Persistent pain after finishing breast cancer treatment is a common and disabling problem. The current state-of-the-art pain management advocates, in addition to biomedical (non-)pharmacological approaches, a biopsychosocial rehabilitation approach to address persistent pain, combining pain science education with promoting an active lifestyle through self-regulation techniques. We propose testing an innovative eHealth self-management support programme for this purpose in the breast cancer population with persistent pain after finishing cancer treatment. This delivery mode is believed to reduce barriers to pain self-management by providing timely, safe and cost-effective assistance addressing the biopsychosocial needs of patients. Utilising a chatbot format, the eHealth programme delivers pain science education and promotes physical activity (PA), personalised through decision-tree-based algorithms to support pain self-management. The programme aims to empower patients with understanding, coping skills and self-management techniques to reduce pain-related disability and enhance participation in daily life. The primary objective is to determine programme effectiveness compared with (1) usual care (superiority) and (2) a similar face-to-face pain self-management support programme (non-inferiority).

A pragmatic, three-arm randomised controlled trial was started in April 2024 at the University Hospitals of Antwerp and Leuven and primary care settings in Belgium. Participants are breast cancer survivors with persistent pain after finishing cancer treatment. Two hundred seventy participants will be randomised to one of three trial arms: (1) eHealth self-management support programme, (2) usual care or (3) a face-to-face self-management support programme. The ‘eHealth self-management support programme’ begins with a pain science education (PSE) module to initially convey key pain-related concepts and provide personalised pain management tips. Then, the programme progresses to daily activity planning to promote an active lifestyle. Guided by the Health Action Process Approach (HAPA) model, participants set and review daily activity goals and track progress. The eHealth self-management programme uses a chatbot and is accessible on any digital device. The ‘usual care programme’ involves sending the participants a study-specific brochure by postal mail and does not include any formal PSE and/or PA programmes. They may pursue or continue self-initiated care. In Belgium, usual care primarily involves pharmacological treatment, general advice on PA and the provision of informational brochures. The ‘face-to-face self-management support programme’ mirrors the eHealth intervention, combining PSE with PA coaching. It starts with three individual sessions with a trained physical therapist for biopsychosocial assessment and PSE, followed by six sessions on goal setting and active lifestyle coaching. The educational content is delivered both verbally and in written form. The primary outcome will be pain-related disability 6 months after baseline assessment. As a key secondary outcome, the effect on pain beliefs and attitudes will be investigated after the educational part of the eHealth and face-to-face programme (ie, at 6 weeks after baseline). Other secondary outcomes related to other dimensions of pain and physical-, psychosocial- and health-economic outcomes will be assessed at 12 weeks and 6 and 12 months after baseline as well.

The study will be conducted in accordance with the Declaration of Helsinki (2024). The protocol has been approved by the ethical committee of the University Hospitals of Leuven and Antwerp. Results will be disseminated via peer-reviewed scientific journals and presentations at congresses. Ethical Committee of the University Hospitals Leuven and Antwerp: BUN B3002023000132.

ClinicalTrials.gov Identifier: NCT06308029.

Preoperative exercise training is recommended, when feasible, for people undergoing resection for lung cancer and has been shown to reduce the risk of postoperative pulmonary complications and improve preoperative exercise capacity. However, preoperative exercise training programmes are not commonly available in the Australian clinical practice setting due to a range of factors including resource and time restrictions. We aim to describe the protocol to evaluate the implementation of an existing preoperative exercise training programme in people undergoing lung cancer resection in an Australian setting.

This is an evaluation of a secondary objective of a study examining the effect of lung cancer resection on exercise capacity, lung function and symptoms of dyspnoea and quality of life. Participants will be prospectively recruited at the time of lung cancer diagnosis and planned surgical treatment through the lung cancer multidisciplinary team of a metropolitan hospital in Sydney, Australia. All participants will be offered the choice of participating in the preoperative exercise training programme which encompasses a hybrid gym and telerehabilitation programme of up to five sessions/week from baseline until surgical date. The programme will be evaluated using the Reach, Effectiveness, Adoption, Implementation, Maintenance Framework including both quantitative and qualitative measures which will be analysed using descriptive statistics and qualitative analysis coded inductively.

The study has received ethical approval through the Northern Sydney Local Health District reference 2023/ETH01643 and has been registered prospectively. Findings will be disseminated through peer-reviewed publication and scientific conference presentation.

ACTRN12624000359538.