(275) Ask about activities of daily living! A prospective analysis of adult cystic fibrosis referrals to occupational therapy - a single center experience

Background: Cystic fibrosis is a lifelong multisystem condition that can be emotionally and physically challenging, impacting the ability to manage everyday activities of daily living (ADL) [1]. Despite this, there is limited literature describing the extent and nature of the impact on activities and participation in people with cystic fibrosis (pwCF). Occupational therapy is an evidence-based profession that aims to promote health and wellbeing by enabling people of all ages to do the activities that matter to them now and in the future. In the United Kingdom however, pwCF are not routinely offered an occupational therapy review within specialist care and there is limited knowledge of the impact of CF on their daily activities.

Methods: In December 2021, a pilot occupational therapy role was introduced at a single adult center covering a mixed caseload including both CF and non-CF respiratory conditions. Referrals were triaged through verbal discussions before being accepted. Prospective data collection of age, gender, presence of CF complications, employment status and reasons for referral was undertaken and will continue for the duration of a 12-month pilot.

Results: From December 2021 to March 2022 referrals to occupational therapy were accepted for 19 pwCF (6 male, 13 female; age range 18 to 69 years). CF-related arthritis (CFRA) was a complication experienced by 52% (n=10) and 79% (n=15) had CF-related diabetes (CFRD). None of the pwCF referred were in full-time employment. Reasons for referral were: personal ADLs (n=15) including transfers/ mobility, bathing, grooming, toileting, dressing and managing treatments, instrumental ADLs (n=11) including meal preparation, laundry, shopping and driving, leisure (n=3) including forming new relationships and sports, and rest (n=1). The majority of referrals indicated difficulties in more than one category.

Conclusions: Adults with cystic fibrosis related complications such as CFRD and CFRA are overrepresented in referrals to occupational therapy within this small sample size. Personal ADLs appear to be the most commonly reported area of difficulty. Preliminary results suggest that those with CF related complications may benefit from occupational therapy assessment and intervention to improve performance in ADLs and overall quality of life.

Acknowledgements:

References: [1] Castellani C, Duff A, Bell S, Heijerman H, Munck A, Ratjen F et al. ECFS best practice guidelines: the 2018 revision. Journal of Cystic Fibrosis. 2018;17(2):153-178. https://doi.org/10.1016/j.jcf.2018.02.006