title: Positive and cost-effectiveness effect of spa therapy on the resumption of occupational and non-occupational activities in women in breast cancer remission: a French multicentre randomised controlled trial.
abstract: OBJECTIVE
  The main aim was to assess the effects of a spa treatment on the resumption of occupational and non-occupational activities and the abilities of women in breast cancer remission. A cost-effectiveness analysis (CEA) was also performed.
  
  
  METHODS
  A multicentre randomised controlled trial was carried out between 2008 and 2010 in the University Hospital of Auvergne and two private hospitals in Clermont-Ferrand, France. Eligible patients were women in complete breast cancer remission without contraindication for physical activities or cognitive disorders and a body mass index between 18.5 and 40 kg/m(2). The intervention group underwent spa treatment combined with consultation with dietician whereas the control underwent consultations with the dietician only. Of the 181 patients randomised, 92 and 89 were included in the intervention and the control groups, respectively. The CEA involved 90 patients, 42 from the intervention group and 48 from the control group.
  
  
  RESULTS
  The main results showed a higher rate of resumption of occupational activities in the intervention group (p = 0.0025) and a positive effect of the intervention on the women's ability to perform occupational activities 12 months after the beginning of the study (p = 0.0014), and on their ability to perform family activities (p = 0.033). The stay in a thermal centre was cost-effective at 12 months.
  
  
  CONCLUSIONS
  Spa treatment is a cost-effective strategy to improve resumption of occupational and non-occupational activities and the abilities of women in breast cancer remission.
authors.affiliation: Department of Public Health of Clermont-Ferrand Hospital University Hospital, 7 Place Henri Dunant, 63000 Clermont Ferrand, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE, F-63000 Clermont-Ferrand, France. Electronic address: c_mourgues@chu-clermontferrand.fr.
authors.forename: Charline
authors.initials: C
authors.lastname: Mourgues
authors.affiliation: Department of Public Health of Clermont-Ferrand Hospital University Hospital, 7 Place Henri Dunant, 63000 Clermont Ferrand, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE, F-63000 Clermont-Ferrand, France. Electronic address: lgerbaud@chu-clermontferrand.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Gerbaud
authors.affiliation: Department of Public Health of Clermont-Ferrand Hospital University Hospital, 7 Place Henri Dunant, 63000 Clermont Ferrand, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE, F-63000 Clermont-Ferrand, France. Electronic address: s_leger@chu-clermontferrand.fr.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Leger
authors.affiliation: Department of Public Health of Clermont-Ferrand Hospital University Hospital, 7 Place Henri Dunant, 63000 Clermont Ferrand, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE, F-63000 Clermont-Ferrand, France. Electronic address: cauclair@chu-clermontferrand.fr.
authors.forename: Candy
authors.initials: C
authors.lastname: Auclair
authors.affiliation: Department of Public Health of Clermont-Ferrand Hospital University Hospital, 7 Place Henri Dunant, 63000 Clermont Ferrand, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE, F-63000 Clermont-Ferrand, France. Electronic address: fpeyrol@chu-clermontferrand.Fr.
authors.forename: Fleur
authors.initials: F
authors.lastname: Peyrol
authors.affiliation: Department of Public Health of Clermont-Ferrand Hospital University Hospital, 7 Place Henri Dunant, 63000 Clermont Ferrand, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE, F-63000 Clermont-Ferrand, France. Electronic address: mblanquet@chu-clermontferrand.fr.
authors.forename: Marie
authors.initials: M
authors.lastname: Blanquet
authors.affiliation: Department of Oncogenetics, Comprehensive Anticancer Centre Jean Perrin, 58 Rue Montalembert, 63000 Clermont-Ferrand, France. Electronic address: Fabrice.KWIATKOWSKI@cjp.fr.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Kwiatkowski
authors.affiliation: Department of Oncogenetics, Comprehensive Anticancer Centre Jean Perrin, 58 Rue Montalembert, 63000 Clermont-Ferrand, France. Electronic address: anne.LEGER-ENREILLE@cjp.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Leger-Enreille
authors.affiliation: Department of Oncogenetics, Comprehensive Anticancer Centre Jean Perrin, 58 Rue Montalembert, 63000 Clermont-Ferrand, France. Electronic address: Yves-Jean.BIGNON@cjp.fr.
authors.forename: Yves-Jean
authors.initials: YJ
authors.lastname: Bignon
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000534:rehabilitation*; D003362:Cost-Benefit Analysis; D004035:Diet Therapy / Q000191:economics / Q000379:methods / Q000523:psychology; D005260:Female; D005602:France; D006801:Humans; D008405:Massage; D008875:Middle Aged; D009788:Occupational Therapy / Q000191:economics* / Q000379:methods / Q000523:psychology*; D012064:Relaxation Therapy / Q000191:economics* / Q000379:methods / Q000523:psychology*; D012074:Remission Induction; D029002:Steam Bath; D017741:Survivors / Q000523:psychology
keywords: Breast cancer; Oncology; Randomised controlled trial; Spa therapy; Work resumption