A Scoping Review Exploring Physiotherapy Navigator Roles in Acute Cancer Care Settings

This review aimed to explore and map the current evidence on the use of PT navigator roles, their decision-making processes, interventions delivered, and barriers and facilitators of the role in acute cancer care settings. 

This scoping review was conducted following the methodological framework by Arksey and O’Malley, Levac et al., and the Joanna Briggs Institute. Five databases and grey literature sources were searched from inception to July 2024. Studies had to meet the following criteria to be included: 1) adults ≥18 years old living with cancer, 2) used a navigation role or model of care led by a physical therapist, and 3) occurred in an acute cancer care setting. Two independent reviewers completed all screening and data extraction. Descriptive statistics and narrative summaries were provided where appropriate. 

Thirteen references were included, seven from database searches and six from the grey literature search. The PT navigator roles exhibited a range of characteristics, primarily focusing on triaging rehabilitation services based on assessment findings (100%), exercise planning and prescription (69.2%), referrals to appropriate services (53.8%), treatment and rehabilitation barrier identification (38.5%), education provision (30.8%), and goal setting (15.4%). Most PT navigators (76.9%) first interacted with patients soon after diagnosis or early in treatment (e.g., preoperatively or during the second treatment visit) and conducted follow-ups at various intervals (such as weekly, monthly, or as needed). A variety of facilitators and barriers to the PT navigator role were identified, and overall satisfaction with this role was high across studies.

This review summarized and presented the current evidence regarding PT navigation in acute cancer care settings. Future research is essential to develop a clear role description for PT navigators including specific tasks, guidelines for interactions, outcome assessment, and decision-making frameworks to assist in triaging patients effectively. 

PTs serving in navigator roles have the potential to improve the function and quality of life for individuals living with cancer. The barriers and facilitators identified in this review will be vital to consider for the development of PT navigator roles. Future research specifically investigating the cost-effectiveness of PT navigator interventions will be necessary to support the need for additional funding of such roles for cancer care managers and policy makers.