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Baum J, Lax H, Lehmann N, Merkel-Jens A, Beelen DW, Jöckel KH, Dührsen U. Impairment of vocational activities and financial problems are frequent among German blood cancer survivors. Sci Rep 2023; 13:22856. [PMID: 38129654 PMCID: PMC10739705 DOI: 10.1038/s41598-023-50289-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
Little is known about changes in the personal living conditions of long-term blood cancer survivors in Germany. To gather information about social relationships, work life, overall well-being, and religion, we performed a questionnaire-based retrospective study on 1551 survivors who had been on follow-up for ≥ 3 years (median, 9 years). Most survivors reported that marital status and relationships with relatives and friends remained constant before and after blood cancer. Vocational activities were temporarily impaired for 47.5%, with a median time of 11 months to return to work. More than a third of the patients (35.6%) discontinued work permanently, with disability and retirement pension rates of 7.9% and 38.1%, respectively, at the time of the survey. Financial problems due to reduced income were reported by 26.2%, in particular after relapse or allogeneic transplantation. Patient reports addressing their quality of life showed large variations. It was best in acute leukemia survivors without a history of allogeneic transplantation and worst in patients with myeloproliferative disorders. Religion tended to become more important after blood cancer. In conclusion, vocational impairment and financial problems are frequent among German blood cancer survivors. Efforts should be made at an early stage to reestablish the patients' ability to work.
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Affiliation(s)
- Julia Baum
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Hildegard Lax
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Nils Lehmann
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Anja Merkel-Jens
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Dietrich W Beelen
- Klinik für Knochenmarktransplantation, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Ulrich Dührsen
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
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Svingel LS, Christensen SF, Kjærsgaard A, Stenling A, Paulsson B, Andersen CL, Christiansen CF, Stentoft J, Starklint J, Severinsen MT, Borg Clausen M, Hagemann Hilsøe M, Hasselbalch HC, Frederiksen H, Bak M, Mikkelsen EM. Labor market affiliation of patients with myeloproliferative neoplasms: a population-based matched cohort study. Acta Oncol 2023; 62:1286-1294. [PMID: 37656802 DOI: 10.1080/0284186x.2023.2251670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/19/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Patients with myeloproliferative neoplasms (MPNs) suffer from substantial symptoms and risk of debilitating complications, yet observational data on their labor market affiliation are scarce. MATERIAL AND METHODS We conducted a descriptive cohort study using data from Danish nationwide registries, including patients diagnosed with MPN in 2010-2016. Each patient was matched with up to ten comparators without MPN on age, sex, level of education, and region of residence. We assessed pre- and post-diagnosis labor market affiliation, defined as working, unemployed, or receiving sickness benefit, disability pension, retirement pension, or other health-related benefits. Labor market affiliation was assessed weekly from two years pre-diagnosis until death, emigration, or 31 December 2018. For patients and comparators, we reported percentage point (pp) changes in labor market affiliation cross-sectionally from week -104 pre-diagnosis to week 104 post-diagnosis. RESULTS The study included 3,342 patients with MPN and 32,737 comparators. From two years pre-diagnosis until two years post-diagnosis, a larger reduction in the proportion working was observed among patients than comparators (essential thrombocythemia: 10.2 [95% CI: 6.3-14.1] vs. 6.8 [95% CI: 5.5-8.0] pp; polycythemia vera: 9.6 [95% CI: 5.9-13.2] vs. 7.4 [95% CI: 6.2-8.7] pp; myelofibrosis: 8.1 [95% CI: 3.0-13.2] vs. 5.8 [95% CI: 4.2-7.5] pp; and unclassifiable MPN: 8.0 [95% CI: 3.0-13.0] vs. 7.4 [95% CI: 5.7-9.1] pp). Correspondingly, an increase in the proportion of patients receiving sickness benefits including other health-related benefits was evident around the time of diagnosis. CONCLUSION Overall, we found that Danish patients with essential thrombocythemia, polycythemia vera, myelofibrosis, and unclassifiable MPN had slightly impaired labor market affiliation compared with a population of the same age and sex. From two years pre-diagnosis to two years post-diagnosis, we observed a larger reduction in the proportion of patients with MPN working and a greater proportion receiving sickness benefits compared with matched individuals.
