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Gallagher A, Shersher V, Mortimer D, Truby H, Haines T. The Cost-Effectiveness of Adjunctive Lifestyle Interventions for the Management of Cancer: A Systematic Review. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:225-242. [PMID: 36163450 PMCID: PMC9931860 DOI: 10.1007/s40258-022-00759-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE There is a paucity of papers synthesizing the cost-effectiveness (CE) of lifestyle interventions to support cancer patients, and the synthesis papers available have used analytic methods that do not permit easy comparison between studies. We therefore evaluated the CE of adjunctive lifestyle interventions compared with usual care. METHODS A systematic literature search of Scopus, MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Library databases was conducted from database inception until June 2021. Eligible studies were economic evaluations from randomised controlled trials or modelled economic evaluations that recruited subjects with a confirmed diagnosis of cancer and were allocated to a lifestyle intervention as an adjunct or supportive treatment, or usual care. Studies were excluded if there was no cost-effectiveness analysis or if costs were identified but not related back to measures of effectiveness. CE of the included interventions was recalculated, adjusting for key differences (with respect to absolute resource costs and timing) between the broad range of study settings and a common 'target' setting. All CE data were converted into incremental net monetary benefit using a common cost-effectiveness threshold to facilitate comparison. The quality of the studies was evaluated for risk of bias using the ECOBIAS check list. RESULTS Nine studies were included in our review. Seven studies investigated the benefits of physical exercise in combination with cancer treatment and two studies investigated the combination of exercise and psychosocial counselling alongside cancer treatment. Six studies with an exercise intervention reported larger quality-adjusted life year (QALY) gains compared with usual care and when cost per QALY gained was considered, three of the interventions were cost effective. One of the two interventions combining exercise with psychosocial counselling was cost effective. All studies were considered of good quality but all had some limitations. CONCLUSIONS The evidence to support the cost effectiveness of lifestyle interventions in patients with cancer is mixed with four of the nine interventions found to be cost effective and two remaining cost effective when uncertainty was taken into account. Sensitivity analysis showed the influence of the CE threshold on the results, highlighting the importance of selecting a CE threshold that is appropriate to the setting. SYSTEMATIC REVIEW REGISTRATION PROSPERO Registration Number: CRD42020185376.
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Affiliation(s)
- Andrew Gallagher
- Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, National Centre for Healthy Ageing, Monash University, Peninsula Campus, Building G, Level 3, Monash University Campus, Frankston, VIC, 3199, Australia.
| | - Violetta Shersher
- Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, National Centre for Healthy Ageing, Monash University, Peninsula Campus, Building G, Level 3, Monash University Campus, Frankston, VIC, 3199, Australia
| | - Duncan Mortimer
- Faculty of Business and Economics, Centre for Health Economics, Monash University, Clayton Campus, Clayton, VIC, Australia
| | - Helen Truby
- Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, National Centre for Healthy Ageing, Monash University, Peninsula Campus, Building G, Level 3, Monash University Campus, Frankston, VIC, 3199, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, Queensland, Australia
| | - Terry Haines
- Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, National Centre for Healthy Ageing, Monash University, Peninsula Campus, Building G, Level 3, Monash University Campus, Frankston, VIC, 3199, Australia
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Nagata T, Ito R, Nagata M, Odagami K, Kajiki S, Fujimoto K, Matsuda S, Mori K. The differences of the economic losses due to presenteeism and treatment costs between high-stress workers and non-high-stress workers using the stress check survey in Japan. J Occup Health 2022; 64:e12346. [PMID: 35797140 PMCID: PMC9262123 DOI: 10.1002/1348-9585.12346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/08/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study sought to examine differences in the economic losses due to presenteeism and costs of medical and dental treatment between high-stress workers and non-high-stress workers using the stress check survey. METHODS We conducted a cross-sectional study from April 1, 2018 to March 31, 2019 in a pharmaceutical company. High-stress workers were classified with the Brief Job Stress Questionnaire using two methods: the sum method and the score converted method. The incidence of presenteeism and its costs were determined using a questionnaire. The costs of medical and dental treatment were calculated according to claims. We compared the costs between high-stress and non-high-stress workers using Wilcoxon's rank-sum test. RESULTS Of 3910 workers, 6.3% were classified as high-stress using the sum method and 6.6% were classified as high-stress using the score converted method. The costs associated with presenteeism and medical treatment among high-stress workers were higher than the costs among non-high-stress workers, whereas the costs associated with dental treatment were not. CONCLUSIONS To motivate employers to improve stressful work environments, it is recommended that presenteeism measurement items be added to the stress check survey, and that the methods used in this study be used to calculate the loss associated with high-stress workers in Japanese companies. However, we must be careful in interpreting absolute presenteeism loss amounts because they are poorly reliable and valid.
