JMIR Publications

ABSTRACT

Background:

Return-to-work (RTW) is a key unmet need for working age cancer survivors.

Objective:

This study sought to evaluate RTW outcomes of a multidisciplinary intervention provided as routine employee support.

Methods:

In a retrospective cohort analysis, patients with cancer and more than 3 months absent from work were provided an intervention consisting of digital resources and calls with a health coach. A logit regression model was used to calculate a propensity score using covariates of age, gender, insurance benefit type, date of cancer diagnosis and time from diagnosis derived from insurance-claims data and captured as standard business practice. Participants were matched on a 1:1 basis using the nearest-neighbor method without replacement to create a matched control group from a further 1,856 participants who did not receive the intervention.

Results:

220 participants 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). In the matched control group, 22 returned to work (17.6%) compared with 38 (30.4%) in the intervention group (P=.02). Nineteen matched controls died prior to claim closure (15.2%) compared with 13 in the intervention group (10.4%; P=.26). Cox model estimated median time for the first 15% of the cohorts to RTW was 87.1 weeks for the matched control (CI 60.0-109.1 weeks) compared with 70.6 weeks for the intervention (CI 52.6-79.6 weeks; P=.08).

Conclusions:

A digitally delivered coaching program in a real-world setting for patients diagnosed with cancer improves the likelihood of RTW.