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Affiliation(s)
- Lise Skovgaard Svingel
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
| | | | - Anders Kjærsgaard
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
| | | | | | | | - Christian Fynbo Christiansen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
| | - Jesper Stentoft
- Department of Hematology, Aarhus University Hospital, Denmark
| | | | | | - Mette Borg Clausen
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | | | | | - Marie Bak
- Department of Hematology, Zealand University Hospital, Denmark
| | - Ellen Margrethe Mikkelsen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
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Amatya B, Dickinson M, Khan F. Factors associated with long-term functional and psychosocial outcomes in patients with non-Hodgkin lymphoma. J Rehabil Med 2023; 55:jrm004816. [PMID: 36852625 PMCID: PMC9986761 DOI: 10.2340/jrm.v55.4816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/13/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE To assess the long-term functional, psychosocial and participation outcomes in an Australian cohort of non-Hodgkin lymphoma (NHL) survivors. METHODS A cross-sectional sample of adult NHL survivors at the Peter MacCallum Cancer Centre (between 2015 and 2020), participated by completing validated questionnaires. A series of analyses described their current level of function, psychosocial well-being, and participation. RESULTS Of 129 participants (mean (M) ± standard deviation (SD) age: 62.5 ± 8.8 years), the majority (58%) had aggressive NHL and grade III-IV (72%), with time since diagnosis of 4.6 ± 1.2 years. Participants reported ongoing issues after completion of treatment: fatigue (63%), bladder dysfunction (61%), cognitive impairment (53%), and NHL-related pain (46%). Most made good functional recovery (M ± SD) (Functional Independent Measure-Motor: 79.5 ± 8.2), reported minimal change in their negative emotional states, and NHL-specific quality of life (QoL) (Functional Assessment of Cancer Therapy-Lymphoma: 133.5 ± 22.1). Participants were "well" adjusted to community living (Community Integration Measure: 42.2 ± 7.4) and satisfied with their current life (Satisfaction with Life Scale: 26.3 ± 6.0). Factors significantly associated with the poorer current level of function were: age at diagnosis < 60 years, time since NHL diagnosis > 4.5 years, and aggressive NHL type. CONCLUSION Despite good functional recovery and adjustment in the community, NHL survivors report the presence of ongoing residual impairments and cognitive issues, which requires long-term rehabilitation-inclusive management.
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Affiliation(s)
- Bhasker Amatya
- Department of Rehabilitation Medicine, Royal Melbourne Hospital and Peter MacCallum Cancer Centre; Department of Medicine (Royal Melbourne Hospital), University of Melbourne; Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville, Victoria; Department of Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria.
