Scoping review of return to work in patients with heart failure

Heart failure (HF) has a significant impact on quality of life and employment. For patients with HF of work age, return to work (RTW) is an important goal because of its social and economic significance. This scoping review aimed to investigate the definition of RTW, RTW rates, support programs, and factors associated with RTW in patients with HF, and to propose future research and clinical support strategies. We included 47 studies with 64,048 individuals: 21 cohort studies (five prospective studies, 16 retrospective studies), three cross sectional studies, three case series studies (two retrospective studies, one prospective study), 18 case reports, two qualitative studies. Participants were aged 18-65 years old and were employed prior to a diagnosis of HF. Only one study defined RTW in patients with HF, and it was described as "whether or not patients were working for income." The overall RTW rate across the studies had a median of was 56.0%, (interquartile range 25.8-100.0%, range 0.0-100.0%) but the rate varied across studies. Support programs were reported in two studies as rehabilitation and in one study as paid leave. The facilitating and inhibiting factors of RTW were classified into medical factors (e.g., ejection fraction, comorbidities), social determinants of health (e.g., education, income), and employment or work-related factors (e.g., job type, work ability). Future research needs to consider the results of this scoping review, particularly the ambiguity in the definition of RTW and the facilitating and inhibiting factors identified.