Return to Work in Lung Transplant Recipients: An Australian Perspective - Predictors, Health Status and Outcomes

Abstract

Purpose Return to work (RTW) and social participation after chronic illness improves functional outcomes, social integration and quality of life, enabling positive contribution to society. Despite this, many studies around the world have reported RTW rates as low as 28% in lung transplant recipients. This study aims to evaluate the number of patients that RTW, predictors of RTW and social participation in Australian lung transplant recipients Methods In a cross-sectional sample of lung transplant recipients, we assessed self-reported pre and post-transplant employment, social participation including volunteer work and carer/social engagement. Quality of life measurements including self-reported hospital admissions, sick days and Euroquol 5D-5L scores were collated. Results 82 patients (47 males; mean age 57.8±14.5) are included to date. Underlying condition requiring transplantation included COPD (42%), Cystic fibrosis (23%), ILD (20%) and other (15%). Mean time post-transplant at time of survey was 5 years. At the time of transplant: 15% (n=12) were working, 11% (n=9) were looking after a child, 10% (n=9) had retired, 10% (n=8) were carers for family members with disability or chronic illness, 7% (n=6) were engaged in voluntary work, 6% (n=5) of patients had never worked and 2% (n=2) were studying. The majority of patients (79%) had worked at some-point. Following transplant: 40% (n=32) are retired, 27% (n= 22) have returned to work, 7% (n=6) looking after children, 6% (n=5) engaged in voluntary work, 4% (n=3) are studying and 4% (n=3) are carers for family members with disability or chronic illness. The mean Euroquol health status scores (scale 0 to 100 [best health possible]) for the post-transplant population were: 86 (carer/volunteer/studying), 82 (working), 80 (retired) and 77 (not working). Conclusion This study provides preliminary data in Australia comparable to world-wide studies, with an estimated RTW rate of 27% post-lung transplantation. However, patients are also engaged in other activities including volunteer work and carer responsibilities, which has not been previously documented. Further analysis is planned. Return to work and social engagement should be encouraged for lung transplant recipients for improving health status.