MBOR-O - Effectiveness of work-related medical rehabilitation in cancer: a cluster-randomized multicenter study

More than one third of all cancers affect persons of working age. For persons with cancer, the return to work is often a sign that their lives are returning to normality. It is therefore perceived as an important step in coping after this life-threatening event.
In the first two years after the diagnosis, nine in every 10 of those affected successfully return to work, but persons with cancer are at higher risk of unemployment and occupational restrictions than healthy control groups. Multidisciplinary interventions with a clear occupational focus can support the return after cancer disease.
Work-related medical rehabilitation is considered a promising strategy to improve work participation. Randomized controlled trials have compared the effectiveness of work-related medical rehabilitation in individuals with orthopedic diseases to the outcomes of conventional medical rehabilitation and have been able to confirm improved return to work-rates in favor of participants in work-related medical rehabilitation programs. The aim of the research project was to evaluate the effectiveness of work-related medical rehabilitation in patients with cancer and specific vocational challenges. For this purpose, conventional medical rehabilitation for oncological diseases was supplemented, among work-related functional capacity training, psychosocial group sessions, and intensified social counseling.
The study was conducted as a cluster-randomized trial in four oncological rehabilitation centers. Data were collected through surveys at the beginning and end of rehabilitation, as well as three months and one year after the end of rehabilitation. The primary outcome was role functioning in work and leisure. Secondary outcome measures included general health status, physical and emotional functioning, pain, fatigue, coping with illness, subjective work ability, and return to work.

The analyses of the dose delivered and the perception of work-related content showed that work-related medical rehabilitation was successfully implemented and carried out. Our study was able to consistently demonstrate slight advantages of work-related medical rehabilitation at the end of rehabilitation and after three months. However, no long-term benefits for the intervention group could be documented one year after rehabilitation. An implementation of work-related medical rehabilitation in oncology, as carried out by us in the four rehabilitation centers, is unlikely to improve work participation of individuals with cancer.