Internet-based cognitive rehabilitation for working cancer survivors: Results of a multicenter randomized controlled trial
Mené sur 279 patients ayant survécu à un cancer du système nerveux central, présentant des troubles cognitifs et professionnellement actifs, cet essai multicentrique randomisé évalue l'intérêt d'une intervention de réadaptation cognitive dispensée sur internet pour améliorer leurs fonctions physiques et leur qualité de vie
Cognitive problems contribute to decline in work performance. We evaluated (1) the effectiveness of basic self-management and extensive therapist-guided online cognitive rehabilitation on attainment of individually predetermined work-related goals among occupationally active cancer survivors, and (2) whether effectiveness of the programs differed for survivors with and without formal cognitive impairment.In a three-armed randomized controlled trial (NCT03900806), 279 non-central nervous system cancer survivors with cognitive complaints were assigned to the basic program (n = 93), the extensive program (n = 93), or a waiting-list control group (n = 93). Participants completed measurements pre-randomization (T0), 12 weeks post-randomization upon program completion (T1), and 26 weeks post- randomization (T2). Mixed-effects modeling was used to compare intervention groups with the control group on goal attainment, and on self-perceived cognitive problems, work ability, and health-related quality of life.Participants in the extensive program achieved their predetermined goals better than controls, at short- and long-term follow-up (Effect Size (ES)=.49; p<.001; ES=.34; p=.014). They also had less recovery needs after work (ES=-.21; p=.011), more vitality (ES=.20; p=.018), and better physical role functioning (ES=.0.43 p=.015) than controls. At long-term follow-up, this finding persisted for physical role functioning (ES=.42; p=.034). The basic program elicited a small positive non-significant short-term (not long-term) effect on goal attainment for those with adequate adherence (ES=.28, p=.053). Effectiveness of the programs did not differ for patients with or without cognitive impairment.Internet-based therapist-guided extensive cognitive rehabilitation improves work-related goal attainment. Considering the prevalence of cognitive problems in survivors, it is desirable to implement this program.