Tailored work-related support for patients with gastrointestinal cancer Development and evaluation of an early intervention in clinical practice

Almost half of the patients with cancer are of working age and their survival rate is steadily increasing. Due to the increasing retirement age, the number of cancer survivors in the working population will rise. Although (return-to) work-related problems are experienced even at diagnosis, there are no support interventions yet at that particular moment. Work-related problems can vary in severity and therefore it is of interest to tailor this kind of support to the patient.
The focus of this thesis was to develop and evaluate a tailored work-related support intervention in the clinical setting for patients diagnosed with curative gastro-intestinal (GI) cancer. The development of the intervention was based on literature and expert consultations; it included three types of psychosocial work-related support, based on the severity of the work-related problems. The healthcare professionals assigned to provide this supportive care were tailored as well including an oncological nurse, an oncological occupational physician or a multidisciplinary team.
A multicenter Randomized Controlled Trial (RCT) was performed to evaluate this tailored work-related support intervention in clinical practice. In total, 88 patients were randomly assigned. The primary outcome ‘days until full-time or partial RTW’ showed a difference of 43 days between the intervention – and control group. The intervention was generally perceived as positive and feasible. Notwithstanding, along with the positive experiences, there were some barriers as well which need to be tackled in future. The process evaluation offers scope for improvement in future research.