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Identifying Barriers and Motivators to Breast Cancer-related Lymphedema Self Management Programs: A Case Series

Radhika Manne, MD (University of Pennsylvania PM&R Department, Philadelphia, PA); Jasmine Zheng, MD

Meeting: AAPM&R Annual Assembly 2021

Categories: General Rehabilitation (2021)

Session Information

Session Title: Research Spotlight: General Rehabilitation

Session Time: None. Available on demand.

Disclosures: Radhika Manne, MD: No financial relationships or conflicts of interest

Objective: To identify adherence rates to self-management programs in patients with breast cancer-related lymphedema, as well as to determine barriers and motivators in compliance with programs in the adult breast cancer-related lymphedema population.

Design: Cross-sectional studySetting : Outpatient lymphedema therapy centerParticipants : A case series of ten women with breast cancer-related upper extremity lymphedema between the ages of 38-58 were surveyed on factors affecting compliance with self-management home programs following completion of outpatient lymphedema therapy.

Interventions: Not applicable

Main Outcome Measures: Electronic survey measured the compliance with manual lymphatic drainage, home exercises, and compression garments; compliance was measured as “less than”, “same” or “more than” the amount of time each component of the program was prescribed by the therapist. The survey examined motivating factors in compliance, barriers to poor compliance, and approaches to improve continuity of home lymphedema program.

Results: Nine respondents with strong compliance in at least one portion of their home program reported the desire to improve pain, function, strength, and to decrease swelling and burden on their loved ones as motivating factors. Of the five poorly compliant patients, barriers included pain and lack of motivation. Only two respondents reported that time was a barrier, despite all respondents working full-time. One respondent reported insurance delayed her ability to obtain garments. Three of the respondents thought a short outpatient lymphedema therapy refresher course would be helpful in improving their compliance. Two thought teletherapy visits with their therapist and another two thought visits with the physician would increase their compliance.Conclusions: Pain, lack of motivation, and time were reasons that patients had poor compliance with home lymphedema programs. Majority of patients reported that availability of additional visits with therapists and physicians would improve compliance with home lymphedema programs.

Level of Evidence: Level IV

To cite this abstract in AMA style:

Manne R, Zheng J. Identifying Barriers and Motivators to Breast Cancer-related Lymphedema Self Management Programs: A Case Series [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/identifying-barriers-and-motivators-to-breast-cancer-related-lymphedema-self-management-programs-a-case-series/. Accessed May 12, 2025.
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