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Municipality-based pragmatic rehabilitation stratified in accordance with individual needs—results from a longitudinal survey study

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Abstract

Objective

Evidence on municipality-based cancer rehabilitation is sparse. This longitudinal study explores the following: (1) Rehabilitation needs, (2) effectiveness of municipality-based rehabilitation, and (3) whether rehabilitative services are stratified according to individual needs in breast cancer patients.

Methods

We collected data from a longitudinal survey among 82 breast cancer patients referred to municipality-based rehabilitation at the Copenhagen Centre for Cancer and Health. Rehabilitation needs, health-related quality of life (HRQoL), and functional status were collected using patient-reported outcomes (PROs) including distress thermometer, problem list, Functional Assessment of Cancer Therapy-Breast questionnaire (FACT-B), and upper body function with the abbreviated disability of the arm, shoulder, and hand (Quick-DASH) questionnaire. Data collection time points are as follows: entry, follow-up, and end of intervention.

Results

At referral, scores were (mean (range)) distress 4.0 (0–10), problems 9.5 (0–24), and FACT-B 103.0 (49.8–135.5). HRQoL increased during rehabilitation (FACT-B ∆ mean 8.1 points (> MID, p < 0.0001)); 56% had a positive change, 34% no difference, and 11% a decline. Those with the lowest FACT-B entry score had significantly longer duration of rehabilitation (10.9 vs 8.7 months, p < 0.001), higher number of services (7.0 vs 5.3, p < 0.003), and participated more in group-based exercise (+3 sessions: 57% vs 8%, p < 0.001).

Conclusion

This is the first study to report on pragmatic municipality-based cancer rehabilitation. The results suggest that services are aimed at patients with rehabilitation needs, improve HRQoL, and are properly stratified to those who need it the most. We suggest future monitoring of municipality-based rehabilitation services to ensure quality of care.

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Acknowledgements

The authors would like to thank the patients and staff at the rehabilitation center who participated in the study and Malene Strømberg Rasmussen for handling registry data.

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Authors and Affiliations

  1. Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Nørre Alle 45, DK-2200, Copenhagen N, Denmark

    Sine Rossen, Karen Trier & Jette Vibe-Petersen

  2. Department for Data and Analysis, Municipality of Copenhagen, Sjællandsgade 40, DK-2200, Copenhagen N, Denmark

    Berit Christensen

  3. Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark

    Martina A. Eriksen

  4. Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Vestergade 17, DK-5800, Nyborg, Denmark

    Ann-Dorthe Zwisler

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  1. Sine Rossen
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Correspondence to Sine Rossen.

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Rossen, S., Trier, K., Christensen, B. et al. Municipality-based pragmatic rehabilitation stratified in accordance with individual needs—results from a longitudinal survey study. Support Care Cancer 28, 1951–1961 (2020). https://doi.org/10.1007/s00520-019-04993-w

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