A retrospective cohort analysis of return-to-work outcomes for cancer survivors using a digital coaching intervention.

1566 Background: Return-to-work (RTW) is a key unmet need for working age cancer survivors, with up to 40% failing to RTW 1 to 2 years post-diagnosis. This study sought to evaluate RTW outcomes of a multidisciplinary digital coaching intervention provided as routine employee support. Methods: A retrospective cohort analysis was conducted from October 2018 to February 2020 where cancer patients with more than 3 months absent from work were provided by their insurance carriers with a multidisciplinary intervention comprising digital resources and telephone calls with a health coach. A logit regression model was used to calculate a propensity score using covariates of age, gender, insurance benefit type, cancer diagnosis date and time from diagnosis. Participants were then matched on a 1:1 basis using the nearest-neighbour method without replacement to create a matched control group out of 1,856 participants who did not receive the intervention. Primary outcomes, derived from insurance-claims data as standard business practice, included rate and time to RTW, along with death and other reasons for claim closure. Results: 220 participants enrolled in the intervention, of which 125 met the criteria for analysis (median age 53, IQR 45-58, 91% female). These participants were matched with 125 controls (median age 53, IQR 47-59, 94% female). Median follow-up from cancer diagnosis was 79 weeks (IQR 60-106). Of the matched controls, 22 returned to work (17.6%) compared with 38 (30.4%) in the intervention group (P =.02). 19 matched controls died prior to claim closure (15.2%) compared with 13 in the intervention group (10.4%; P =.26). Finally, Kaplan-Meier method estimated median time for the first 15% of participants to RTW was 87.1 weeks for controls (CI 60.0-109.1 weeks) compared with 70.6 weeks for the intervention group (CI 52.6-79.6 weeks; P =.08). Conclusions: This study evaluated the impact of a digitally delivered coaching program in a real-world setting for cancer patients, demonstrating a 12.8% increase in RTW rate over 18 months compared to matched controls. These findings corroborate and add to the literature on cancer as a chronic and manageable disease in the workplace.