| | - Michael Dickinson
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne; Department of Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Fary Khan
- Department of Rehabilitation Medicine, Royal Melbourne Hospital and Peter MacCallum Cancer Centre; Department of Medicine (Royal Melbourne Hospital), University of Melbourne; Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville, Victoria; Department of Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria
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Maksten EF, Jakobsen LH, Kragholm KH, Baech J, Andersen MP, Madsen J, Jørgensen JM, Clausen MR, Pedersen RS, Dessau-Arp A, Larsen TS, Poulsen CB, Gang AO, Brown P, Fonager K, El-Galaly TC, Severinsen MT. Work Disability and Return to Work After Lymphoma: A Danish Nationwide Cohort Study. Clin Epidemiol 2023; 15:337-348. [PMID: 36941977 PMCID: PMC10024509 DOI: 10.2147/clep.s399488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/23/2023] [Indexed: 03/14/2023] Open
Abstract
Purpose Many patients diagnosed with lymphoma are of working age. Cancer patients are known to have a higher risk of sick leave and disability pension, but this has only been delineated for certain subtypes of lymphoma. Therefore, this study aimed at investigating the overall risk of disability pension for all lymphoma subtypes and at quantifying return to work for patients with lymphoma in work before diagnosis. Patients and Methods Patients aged 18-60 years with lymphoma in complete remission (CR) diagnosed between 2000 and 2019 were included in the study. Using national registers, each patient was matched with five comparators from the general population with same sex, birth year, and level of Charlson Comorbidity Index. Risk of disability pension was calculated from 90 days after CR or end of treatment with competing events (death, retirement pension, early retirement pension, relapse for patients, or lymphoma diagnosis for comparators). Return to work for patients was calculated annually until 5 years after diagnosis for patients employed before diagnosis. Results In total, 4072 patients and 20,360 comparators were included. There was a significant increased risk of disability pension for patients with all types of lymphoma compared to the general population (5-year risk difference: 5.3 (95% confidence interval (CI): 4.4;6.2)). Patients with non-Hodgkin lymphoma were more likely to get disability pension than patients with Hodgkin lymphoma (sex- and age-adjusted 10-year risk difference: 2.9 (95% CI: 0.3;5.5)). One year after diagnosis, 24.5% of the relapse-free patients were on sick leave. Return to work was highest 2 years after diagnosis (82.1%). Conclusion Patients with lymphoma across all subtypes have a significantly higher risk of disability pension. Return to work peaks at 2 years after diagnosis.
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Affiliation(s)
- Eva Futtrup Maksten
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Correspondence: Eva Futtrup Maksten, Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Sdr. Skovvej 15, Aalborg, 9000, Denmark, Tel +45 97663872, Fax + 45 97666323, Email
| | - Lasse Hjort Jakobsen
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department Mathematical Sciences, Aalborg University, Aalborg, Denmark
| | - Kristian Hay Kragholm
- Department of Cardiology & Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Joachim Baech
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Jakob Madsen
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | | | - Robert Schou Pedersen
- Department of Medicine, Section of Haematology, Regionshospital Goedstrup, Goedstrup, Denmark
| | | | | | | | - Anne Ortved Gang
- Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Peter Brown
- Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kirsten Fonager
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Tarec C El-Galaly
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marianne Tang Severinsen
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Salit RB, Schoeppner K, De Biase C, Mohammed J, Gonzales AL, Hashmi SK, Gea-Banacloche J, Savani BN, Carpenter PA, Syrjala KL. American Society for Transplantation and Cellular Therapy Return to Work Guidance Committee Recommendations for Health Care Providers Who Take Care of Hematopoietic Cell Transplantation Patients. Transplant Cell Ther 2022; 28:822-828. [PMID: 36184059 DOI: 10.1016/j.jtct.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 12/24/2022]
Abstract
Hematopoietic cell transplantation (HCT) health care providers report a desire to improve long-term outcomes and quality of life for their patients. One of the items frequently cited by patients in terms of transitioning from being a patient back to pre-HCT life is return to work (RTW). However, these patients report little support from their health care providers in facilitating this process, and only 50% to 60% achieve RTW, at a median of 3 years post-HCT. Barriers are physical, psychological, and logistical, as well as poor communication between the patient and their employer. We convened a group of experts in survivorship, rehabilitation, social work, and psychology to draft an evidence-based document to assist health care providers in guiding their patients' RTW journey. Guidance is drawn from the existing literature for HCT and general cancer patients and is divided into pre-HCT, peri-HCT, and post-HCT categories. Collaboration among health care providers, patients, and their employers is key to this transition. Suggested referrals and evaluations also are provided. The goal is for this guidance to be continually updated as we advance the field with more HCT-specific literature.
