ABSTRACT
BACKGROUND: Returning to work is a key unmet need for working-age cancer survivors. OBJECTIVE: This study sought to evaluate return-to-work outcomes of a multidisciplinary intervention provided as routine employee support. METHODS: In a retrospective cohort analysis, patients with cancer and more than 3 months of absence from work were provided with an intervention consisting of digital resources and calls with a health coach. Propensity score matching was used to define a similar cohort of cancer patients absent from work, who were not offered the coaching intervention. The return-to-work rate as a percentage of all participants and secondary outcomes, such as the rate of death, were measured. The median time to return to work was compared between the cohorts using the Kaplan-Meier method. RESULTS: A total of 220 participants were enrolled in the intervention, of which 125 met the criteria for analysis. The median follow-up from cancer diagnosis was 79 weeks (IQR 60-106 weeks). In the matched control group, 22 (17.6%) participants returned to work compared with 38 (30.4%) in the intervention group (P=.02). Additionally, 19 (15.2%) matched controls died prior to claim closure compared with 13 (10.4%) in the intervention group (P=.26). The Kaplan-Meier estimated median time for the first 15% of the cohort to return to work was 87.1 weeks (95% CI 60.0-109.1 weeks) for the matched control group compared with 70.6 weeks (95% CI 52.6-79.6 weeks; P=.08) for the intervention group. CONCLUSIONS: Patients receiving a remotely delivered coaching program in a real-world setting returned to work at a higher frequency than did control participants receiving usual care.
ABSTRACT
Pain is an understudied and undertreated consequence of cancer survival. Pain education is now a recommended treatment approach for persistent non-cancer pain, yet it has not been well applied to the context of adolescent and young adult (AYA) cancer survival. In March 2018, an interdisciplinary meeting was held in Adelaide, South Australia to set a research agenda for pain education in AYA cancer survivors. We identified that AYAs with persistent pain and those with heightened pain-related fear have the potential to benefit from pain education. We identified a number of unique challenges of engaging AYA survivors in pain education, and point towards future research directions.