decongestive therapy. Clinicians’ dose determination is significantly impacted by their perception of a survivor’s readiness and adherence to lymphedema treatment and self-management. Comparative clinical outcomes studies of various therapeutic dosage levels (times per week) and duration (length of delivery) of complete decongestive therapy are imperative for development of best treatment protocols for survivors with Breast Cancer-Related Lymphedema. This study serves as a first step toward evidence based planning for complete decongestive therapy treatment of Breast Cancer-Related Lymphedema