0861 Does Cognitive Behavioral Therapy for Insomnia Reduce Productivity Loss in Cancer Survivors with Cognitive Impairment?

Abstract

Abstract Introduction Insomnia and perceived cognitive impairments (PCI) affect 1 in 4 cancer survivors and negatively affects work productivity. This study explores the impact of cognitive behavioral therapy for insomnia (CBT-I) on work presenteeism and absenteeism in cancer survivors with comorbid insomnia and PCI. Methods A sub-sample of 42 Atlantic Canadian survivors with insomnia disorder and PCI who were currently working for pay were analyzed as part of a larger randomized clinical trial. Participants completed 7 virtual sessions of CBT-I. The Work Productivity and Activity Impairment Index Specific Health Problem Questionnaire (WPAI: SHP) was administered pre-and post-treatment. Absenteeism was defined as the percentage of time absent from work, while presenteeism was defined as the extent to which health problems affected productivity at work in the past 7 days. Costs were calculated by the human capital method. Significant changes in productivity loss were defined at ≥15% or 20% change in absenteeism and presenteeism, respectively. Descriptive statistics and paired samples t-tests were used to measure changes in productivity following treatment. Average net benefit was calculated by subtracting the average treatment cost from average treatment benefits after 1 year to reflect cost savings after CBT-I. The cost of treatment was estimated in terms of average cost per session and lost time at work. Results Participants (76% Female) were, on average, 50.4 years old with 16.6 years of education. Breast cancer was the most reported cancer type (43%). Overall rates of presenteeism were significantly lower at post-treatment (p=<.001, d=0.55), with 52.4% reporting significant reductions. Absenteeism rates from pre- to post-treatment were not significant (p=.11, d=0.20). Reduced productivity loss post-treatment was associated with an average savings of CAD$10,979/person/year. Average net benefits for the first-year post-treatment equaled CAD$9348/person. Conclusion CBT-I can improve work productivity in cancer survivors. Investments to increase and provide access to evidence-based treatment may lead to significant savings for individuals and businesses. Support (if any) Dr. Sheila Garland is supported by a Canadian Cancer Society Emerging Scholar Award (Survivorship) (grant #707146). This project was funded through a grant from the Canadian Institutes of Health Research (CIHR) (grant number: PJT 162428) and the Beatrice Hunter Cancer Research Institute.