Abstract
Purpose Purpose is to: (1) study effectiveness of the hospital-based work support intervention for cancer patients at two years of follow-up compared to usual care and (2) identify which early factors predict time to return-to-work (RTW). Methods In this multi-center randomised controlled trial (RCT), 106 (self-)employed cancer patients were randomized to an intervention group or control group and provided 2 years of follow-up data. The intervention group received patient education and work-related support at the hospital. Primary outcome was RTW (rate and time) and quality of life (SF-36), and secondary outcomes were, work ability (WAI), and work functioning (WLQ). Univariate Cox regression analyses were performed to study which early factors predict time to full RTW. Results Participants were diagnosed with breast (61%), gynaecological cancer (35%), or other type of cancer (4%). RTW rates were 84% and 90% for intervention versus control group. They were high compared to national register-based studies. No differences between groups were found on any of the outcomes. Receiving chemotherapy (HR = 2.43, 95% CI 1.59–3.73 p < 0.001), low level of education (HR = 1.65, 95% CI 1.076–2.52 p = 0.02) and low work ability (HR = 1.09 [95% CI 1.04–1.17] p = 0.02) were associated with longer time to full RTW. Conclusions We found high RTW rates compared to national register-based studies and we found no differences between groups. Future studies should therefore focus on reaching the group at risk, which consist of patients who receive chemotherapy, have a low level of education and have a low work ability at diagnosis.Trial registrationNetherlands Trial Registry (NTR) (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1658): NTR1658.
Highlights
Due to improvement in survival rates, returning to paid work after a cancer diagnosis is of increasing relevance to cancer patients, their families, employers, and the society at large [1]
133 cancer patients were included in the study; 65 were assigned to the intervention group and 68 were assigned to the control group (Fig. 1)
At 2 years of follow-up, RTW status was reported by 49 patients (75% response) in the intervention group and 57 patients (84% response) in the control group
Summary
Due to improvement in survival rates, returning to paid work after a cancer diagnosis is of increasing relevance to cancer patients, their families, employers, and the society at large [1]. When able to return-to-work (RTW), many cancer patients have to make involuntary work changes such as working less hours [3] or experience fewer possibilities for development [4]. This is unfortunate, since work is important to cancer patients. Reasons for not being able to RTW are not primarily medical It is often an interaction between the person (e.g., person- and disease related factors) and the environment (e.g., work-related factors and culture and social security system context) [8,9,10,11,12]
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