Introduction
Patients and methods
Study design
Study population
Assessments
Disease-specific and sociodemographic characteristics
Work status
Health-related quality of life and utility
Perceived bother and needs for support
Statistical analysis
Results
Study population (Fig. 1)
Patient characteristics (Table 1)
Total (N = 241) | No paid job (N = 68) | Paid job (N = 173) | P-value | |
---|---|---|---|---|
Sociodemographic characteristics | ||||
Female gender, N (%) | 147 (61.0) | 44 (32.0) | 103 (68.0) | 0.459 |
Age in years, median (IQR) | 53.0 (45.0–59.5) | 54.7 (45.6–60.7) | 52.4 (44.9–59.2) | 0.114 |
Marital status, N (%) | ||||
Relationship/married | 190 (79.2) | 48 (70.6) | 142 (82.6) |
0.040
|
Education, N (%) | ||||
Low | 65 (27.0) | 27 (39.7) | 38 (22.0) | < 0.001 |
Intermediate | 60 (24.9) | 22 (32.4) | 38 (22.0) | |
High | 115 (47.7) | 19 (27.9) | 96 (55.5) | |
Disease-specific characteristics | ||||
Tumor type, N (%), % per tumor type | ||||
NFPA | 65 (27.0) | 15 (23.1) | 50 (76.9) |
0.021
|
ACRO | 41 (17.0) | 16 (39.0) | 25 (61.0) | |
CD | 32 (13.3) | 15 (46.9) | 17 (53.1) | |
PRL | 97 (40.2) | 20 (20.6) | 77 (79.4) | |
RCC | 6 (2.5) | 2 (33.3) | 4 (66.7) | |
Time since diagnosis in years, median (IQR) | 11.4 (5.2–20.5) | 10.8 (5.1–19.0) | 13.7 (6.6–23.8) | 0.204 |
Treatment, N (%) | ||||
No treatment/discontinued medication | 36 (14.9) | 6 (8.8) | 30 (17.3) |
0.022
|
Ongoing medication | 75 (31.1) | 17 (25.0) | 58 (33.5) | |
Surgery | 96 (39.8) | 29 (42.6) | 67 (38.7) | |
Radiotherapy | 34 (14.1) | 16 (23.5) | 18 (10.4) | |
Endocrine status, N (%) | ||||
No deficits | 112 (46.5) | 18 (26.5) | 94 (54.3) | < 0.001 |
Hypopituitarism | 84 (34.9) | 34 (50.0) | 50 (28.9) | |
Panhypopituitarism | 45 (18.7) | 16 (23.5) | 29 (16.8) | |
HRQoL and disease bother | ||||
EQ-5D score, mean (SD)a | 0.908 (0.08) | 0.862 (0.12) | 0.926 (0.06) | < 0.001 |
EQ-5D VAS, mean (SD)a | 73.32 (20.7) | 63.88 (19.1) | 77.02 (20.1) | < 0.001 |
SF-36 PCS, mean (SD)a | 46.53 (10.5) | 39.91 (11.5) | 49.13 (8.9) | < 0.001 |
SF-36 MCS, mean (SD)a | 47.84 (12.0) | 44.41 (13.3) | 49.19 (11.1) |
0.005
|
LBNQ-pituitary total score, mean (SD)b | 17.37 (18.9) | 25.99 (20.8) | 13.98 (17.0) | < 0.001 |
Work status (Table 1)
Determinants for having a paid job or not (Table 2)
Determinant | Crude | Adjusted for disease-specific and sociodemographic characteristics | Adjusted for disease-specific, sociodemographic characteristics and HRQoL | ||||||
---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | p-value | OR | 95% CI | p-value | OR | 95% CI | p-value | |
Female gender | 1.25 | 0.70–2.23 | 0.460 | – | – | – | – | – | – |
Age | 1.02 | 0.99–1.05 | 0.218 | – | – | – | – | – | – |
Marital status (ref: relationship/married)a | |||||||||
Single/divorced/widow |
1.97
|
1.03–3.79
|
0.042
|
2.27
|
1.15–4.49
|
0.019
| 1.77 | 0.80–3.87 | 0.157 |
Education (ref: high)a | |||||||||
Intermediate |
3.59
|
1.79–7.21
| < 0.001 |
3.43
|
1.70–6.93
|
0.001
| 2.13 | 0.96–4.75 | 0.064 |