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Affiliation(s)
- Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Ryotaro Ito
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Masako Nagata
- Department of Occupational MedicineSchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
- Occupational Health Data Science CenterUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Kiminori Odagami
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Shigeyuki Kajiki
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Kenji Fujimoto
- Occupational Health Data Science CenterUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Shinya Matsuda
- Occupational Health Data Science CenterUniversity of Occupational and Environmental HealthKitakyushuJapan
- Department of Preventive Medicine and Community Health, School of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental HealthKitakyushuJapan
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Soejima T, Sato I, Takita J, Koh K, Kaneko T, Inada H, Ozono S, Kamibeppu K. Impacts of physical late effects on presenteeism in childhood cancer survivors. Pediatr Int 2020; 62:1241-1249. [PMID: 32402092 DOI: 10.1111/ped.14293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/28/2020] [Accepted: 05/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many childhood cancer survivors (CCSs) experience physical late effects related to their cancer types and treatment modalities. Physical late effects are an important factor in various occupational outcomes among CCSs. However, the relationship between physical late effects and presenteeism has remained unclear. This study aimed to estimate the impacts of physical late effects on presenteeism among employed CCSs. METHODS Childhood cancer survivors replied to a questionnaire regarding presenteeism, and their attending physicians assessed their physical late effects between September 2014 and December 2015. The Work Limitations Questionnaire was used to measure presenteeism. Propensity score analysis and a generalized linear model were used to adjust covariates related to physical late effects and / or presenteeism. RESULTS Of the 125 questionnaires distributed, 114 were returned. The data from 61 employed CCSs were analyzed. After controlling for covariates by propensity score analysis and generalized linear model, there were no significant differences in presenteeism between employed CCSs with either no or single physical late effects. However, employed CCSs with multiple physical late effects reported higher scores in Output (Estimate = 9.3, P = 0.041), Physical Demands (Estimate = 12.2, P = 0.020), and Productivity Loss scores (Estimate = 2.4, P = 0.045) on the Work Limitations Questionnaire than employed CCSs with no physical late effects. CONCLUSIONS Employed CCSs with multiple physical late effects were at an increased risk for presenteeism. Healthcare and social welfare systems should be established to provide vocational assistance for CCSs after being employed to alleviate presenteeism.
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Affiliation(s)
- Takafumi Soejima
- Department of Family Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Health Quality and Outcome Research, Division of Nursing Systems, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Iori Sato
- Department of Family Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Health Quality and Outcome Research, Division of Nursing Systems, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Takita
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto-shi, Kyoto, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama-shi, Saitama, Japan
| | - Takashi Kaneko
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Fuchu-shi, Tokyo, Japan
| | - Hiroko Inada
- Department of Pediatrics, Kurume University School of Medicine, Kurume-shi, Fukuoka, Japan
| | - Shuichi Ozono
- Department of Pediatrics, Kurume University School of Medicine, Kurume-shi, Fukuoka, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Health Quality and Outcome Research, Division of Nursing Systems, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Drewnowski A. Impact of nutrition interventions and dietary nutrient density on productivity in the workplace. Nutr Rev 2020; 78:215-224. [PMID: 31889196 DOI: 10.1093/nutrit/nuz088] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The global spread of diet-related noncommunicable diseases represents a threat to public health and national economies alike. The elimination of poverty and the eradication of hunger, two key United Nations Sustainable Development Goals, cannot be accomplished without a well-nourished labor force. Easy access to low-cost diets that are energy dense but nutrient poor has resulted in hidden hunger, in which micronutrient deficiencies coexist with obesity or overweight. Workplace interventions in low- and middle-income countries have addressed nutrient adequacy and micronutrient deficiencies, often using fortified foods. Workplace interventions in high-income countries have largely focused on weight loss, smoking cessation, stress reduction, and physical activity. Even though improvement of productivity may have been the ultimate goal, relatively few interventions in high-income countries have explored the likely impact of improved dietary nutrient density on workplace performance. Given that optimal nutrition benefits both physical and mental health, interventions to improve diet quality ought to have a measurable impact on the productivity of the labor force. The present review examines the evidence linking workplace dietary interventions with workplace productivity measures.
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Affiliation(s)
- Adam Drewnowski
- A. Drewnowski is with the Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
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