Oral Presentation COSA-IPOS Joint Scientific Meeting 2012

Vocational rehabilitation services for patients with cancer: a pilot randomised controlled trial among women with breast cancer following surgery (#199)

Richard G Kyle 1 , William R Culbard 1 , Josie Evans 2 , Nicola M Gray 3 , Gill Hubbard 1
  1. Cancer Care Research Centre, University of Stirling, Stirling, United Kingdom
  2. School of Nursing, Midwifery and Health, University of Stirling, Stirling, United Kingdom
  3. Centre for Academic Primary Care, University of Aberdeen, Aberdeen, United Kingdom

Aims
To assess: (1) effectiveness of an existing vocational rehabilitation (VR) service for people with cancer; (2) intervention acceptability; (3) feasibility of a larger future randomised controlled trial (RCT).

Methods
A pilot RCT was conducted. Eligible participants were: (1) women aged between 18 and 65 years old; (2) in paid employment or self-employed; (3) living or working in Lothian or Tayside, Scotland, UK; (4) diagnosed with an invasive breast cancer tumour or ductal carcinoma in situ (DCIS); (5) treated first with surgery. Twenty-three patients were recruited from two National Health Service (NHS) boards in Scotland over 12 months. Patients were randomised to receive referral to a VR service or usual care, which involved no formal employment support, and followed-up for 6-months post-surgery. The primary outcome measure was self-reported sickness absence in the first 6-months post-surgery. Secondary outcome measures were changes in quality of life (FACT-B), fatigue (FACIT-Fatigue), and employment status between baseline and 6-month follow-up. A qualitative evaluation involving trial participants was conducted to assess intervention acceptability and the feasibility of a future RCT.

Results
This paper presents findings from 6-month follow-up which completes in June 2012. Interviews with trial participants identified the intervention was acceptable among women with breast cancer. Low eligibility rates pose the greatest challenge to the feasibility of a future RCT.

Conclusion
This the first study to determine the effectiveness of VR services for cancer patients in terms of self-reported sickness absence and changes in quality of life, fatigue and employment status. Findings will inform the future development of appropriate VR services for people living with cancer. A future RCT of VR services adopting the pilot trial processes would be feasible. However, recruitment challenges would need to be overcome through inclusion of more clinical sites and people with different types of cancer.

Trial registration
ISRCTN29666484