title: Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial.
abstract: OBJECTIVE
  One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial.
  
  
  METHODS
  Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65) or control group (n = 68). The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial), quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis.
  
  
  RESULTS
  Return-to-work rates were 86% and 83% (p = 0.6) for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14-435) versus 192 days (range 82-465) (p = 0.90) with a hazard ratio of 1.03 (95% CI 0.64-1.6). Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups.
  
  
  CONCLUSIONS
  The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which aspects of the intervention are useful and which elements need improvement.
  
  
  BACKGROUND
  Nederlands Trial Register (NTR) 1658.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. S.J.Tamminga@amc.uva.nl
authors.forename: Sietske J
authors.initials: SJ
authors.lastname: Tamminga
authors.forename: Jos H A M
authors.initials: JH
authors.lastname: Verbeek
authors.forename: Monique M E M
authors.initials: MM
authors.lastname: Bos
authors.forename: Guus
authors.initials: G
authors.lastname: Fons
authors.forename: Jos J E M
authors.initials: JJ
authors.lastname: Kitzen
authors.forename: Peter W
authors.initials: PW
authors.lastname: Plaisier
authors.forename: Monique H W
authors.initials: MH
authors.lastname: Frings-Dresen
authors.forename: Angela G E M
authors.initials: AG
authors.lastname: de Boer
mesh_terms: D003362:Cost-Benefit Analysis / Q000191:economics*; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000534:rehabilitation*; D010817:Physician-Patient Relations; D011788:Quality of Life; D062707:Return to Work / Q000191:economics*; D018582:Sick Leave / Q000191:economics; D014937:Work / Q000191:economics*