Attendance rate and perceived relevance related to type, content, and delivery of current rehabilitation programmes after surgical resection for non-small cell lung cancer

Background: Surgical resection is the preferred treatment for localised non-small cell lung cancer (NSCLC). Rehabilitation is central in the management of the associated impaired quality of life, high symptom burden, deconditioning, and social-existential vulnerability. Yet, optimal content and delivery of rehabilitation are not yet defined. Therefore, we aimed to investigate the current rehabilitation offers, attendance rate, and perceived relevance related to content or delivery. Moreover, we investigated the current symptom burden in the patients.

Methods: We conducted an observational cohort study in patients who had undergone surgical resection for NSCLC 4-6 months earlier at Odense University Hospital, Denmark. We retrieved demographic data from patient registries, and interviewed patients via telephone concerning availability, uptake, and attendance rate of any rehabilitation offer in their local primary care setting; content and delivery; benefits of attending, experienced relevance and "symptom burden generally" (specially developed questions); and "symptom burden here and now" [Edmonton Symptom Assessment Scale (ESAS)].

Results: We approached 128 patients, reached 115, and interviewed the 100 (87%) patients who consented. In total, 88% (88/100) had received a rehabilitation offer, and 75% (66/88) had participated in programmes that either targeted NSCLC (23%) or were general cancer rehabilitation (33%), pulmonary rehabilitation (12%), online (1%), or other (33%). Disease-specific rehabilitation was significantly related to the highest attendance rate and perception of relevance. High attendance (≥75%) was, moreover, significantly related to the offer being delivered by a physiotherapist and having a focus on physical exercise. General symptoms were physically oriented [dyspnoea (65%), pain (47%), fatigue (78%)] and "mild" in ESAS scoring. No differences were observed in any baseline characteristics.

Conclusions: Rehabilitation after surgical resection for localised NSCLC is delivered heterogeneously in Denmark. Disease-specific rehabilitation was positively related to attendance rate and to the perceived relevance of the offer.