Effectiveness of a tailored return to work program for cancer survivors with job loss: results of a randomized controlled trial

Abstract

Background: Up to 53% of cancer survivors (CSs) experiences job loss during or after treatment. To support CSs with job loss in the Netherlands, a tailored return to work (RTW) program was developed. The objective of this study was to assess the effectiveness of the program on duration until sustainable RTW in CSs with job loss. Material and methods: This study employed a two-armed (intervention/control) randomized controlled design with one-year follow-up. The primary outcome measure was duration until sustainable RTW. The secondary outcome measures were: rate of RTW, fatigue, quality of life, and participation in society. Descriptive analyses, Kaplan-Meier estimators and Cox regression analyses were conducted. Results: Participants (N ¼ 171) had a mean age of 48.4 years (SD ¼ 8.6). The majority was female (69%) and breast cancer survivor (40%). The crude hazard ratio (HR) for duration until sustainable RTW was 0.86 (95% CI 0.46-1.62; p ¼ 0.642). In the adjusted model, the intervention group had a slight, but statistically non-significant, improvement in duration until sustainable RTW compared to the control group (HR 1.16; 95% CI 0.59-2.31; p ¼ 0.663). The program did not have any significant effects on secondary outcome measures. Conclusion: As the tailored RTW program did not demonstrate a statistically significant effect on duration until sustainable RTW in CSs with job loss, implementation of the program in its current form is not recommended.

Return to Work Interventions for Cancer Survivors: A Systematic Review and a Methodological Critique

“…The initial search returned 2419 records, of which 34 (among them, two articles identified through reference lists and authors’ names) were retained for full-text analysis. Finally, 10 articles [33,34,35,36,37,38,39,40,41,42] were included in this systematic review without disagreement (i.e., inter-judge agreement = 100%). Figure 1 presents a flow-diagram of the research article selection process.…”

“…The majority of the interventions developed in these studies did not specifically address one cancer location ( n = 7 out of 10; [35,36,37,39,40,41,42]). Nevertheless, more than 50% of the patients recruited in these studies were breast and gynecological cancer patients.…”

“…Intervention programs were offered to either patients undergoing treatment ( n = 4 out of 10; [33,34,35,36]), or to patients who had completed primary treatment for at least 2 weeks [39], 1 year [40,42] or for less than 2 years [37] (i.e., chemotherapy and/or radiotherapy) ( n = 5; [37,39,40,41,42]) or to all the patients, independently of the disease track ( n = 1 out of 10; [38]). In total, 499 patients (from 7 to 106 patients), mostly women (425 women and 74 men), were included in these studies, with a mean age ranging from 45.8 to 56.25 years.…”

Functional Impairments and Work-Related Outcomes in Breast Cancer Survivors: A Systematic Review

“…An important limitation to the study is that findings are difficult to compare between countries, due to major differences in social security systems [ 59 ]. For instance, in countries such as Canada and the Netherlands it is possible to work under therapeutic conditions, that is, to resume part-time work and gradually increase work activities and working hours over the course of multiple years while receiving partial disability benefits [ 60 , 61 ]. In other countries, however, disability benefits are only granted in case of more severe work incapacity, though at the same time, employees are at risk of termination of their employment contract [ 59 ].…”

A return-to-work intervention protocol directed at cancer patients (self-assessment, tailored information & lifestyle management for returning to work among cancer patients, START): A multi-center, randomized controlled trial

“…In recent literature, several studies have documented the development or efficacy of various interventions, including psycho-educational, vocational, and physical support, to facilitate RTW of cancer patients [ [17] , [18] , [19] , [20] ]. Results from several randomized controlled trials (RCT) suggest that multidisciplinary interventions, as compared to a single type of intervention, are more effective in improving RTW outcomes [ 17 , 19 ].…”