Low |
2.93
|
1.42–6.01
|
0.003
|
2.99
|
1.45–6.17
|
0.003
|
3.31
|
1.48–7.42
|
0.004
|
Tumor type (ref: PRL)a | |||||||||
NFPA | 1.16 | 0.54–2.47 | 0.710 | 1.11 | 0.50–2.44 | 0.803 | 0.84 | 0.35–2.04 | 0.698 |
ACRO |
2.46
|
1.11–5.47
|
0.027
|
2.73
|
1.19–6.29
|
0.018
| 1.96 | 0.77–4.99 | 0.161 |
CD |
3.40
|
1.45–8.00
|
0.005
|
3.25
|
1.38–7.67
|
0.007
|
2.86
|
1.10–7.45
|
0.032
|
RCC | 1.93 | 0.33–11.27 | 0.468 | 1.68 | 0.28–9.97 | 0.566 | 0.97 | 0.13–7.34 | 0.979 |
Time since diagnosisb | 1.02 | 0.99–1.05 | 0.154 | 1.00 | 0.96–1.03 | 0.860 | 1.02 | 0.98–1.05 | 0.375 |
Treatment (ref: no treatment)c | |||||||||
Ongoing medication | 1.47 | 0.52–4.10 | 0.467 | 1.35 | 0.45–4.00 | 0.594 | 1.25 | 0.37–4.22 | 0.716 |
Surgery | 2.16 | 0.81–5.76 | 0.122 | 1.55 | 0.50–4.77 | 0.445 | 1.43 | 0.41–5.05 | 0.576 |
Radiotherapy |
4.44
|
1.47–13.42
|
0.008
|
3.87
|
1.11–13.45
|
0.033
| 3.04 | 0.74–12.51 | 0.123 |
Endocrine status (ref: no deficits)b | |||||||||
Hypopituitarism |
3.55
|
1.82–6.92
| < 0.001 |
3.76
|
1.84–7.68
| < 0.001 |
3.97
|
1.77–8.88
|
0.001
|
Panhypopituitarism |
2.88
|
1.31–6.36
|
0.009
|
2.87
|
1.16–7.12
|
0.023
|
2.94
|
1.06–8.17
|
0.039
|
Working problems among patients with a paid job (Table 3)
Total (N = 173) | NFPA (N = 50) | ACRO (N = 25) | CD (N = 17) | PRL (N = 77) | RCC (N = 4) | p-value | |
---|---|---|---|---|---|---|---|
SF-HLQ | |||||||
Working hours/week, median (IQR) | 36.0 (24.0–40.0) | 36.0 (28.0–40.0) | 40.0 (32.0–40.0) | 32.0 (22.0–40.0) | 32.0 (24.0–40.0) | 39.0 (29.0–45.0) | 0.211b |
Bothered by health-related problems during work, N (%) | 68 (39.3) | 22 (44.0) | 9 (36.0) | 5 (29.4) | 30 (39.0) | 2 (50.0) | 0.608b |
Performance at work despite health-related problems, mean among those bothered (SD) (scale 1–10)a | 6.8 (1.7) | 6.3 (1.6) | 7.9 (1.4) | 7.6 (1.5) | 6.6 (1.7) | 8.5 (0.7) |
0.025
b
|
Absence from work during the past year due to health-related problems, N (%) | 70 (40.5) | 25 (50.0) | 7 (28.0) | 8 (47.1) | 27 (35.1) | 3 (75.0) | 0.104b |
Days absent during previous year, median days (IQR) | 5.0 (4.0–28.0) | 10.0 (4.0–30.0) | 10.0 (5.0–35.0) | 5 (4.5–5.0) | 5 (3.0–30.0) | 10 (3.0–130.0) | 0.424b |
Medical consumption | |||||||
Contact with occupational physician, N (%) | 21 (12.1) | 8 (16.0) | 3 (12.0) | 1 (5.9) | 8 (10.4) | 1 (25.0) | 0.706 |
WRFQ (scale 0–100) | |||||||
Work scheduling and output demands, mean (SD)a | 78.0 (28.7) | 77.0 (28.3) | 81.8 (27.0) | 84.1 (29.5) | 76.8 (28.8) | 63.3 (52.7) | 0.714b |
Physical demands, mean (SD)a | 84.3 (27.1) | 83.7 (28.6) | 87.2 (25.2) | 83.9 (24.1) | 84.5 (26.6) | 68.3 (54.8) | 0.849b |
Mental demands and social demands, mean (SD)a | 75.6 (31.2) | 85.2 (24.8) | 84.0 (28.0) | 76.6 (28.6) | 60.7 (52.9) | 77.9 (29.2) | 0.380b |
Flexibility demands, mean (SD)a | 79.8 (29.1) | 76.1 (30.3) | 86.3 (25.2) | 84.1 (27.9) | 79.6 (29.0) | 68.3 (50.6) | 0.563b |
Index score, mean (SD)a | 78.6 (28.1) | 77.2 (28.6) | 83.1 (26.5) | 85.7 (25.4) | 77.8 (27.1) | 50.4 (51.3) | 0.179b |