Work ability following breast cancer - the MyHealth randomized controlled trial

BACKGROUND AND PURPOSE: We previously demonstrated positive effects on quality of life and mental health following breast cancer when comparing a nurse-led follow-up program without scheduled visits (MyHealth) to regular follow-up. This study aims to examine whether MyHealth also positively impacts self-reported work ability.

PATIENTS/MATERIAL AND METHODS: A total of 288 patients, potentially active on the labour market, were randomized to MyHealth or control follow-up after primary treatment for early-stage breast cancer (2017-2019). MyHealth included individual self-management sessions, electronic symptom monitoring, and assistance with navigating healthcare services. Control follow-up consisted of biannual outpatient visits with a physician. Linear mixed-effect models were applied to evaluate the effect of MyHealth on self-reported work ability at 6, 12, 24, and 36 months after randomization as measured by the Work Ability Score (WAS).

RESULTS: Work ability increased significantly in both groups during the first 6 months (mean WAS increase MyHealth: 1.64, 95% confidence interval [CI]: 1.26; 2.02 and control: 1.57, 95% CI: 1.17; 1.97) and continued to increase slightly but non-significantly (p-values > 0.13) until end of follow-up at 36 months. Improvement was especially pronounced among patients reporting poor work ability at baseline. Differences in mean WAS between patients in MyHealth and control follow-up were non-significant and close to zero at all time points (-0.21 to 0.48).

INTERPRETATION: The MyHealth follow-up program had no additional effect on self-reported work ability compared to regular follow-up. Future interventions should target patients with poor work ability and include components specifically designed to enhance work ability.