Work Productivity Among Younger Breast Cancer Survivors: The Impact of Behavioral Interventions for Depression

Mar 1, 2024, 00:00
10.1016/j.jval.2023.12.004
https://www.valueinhealthjournal.com/article/S1098-3015(23)06236-8/fulltext
Title : Work Productivity Among Younger Breast Cancer Survivors: The Impact of Behavioral Interventions for Depression
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(23)06236-8&doi=10.1016/j.jval.2023.12.004
First page : 322
Section Title : ECONOMIC EVALUATION
Open access? : Yes
Section Order : 322

Objectives

The Pathways to Wellness randomized controlled trial found that 2 behavioral interventions, mindfulness awareness practices and survivorship education, reduced depressive symptoms in younger breast cancer survivors (BCSs) compared with wait-list control. This secondary analysis examines whether the interventions led to reduced loss of work productivity among younger BCSs and whether such reductions were mediated by reductions in depressive symptoms.

Methods

The Work Productivity and Activity Impairment scale was used to measure work productivity loss at 4 assessment time points. Correlates of productivity loss at enrollment were examined using multivariable linear regression. Differences in change over time in productivity loss between each intervention group and control were assessed using linear mixed models. Reduced depressive symptoms were tested as a mediator of reduced productivity loss.

Results

Of 247 trial participants, 199 were employed and included in the analyses. At enrollment, higher productivity loss was associated with chemotherapy receipt (P = .003), younger age (P = .021), more severe cognitive problems (P = .002), higher musculoskeletal pain severity (P = .002), more depressive symptoms (P = .016), and higher fatigue severity (P = .033). The mindfulness intervention led to significantly less productivity loss compared with control at all 3 postintervention assessment points (all P .05), with about 54% of the effect mediated by reduction in depressive symptoms. Survivorship education was not associated with reduced loss of productivity.

Conclusions

These findings suggest that addressing depressive symptoms through behavioral interventions, such as mindfulness, may mitigate impacts on work productivity in younger BCSs.

Categories :
  • Clinical Trials
  • Economic Evaluation
  • Mental Health
  • Oncology
  • Specific Diseases & Conditions
  • Study Approaches
  • Work & Home Productivity - Indirect Costs
Tags :
  • behavioral interventions
  • breast cancer survivorship
  • depressive symptoms
  • longitudinal study
  • mediation
  • mindfulness
  • randomized trial
  • work productivity loss
Regions :
  • North America
ViH Article Tags :