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Affiliation(s)
- Rachel B Salit
- Fred Hutchinson Cancer Center, Seattle, Washington; University of Washington Medical Center, Seattle, Washington.
| | | | | | - Jaleel Mohammed
- Rehabilitation Association for Hematopoietic Cell Transplantation, Sheffield, United Kingdom; Lincolnshire Community Health Service NHS Trust, Lincoln, United Kingdom
| | | | - Shahrukh K Hashmi
- Mayo Clinic, Rochester, Minnesota; SSMC, Abu Dhabi, United Arab Emirates
| | | | | | - Paul A Carpenter
- Vanderbilt University Medical Center, Nashville, Tennessee; Seattle Children's Medical Center, Seattle, Washington
| | - Karen L Syrjala
- Fred Hutchinson Cancer Center, Seattle, Washington; University of Washington Medical Center, Seattle, Washington
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Boland V, Drury A, Sheaf G, Brady AM. Living with or beyond lymphoma: A rapid review of the unmet needs of lymphoma survivors. Psychooncology 2022; 31:1076-1101. [PMID: 35670252 PMCID: PMC9545574 DOI: 10.1002/pon.5973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/04/2022] [Accepted: 05/29/2022] [Indexed: 11/08/2022]
Abstract
Objective To establish an understanding of the unmet needs of people living with or beyond a lymphoma diagnosis. Survivors of lymphoma are at increased risk of unmet needs due to cancer, treatment‐related toxicities and extended survivorship. Despite the rapidly growing numbers of lymphoma survivors, their needs and research priorities are underserved and undervalued, therefore left largely unaddressed. Methods A rapid review method and reflexive thematic analysis approach assimilated current knowledge. Eligibility criteria included quantitative, qualitative, or mixed approaches employing cross‐sectional, longitudinal, cohort or review designs focused on the needs of adult lymphoma survivors (any subtype or stage of disease). Five databases: CINAHL, EMBASE, Medline, PsycInfo and Scopus, were systematically searched. Results Forty‐seven studies met the inclusion criteria via a stringent screening process facilitated by NVivo. Almost 60 per cent of articles were published within the last five years and investigated a homogenous lymphoma sample. Most studies employed quantitative approaches (77%) and cross‐sectional designs (67%). Studies were of high methodological quality. Five major themes were identified: disparity in health service delivery, the psychological impact of cancer, impactful and debilitating concerns, the monetary cost of survival and insufficient provision of survivorship information. A meta‐analytical approach was not feasible due to the breadth of methodologies of included studies. Conclusions This review shows that lymphoma survivors experience a myriad of unmet needs across multiple domains, reinforcing the need for lymphoma‐specific research. However, more research is needed to advance and achieve informed decision‐making relating to survivorship care, placing due attention to the needs and research priorities of lymphoma survivors.
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Affiliation(s)
- Vanessa Boland
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland, D02 T283
| | - Amanda Drury
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland, D04 V1W8
| | - Greg Sheaf
- The Library of Trinity College Dublin, Dublin, 2, Ireland
| | - Anne-Marie Brady
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland, D02 T283
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Thielen FW, Kersten MJ, Kuizenga P, Hoogendoorn M, Posthuma EF, Stevens WB, A Uyl-de Groot C, Blommestein HM. Cost-effectiveness of lenalidomide plus rituximab versus rituximab monotherapy in patients with previously treated follicular lymphoma: a societal view. Expert Rev Anticancer Ther 2021; 21:1411-1422. [PMID: 34428992 DOI: 10.1080/14737140.2021.1971520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Efficacy of lenalidomide plus rituximab (R-LEN) compared to rituximab monotherapy (R-mono) for patients with previously treated follicular lymphoma (FL) was investigated in AUGMENT (NCT01938001). Our aim was to evaluate the cost-effectiveness of R-LEN versus R-mono in this setting from a Dutch perspective. AREAS COVERED Cost-effectiveness was assessed through a partitioned survival model from three perspectives (i.e. societal, healthcare, and societal, including future non-medical costs). Patient-level data from AUGMENT informed effectiveness parameters (i.e. long-term survival) and health state utilities. Resource use and prices were based on AUGMENT and the literature. Clinical experts validated efficacy input parameters and results. Uncertainty was explored through sensitivity and scenario analyses. EXPERT OPINION R-LEN resulted in 1.7 incremental discounted quality-adjusted life years (QALYs). Total incremental discounted costs were 67,161 EUR from a societal perspective. In conclusion, R-LEN was cost-effective at a willingness-to-pay (WTP) threshold of 50,000 EUR/QALY in the base-case analyses(incremental cost-effectiveness ratio = 40,493 EUR/QALY). Scenario and sensitivity analyses indicated some level of uncertainty regarding this conclusion, depending on the chosen WTP-threshold and perspective.
