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A randomized controlled trial of support group intervention after breast cancer treatment: Results on sick leave, health care utilization and health economy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.ORCID iD: 0000-0003-3691-8326
Immune and Gene Therapy Laboratory,Cancer Centre,Karolinska,Karolinska University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
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2013 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 52, no 1, 38-47 p.Article in journal (Refereed) Published
Abstract [en]

Background

More than 50% of breast cancer patients are diagnosed before the age of 65.  Returning to work after treatment is, therefore, of interest for both the individual and society. The aim was to study the effect of support group intervention on sick leave and health care utilization in economic terms.

Material and Methods

Of 382 patients with newly diagnosed breast cancer, 191 + 191 patients were randomized to an intervention group or to a routine control group respectively. The intervention group received support intervention on a residential basis for one week, followed by four days of follow-up two months later. The support intervention included informative-educational sections, relaxation training, mental visualization and non-verbal communication. Patients answered a questionnaire at baseline, 2, 6 and 12 months about sick leave and health care utilization.

Result

There was a trend towards longer sick leave and more health care utilization in the intervention group. The difference in total costs was statistically significantly higher in the intervention group after 12 months (p= 0.0036).

Conclusion

Costs to society were not reduced with intervention in its present form.

Place, publisher, year, edition, pages
2013. Vol. 52, no 1, 38-47 p.
Keyword [en]
Support intervention, breast cancer, return to work, sick leave, health care utilization, health economy
National Category
Medical and Health Sciences
Research subject
Oncology
Identifiers
URN: urn:nbn:se:uu:diva-182056DOI: 10.3109/0284186X.2012.734921ISI: 000312505900006OAI: oai:DiVA.org:uu-182056DiVA: diva2:558307
Available from: 2012-10-02 Created: 2012-10-02 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Support Group Intervention in Primary Breast Cancer: Health-Related Quality of Life, with Special Reference to Anxiety, Depression and Fatigue
Open this publication in new window or tab >>Support Group Intervention in Primary Breast Cancer: Health-Related Quality of Life, with Special Reference to Anxiety, Depression and Fatigue
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to investigate in a (RCT) the effect of support group intervention in women with primary breast cancer in the short term, and with a long-term follow-up. Women with primary breast cancer were randomized between April 2002 and November 2007 and stratified according to adjuvant treatment with chemotherapy. Of 382 eligible patients, 191+191 patients were randomized to intervention and control groups respectively. Control patients were subjected to standard follow-up procedures. Patients in the intervention group received support intervention at the Foundation of Lustgården Mälardalen during one week followed by four days of follow-up two months later. Patients in intervention and control groups filled in questionnaires at baseline, after 2, 6 and 12 months and in the long-term follow-up after a mean of 6.5 years. In paper I, we studied the effect of the intervention on anxiety and depression measured by the HAD scale and we could show that a significantly lower proportion of women in the intervention group had high anxiety scores compared with women in the control group after 12 months; however, the proportion of women with high depression scores were unaffected. In paper II, we studied the effect of the intervention on fatigue and health-related quality of life (HRQoL) measured by the Norwegian version of the fatigue questionnaire (FQ) and EORTC-QLQ 30 and BR 23.We could not demonstrate any significant effect of the intervention. In paper III, we studied the effect of the intervention on sick-leave, healthcare utilization and the effect of the intervention in economic terms. We used a specially formulated questionnaire. There was a trend towards longer sick leave and more health-care utilization in the intervention group. The difference in total costs was statistically significantly higher in the intervention group after 12 months (p= 0.0036). In paper IV, we studied the long-term effects of the support intervention on anxiety, depression, fatigue and HRQoL. We could show a significant effect of the intervention on cognitive function, body image, future perspective and fatigue, the largest effect was seen among women who received chemotherapy; however, no effects on anxiety and depression were demonstrated.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 77 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 819
Keyword
Support group intervention, breast cancer, anxiety, depression, fatigue, health-related quality of life, sick-leave, health-care utilization
National Category
Clinical Medicine
Research subject
Oncology
Identifiers
urn:nbn:se:uu:diva-182083 (URN)978-91-554-8485-9 (ISBN)
Public defence
2012-11-17, Aulan, Ingång 21, Västmanlands sjukhus Västerås, Västerås, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-10-26 Created: 2012-10-03 Last updated: 2013-01-23Bibliographically approved

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Granstam Björneklett, HelenaRosenblad, AndreasOjutkangas, Marja-LeenaBergkvist, Leif

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