Effectiveness and implementation of work-related medical rehabilitation in cancer patients: Results from a cluster randomized multicenter trial

Introduction/Background Work is a central resource for cancer survivors impacting health and quality of life. Effective rehabilitation programs supporting return to work become increasingly relevant for cancer survivors. In Germany, such programs were established as work-related medical rehabilitation, comprising work-related diagnostics, functional capacity training, psychosocial groups and intensified social counseling. The study investigated the effectiveness of work-related medical rehabilitation compared to conventional medical rehabilitation. Material and method We conducted a cluster randomized multicenter trial. 484 cancer patients aged 18 to 60 years were recruited in four inpatient rehabilitation centers. Patients of a center starting their rehabilitation in the same week represented a cluster. These clusters were randomly assigned with computer-generated randomization schedules to intervention (IG) or control group (CG). The primary outcome was the role functioning scale of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire as assessed at the 12-month follow-up. Secondary outcomes were other quality of life domains, disease coping and return to work. Effects were estimated using random effects models. The study was registered in the German Clinical Trials Register (DRKS00007770). Results Analysis of delivered dose of treatments indicated a successful implementation of work-related medical rehabilitation. 379 patients, 197 in IG, were included in the analysis of the 12-month follow-up. There was no significant difference between IG and CG in role functioning ( b  = 3.69; 95% CI: −2.01;9.39; P  = 0.204) and any secondary outcome. Results indicate effects in favor of those patients with a high risk for early retirement in IG regarding role functioning ( b  = 10.54; 95% CI: 1.68–19.40; P  = 0.020) and physical functioning ( b  = 7.84; 95% CI: 2.60–13.08; P  = 0.003). Conclusion Work-related medical rehabilitation had no significant effects on primary and secondary outcomes compared to conventional medical rehabilitation. However, participants with an increased risk for health-related early retirement may benefit from a work-related medical rehabilitation program.