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Affiliation(s)
- Frederick W Thielen
- Section Health Technology Assessment, Erasmus School of Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
| | - Marie-José Kersten
- Division of Haematology, Amsterdam University Medical Centers, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Pim Kuizenga
- Celgene BV A Bristol Myers Squibb Company, Utrecht, The Netherlands
| | - Mels Hoogendoorn
- Division of Haematology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Eduardus Fm Posthuma
- Department of Internal Medicine, Leiden University Medical Center & Reinier de Graaf Hospital, Delft, The Netherlands
| | - Wendy Bc Stevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carin A Uyl-de Groot
- Section Health Technology Assessment, Erasmus School of Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
| | - Hedwig M Blommestein
- Section Health Technology Assessment, Erasmus School of Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
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Granell M, Senín A, Barata A, Cibeira MT, Gironella M, López-Pardo J, Motlló C, Garcia-Guiñón A, Ben-Azaiz R, Abella E, Soler A, Canet M, Martí JM, Martino R, Sierra J, de Larrea CF, Oriol A, Rosiñol L. Predictors of return to work after autologous stem cell transplantation in patients with multiple myeloma. Bone Marrow Transplant 2021; 56:2904-2910. [PMID: 34404917 DOI: 10.1038/s41409-021-01429-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/16/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022]
Abstract
Return to work (RTW) is a marker of functional recovery in cancer patients, with quality of life, financial and social implications. We investigated frequency and factors associated with RTW in a cohort of patients younger than 66 years, with newly diagnosed multiple myeloma (MM), uniformly treated with a bortezomib-based induction followed by autologous stem cell transplantation (ASCT). Socio-economic and working status data were collected by a self-administered questionnaire. One hundred and eighty-six patients entered the study. Of whom, 145 (78%) where employed at diagnosis, which was more frequent in younger (median 55 vs. 60 years, p < 0.001), men (59.3% vs. 34.2%, p = 0.004), and with college studies (44.8% vs. 24.4%, p = 0.008). Forty-three (30%) of the 145 patients who had a job at diagnosis, RTW after ASCT in a median of 5 (range 1-27) months. Factors independently associated with RTW were having three or more children (HR 2.87, 95% CI 1.33-6.18), college studies (HR 2.78, 95% CI 1.21-6.41), and a family income >40 × 103€/year (HR 2.31, 95% CI 1.12-4.78). In conclusion, the frequency of RTW herein reported in MM patients seems lower than reported in other malignancies. The risk factors observed may guide the design RTW programs.
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Affiliation(s)
- Miquel Granell
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Alicia Senín
- Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | - Anna Barata
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Health Outcomes and Behavior Department, Moffitt Cancer Center, Tampa, FL, US.
