Screening based individualized rehabilitation following primary breast cancer treatment -The ReScreen study

Even though breast cancer is associated with a good prognosis it is well known that almost half of the women develop chronic physical and psychological problems and that their need for rehabilitation support varies greatly.

Despite this, no evidence exists for how women with increased need for support systematically can be identified and how evidence-based individualized rehabilitation can be secured.

The ReScreen study is designed as a complex randomized controlled trial with the overall aim to develop and evaluate a model for screening-based individualized rehabilitation for women with breast cancer.

Study 1 is conducted as a randomized controlled trial in which all patients are screened 2 weeks following diagnosis aiming to identify women with extended rehabilitation needs, using the Distress Thermometer (scale 0-10).

Those who report distress ≥5 are randomized to intervention (IG) or control group (CG), while women with low distress (≤4) form an observation group (OG). Patients in the CG and OG receive "care as usual".

In addition, the IG receive evidence-based individualized rehabilitation and is followed up proactively by a research nurse.

The effect of the intervention is evaluated focusing on physical and psychological recovery, health care utilization, sick absence and experiences of the rehabilitation process.

In addition, a psychometric study evaluating the optimal cut-off for screening for distress (study 2) and a registered based cohort study focusing on the effects of the Swedish guidelines for cancer rehabilitation (study 3) will be conducted.

The project has the potential to fundamentally influence the healthcare organization on cancer rehabilitation by developing and evaluating a clinically relevant model for individualized rehabilitation.

With diagnosis-specific adjustments, the model can also be used as a basis for the development towards individualized rehabilitation for patients with other cancer diagnoses.