Healthcare service utilization and work-related productivity in reflexology intervention for advanced breast cancer women

Support Care Cancer. 2019 Aug;27(8):2837-2847. doi: 10.1007/s00520-018-4592-4. Epub 2018 Dec 14.


Purpose: This project's purpose was to determine the effects of a home-based reflexology intervention on symptom-related use of health services and work-related productivity during the 11-week study.

Methods: A total of 256 patients were randomized to four weekly reflexology sessions (each lasting 30 min, delivered by lay caregivers who received two training sessions by a professional reflexologist) or attention control. The Conventional Health Service and Productivity Costs Form was used to collect information on health service utilization and out-of-pocket expenditure of symptom management. The Health and Work Performance Questionnaire was used to measure workplace performance for patients during the study period. We used weighted and unweighted logistic and linear regression analyses.

Results: Patients in the reflexology group were less likely to have hospital visits compared to the control group in the weighted unadjusted (odds ratio [OR] = 0.49; 95% confidence interval [CI] = [0.25, 0.97]), unweighted adjusted (OR = 0.35; 95% CI = [0.16, 0.75]), and weighted adjusted (OR = 0.30, 95% CI = [0.13, 0.66]) logistic regressions. Compared to attention control, patients in the reflexology group had lower relative absenteeism in the unweighted adjusted (- 0.32; 95% CI = [- 0.60, - 0.03]) linear regressions and less absolute presenteeism (15.42, 95% CI = [0.87, 29.98]) in the weighted unadjusted analysis.

Conclusion: The reflexology intervention delivered by lay caregivers reduced hospital visits and increased workplace productivity in a short-term period, which has potential for cost saving for health care systems and employers.

Trial registration: NCT01582971.

Keywords: Breast cancer; Health service expenditure, absenteeism, presenteeism; Health service utilization; Reflexology.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Breast Neoplasms / physiopathology
  • Breast Neoplasms / therapy*
  • Efficiency
  • Female
  • Humans
  • Massage / methods*
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Regression Analysis
  • Work / statistics & numerical data

Associated data