| | - Maria-Teresa Cibeira
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Mercedes Gironella
- Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jordi López-Pardo
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Motlló
- Hematology Department, Hospital Sant Joan de Déu Manresa, Barcelona, Spain
| | | | - Randa Ben-Azaiz
- Hematology Department, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eugènia Abella
- Hematology Department, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alfons Soler
- Hematology Department, Hospital Universitari Parc Taulí Sabadell, Barcelona, Spain
| | - Marta Canet
- Hematology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Josep Ma Martí
- Hematology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Rodrigo Martino
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jorge Sierra
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Fernández de Larrea
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Albert Oriol
- Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | - Laura Rosiñol
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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Eriksson L, Wennman-Larsen A, Bergkvist K, Ljungman P, Winterling J. Important factors associated with sick leave after allogeneic haematopoietic stem cell transplantation-a 1-year prospective study. J Cancer Surviv 2021; 15:933-41. [PMID: 33417181 DOI: 10.1007/s11764-020-00986-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/24/2020] [Indexed: 12/03/2022]
Abstract
Purpose This study examines sick leave (SL) and factors associated with full-time SL 1 year after allogeneic haematopoietic stem cell transplantation (allo-HSCT) in patients of working age from 2009 to 2016 (n = 122). Methods Questionnaire data were collected on admission to the allo-HSCT unit, at 7 months and 1 year after allo-HSCT. Associations between factors and SL were analysed using logistic regression analyses. Results One year after allo-HSCT, 76% of participants were on SL, with 36% on full-time SL. In univariable analyses, chronic graft-versus-host-disease (cGvHD) (OR 3.07; 95% CI 1.34–7.07; p = 0.01), having symptoms of depression at 7 months (OR 4.81; 95% CI 1.69–13.69; p = 0.00) and low levels of vocational satisfaction at 7 months after treatment (OR 3.27; 95% CI 1.27–8.41; p = 0.01) were associated with full-time SL 1 year after allo-HSCT. cGvHD (OR 3.43; 95% CI 1.35–8.73; p = 0.01) and having symptoms of depression at 7 months after allo-HSCT (OR 3.37; 95% CI 1.2–11.58; p = 0.02) remained significant in multivariable analysis. Conclusion The majority of allo-HSCT survivors were on SL 1 year after treatment, and cGvHD, low vocational satisfaction and depressive symptoms were associated with full-time SL 1 year after allo-HSCT. Implications for Cancer Survivors Healthcare professionals need to be observant of and manage the consequences of cGvHD and patients’ symptoms of depression in order to support them appropriately in their return-to-work process.
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Taylor K, Chivers P, Bulsara C, Joske D, Bulsara M, Monterosso L. Care After Lymphoma (CALy) trial: A phase II pilot pragmatic randomised controlled trial of a nurse-led model of survivorship care. Eur J Oncol Nurs 2019; 40:53-62. [DOI: 10.1016/j.ejon.2019.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 03/21/2019] [Accepted: 03/25/2019] [Indexed: 01/02/2023]
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Persoon S, Buffart LM, Chinapaw MJM, Nollet F, Frings-Dresen MH, Koning S, Kersten MJ, Tamminga SJ. Return to work experiences of patients treated with stem cell transplantation for a hematologic malignancy. Support Care Cancer 2019; 27:2987-97. [PMID: 30591967 DOI: 10.1007/s00520-018-4596-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/10/2018] [Indexed: 01/08/2023]
Abstract
Purpose This qualitative study aimed to identify hematopoietic stem cell transplantation (HSCT) survivors’ (1) work perceptions; (2) barriers to and facilitators of return to work (RTW); and (3) possible solutions to improve RTW. Method Fifteen patients treated with HSCT 1–5 years ago participated in face-to-face semi-structured interviews. Interviews were analyzed following the steps of thematic content analyses. Results RTW was often characterized as a complex and prolonged trajectory, and it was frequently incomplete in working hours, tasks, and/or responsibilities. Work perceptions varied between patients; most valued work as positive, but some also reported a decline in work capacity and/or in importance. Perceived barriers included the duration and side effects of cancer treatment, the presence of comorbidity and poor health before diagnosis, having difficulties commuting and doing household tasks. Perceived facilitators were financial incentives, keeping in touch with the workplace, support of other patients and family, and looking after one’s health. Proposed solutions to improve RTW included discussing RTW at the hospital, enhanced employer support, improved accessibility of rehabilitation programs, and more information about the consequences of being sick-listed. Conclusions Many HSCT survivors value work as important and they are motivated to RTW. Insight in work perceptions, RTW barriers, and solutions might help researchers, healthcare professionals, and employers to develop and/or tailor individualized multidisciplinary care to facilitate RTW.
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