Effektivität von Interventionen in der Rehabilitation bei Prostatakarzinompatienten – Ein systematischer Literaturüberblick

Zusammenfassung

Hintergrund und Fragestellung: Eine systematische Literaturrecherche zur Wirksamkeit spezifischer, im Rahmen der Rehabilitation durchgeführter, Interventionen liegt bislang noch nicht für den Indikationsbereich Prostatakarzinom vor.

Methoden: Es erfolgte eine systematische Suche nach deutsch- oder englischsprachigen Studien zur Wirksamkeit rehabilitativer Interventionen bei Patienten mit Prostatakarzinom in den gängigen Datenbanken (Medline, Psyndex, PsychINFO, EBMR), Referenzlisten in Metaanalysen und Reviews. Außerdem fand eine Überprüfung prostatakarzinomspezifischer Leitlinien im Hinblick auf rehabilitationsrelvante Inhalte statt. Einbezogen wurden stationär und ambulant durchgeführte Interventionen, nicht berücksichtigt wurden Medikamentenstudien, diagnostische Verfahren und ärztlich-medizinische sowie pflegerische Maßnahmen. Aus einer Gesamtzahl von 1 627 626 Artikeln wurden letztlich 65 Studien einbezogen und hinsichtlich ihrer Qualität nach den Oxford Levels of Evidence eingeschätzt.

Ergebnisse: Für die folgenden rehabilitationsrelevanten Themenbereiche konnten Studien zur Überprüfung der Wirksamkeit bei Prostatakarzinompatienten identifiziert werden: Psychosoziale Intervention, Kontinenztherapie, Massage, Sporttherapie, Entspannungstherapie, Lymphdrainage, künstlerische Therapien und spezifische Interventionsprogramme mit mehreren Behandlungselementen. Keine prostatakarzinomspezifischen Studien fanden sich dagegen für die Interventionsbereiche Ernährungsschulung, Balneotherapie, Ergotherapie oder Sozialarbeit. Zusammenfassend kann für einen Großteil der rehabilitativen Elemente keine ausreichende oder widersprüchliche Evidenz bezüglich ihrer Wirksamkeit konstatiert werden.

Diskussion und Schlussfolgerung: Die Wirksamkeit der Maßnahmen, die in der onkologischen Rehabilitation bei Prostatakarzinompatienten durchgeführt werden, lässt sich nach der vorliegenden systematischen Literaturanalyse nur bei wenigen Interventionen belegen und ist bisher nur selten untersucht worden. Weitere prostatakarzinomspezifische Interventionsstudien in der Rehabilitation sind daher zur Absicherung der Befundlage erforderlich.

Abstract

Purpose: A systematic literature analysis of the effectiveness of specific rehabilitation-related interventions for prostate cancer patients has not been conducted so far.

Materials and Methods: Established literature databases (Medline, Psyndex, PsychINFO, EBMR) as well as reference lists, meta-analyses, and literature reviews were systematically searched for studies on the effectiveness of rehabilitation interventions for prostate cancer patients. Furthermore, guidelines for the treatment of prostate cancer were browsed for rehabilitation related content. Studies on both out-patient and in-patient interventions were included, whereas diagnostic studies as well as medical and nursing procedures and drug trials were excluded from the analysis. Out of a total of 1 627 626 articles, 65 articles were eventually included in the analysis and evaluated according to the Oxford Levels of Evidence.

Results: Studies on the effectiveness of interventions for prostate cancer patients were identified in the following rehabilitation-related areas: psychosocial interventions, urinary incontinence treatment, massage, sport therapy, relaxation techniques, lymph drainage, artistic therapies and interdisciplinary rehabilitation programmes. However, with regard to health education courses, balneotherapy, occupational therapy and social work, no studies including prostate cancer patients could be identified. For the majority of rehabilitation-related interventions, the evidence regarding their effectiveness was not sufficient or contradictory.

Discussion and Conclusions: The effectiveness of interventions carried out in the rehabilitation of prostate cancer patients was rarely examined so far. The systematic literature analysis shows, that up to now sufficient evidence was established for only few of these interventions. To substantiate the evidence, further studies on rehabilitation interventions focusing specifically on prostate cancer patients are required.

Schlüsselwörter

Rehabilitation - Prostatakrebs - rehabilitative Interventionen - systematische Literaturanalyse - Review

Key words

rehabilitation - prostate cancer - interventions - literature analysis - review

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