Informing the development of a personalized mixed digital/in person multidisciplinary intervention to help breast cancer patients return to work: a qualitative study

Abstract Purpose: Return to work (RTW) after breast cancer (BC) can be a major challenge for patients. Existing interventions often suffer from methodological weaknesses that hamper their implementation. In this study, we aimed to explore 1) use, as well as 2) preferences, needs and barriers regarding RTW interventions and their deployment, including 3) preferences regarding the use of digital approaches to deliver such interventions.Methods: We conducted a qualitative study based on semi-structured interviews with 30 early-stage BC patients and 18 providers in four French regions. Interviews were recorded and transcribed. Emergent themes were identified by thematic content analysis.Results: Most providers declared not to proactively address RTW with patients mainly due to having other priorities and a lack of knowledge. The following themes emerged: several development and deployment barriers regarding RTW interventions exist; interventions based on a multidisciplinary approach were generally preferred; need to maintain contact between patient and workplace during sick leave, including clearly identify pathways and interlocutors that can facilitate RTW. Participants had mostly positive representations about using digital tools to facilitate RTW, however fear of loss of human contact and exacerbation of inequalities were identified as possible risks associated with the development of digital-only interventions.Conclusions: In this study several points emerged that can help to develop an intervention that blends needs and preferences of BC patients and health care system. A personalized, multimodal approach with a mixed digital and in person features surfaced as a possible solution to respond to the weaknesses of existing interventions.