"Specialists noted that PRO-P is often used in tandem with medical records by doctors and absence experts to transition employees on leave back to their jobs smoothly. And certainly, PRO-P could be helpful in informing benefits decisions, especially in having individual data on whether employer-sponsored wellness programs improve employees' productivity to produce a return on investment," wrote Nicole Nicksic, PhD, MPH, lead researcher in the study. However, she added, although the PRO-P measurements might hold promise for benefits design, so far employers are generally not using such tools.

Looking at PRO-P from cancer patients

The study focused on PRO-P results from cancer studies because improvements in cancer treatment over the years have allowed many cancer survivors to return to work much sooner than in past decades. "The results of the literature review indicated that while many cancer studies have included PRO-P, most did not use instruments best suited to communicating costs to employers," the study found.

In addition, work productivity in these studies was rarely reported in financial terms, instead tending to focus on quality of life. And the clinical research lacked consistency in terms and measurements of productivity, the study said.

"Very few studies collected PRO-P as part of randomized controlled trials—the typical gold standard of study designs," the IBI study noted. "When assessed, instruments to assess work productivity used various measures to assess absenteeism and presenteeism, but they rarely monetized any findings and often used variables that were not self-reported."

A lack of utility for benefits specialists

Because of the shortcomings in useful data, employers and benefits specialists have not made much use of PRO-P measurements, the report concluded. "Specialists revealed that they rarely use or even see information on employee productivity," Nicksic wrote. "Not surprisingly, employers largely use disability claims and payroll data on sick leave to shape their benefits plans, and therefore did not currently see a strong need for using PRO-P.

"When asking discussants about the literature review findings, they found PRO-P to be important and are receptive to using it; there was, however, a lack of exposure to PRO-P among employers," the study said. "PRO-P is not commonly used to structure benefits directly; rather, it is typically used by other parties—such as doctors, disability carriers, and pharmacy benefits managers—in combination with objective data to show clinical improvement and to work with ill employees individually to help them return to work."

The IBI report concludes by suggesting ways to make PRO-P measurements more relevant to employers. The report suggested the following guidelines:

• Choose self-reported measures that show clinical improvement and can be monetized.
• Include absences and apply compensation to demonstrate the financial burden of illness and the value of effective treatments.
• Link study participants to objective measures such as disability claims. Obtain these data by working with subjects drawn from an employer population where possible.

Read more: 

• Why clinical guidelines are critical to standardize care and improve outcomes
• Focusing on wellness, prevention and return to work issues
• The argument for evidence-based medicine and why employers should care