P04.01 Return to work i patients with low grade glioma

Abstract BACKGROUND We now treat patients with low-grade gliomas (LGG) more aggressively as this prolong survival. Patients are typically in working age, but their ability to return to work (RTW) following treatment has not been studied. We aimed to study patterns of sick leave and return to work among LGG patients in Sweden. In addition, we explored predictors for RTW following LGG diagnosis. MATERIAL AND METHODS We performed a nationwide register-based study of patients with grade II diffuse LGG. Data on adult patients aged 18–60 years with a histopathological diagnosis of LGG between 2005–2015 were obtained from the Swedish Brain Tumor Registry (n=381). A matched control sample (n=1900) was acquired from Statistics Sweden. Patients and controls were linked to the social insurance agency data for individual information on sick leave and disability compensation. Multivariable logistic regression was used in order to find predictors for RTW. RESULTS One year prior to surgery there was no apparent difference between cases and controls with 90 % working. Among LGG patients there was a rapid increase in sick leave starting approximately six months prior to surgery, while the proportion of controls on sick leave remained constant. One year after surgery, 53 % had returned to work with 29 % working full time. Independent predictors for patients working one year after surgery were higher age (OR 0.96, 95 % CI 0.93–0.99, p <0.01) and more days absent from work prior to procedure (OR 0.91, 95 % CI 0.97-0.95, p <0.001), both negatively associated with RTW. CONCLUSIONS In this cohort, more than half of the patients being diagnosed with LGG RTW within one year. Higher prior absence from work and higher age are risk factors for no-RTW. This study provides new information on rates of and factors influencing RTW in patients with LGG. FUNDING This project was funded by research grant from the Swedish Research Council (2017-00944).

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Return to work following diagnosis of low-grade glioma

Neurology ◽

10.1212/wnl.0000000000009982 ◽

2020 ◽

Vol 95 (7) ◽

pp. e856-e866 ◽

Cited By ~ 1

Author(s):

Isabelle Rydén ◽

Louise Carstam ◽

Sasha Gulati ◽

Anja Smits ◽

Katharina S. Sunnerhagen ◽

...

Keyword(s):

Sick Leave ◽

Return To Work ◽

Adjuvant Treatment ◽

Older Age ◽

First Year ◽

Low Grade ◽

Diffuse Glioma ◽

Who Grade ◽

Female Sex ◽

One Year

ObjectiveReturn-to-work (RTW) following diagnosis of infiltrative low-grade gliomas is unknown.MethodsSwedish patients with histopathologic verified WHO grade II diffuse glioma diagnosed between 2005 and 2015 were included. Data were acquired from several Swedish registries. A total of 381 patients aged 18–60 were eligible. A matched control population (n = 1,900) was acquired. Individual data on sick leave, compensations, comorbidity, and treatments assigned were assessed. Predictors were explored using multivariable logistic regression.ResultsOne year before surgery/index date, 88% of cases were working, compared to 91% of controls. The proportion of controls working remained constant, while patients had a rapid increase in sick leave approximately 6 months prior to surgery. After 1 and 2 years, respectively, 52% and 63% of the patients were working. Predictors for no RTW after 1 year were previous sick leave (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.88–0.96, p < 0.001), older age (OR 0.96, 95% CI 0.94–0.99, p = 0.005), and lower functional level (OR 0.64 95% CI, 0.45–0.91 p = 0.01). Patients receiving adjuvant treatment were less likely to RTW within the first year. At 2 years, biopsy (as opposed to resection), female sex, and comorbidity were also unfavorable, while age and adjuvant treatment were no longer significant.ConclusionsApproximately half of patients RTW within the first year. Lower functional status, previous sick leave, older age, and adjuvant treatment were risk factors for no RTW at 1 year after surgery. Female sex, comorbidity, and biopsy only were also unfavorable for RTW at 2 years.

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New episodes of musculoskeletal conditions among employed people in Norway, sickness certification and return to work: a multiregister-based cohort study from primary care

BMJ Open ◽

10.1136/bmjopen-2017-017543 ◽

2018 ◽

Vol 8 (3) ◽

pp. e017543 ◽

Cited By ~ 4

Author(s):

Sturla Gjesdal ◽

Tor Helge Holmaas ◽

Karin Monstad ◽

Øystein Hetlevik

Keyword(s):

Primary Care ◽

Cohort Study ◽

Sick Leave ◽

Return To Work ◽

Upper Limb ◽

Lower Risk ◽

Female Gender ◽

Sickness Certification ◽

One Year ◽

Absence From Work

ObjectivesTo identify new cases of musculoskeletal (MSK) disorders among employed people presenting in Norwegian primary care in 2012, frequency of sickness certification and length of sick leave. To identify patient-, diagnosis- and GP-related predictors of sickness certification, prolonged sick leave and return to work (RTW).MethodsAn observational multiregister-based cohort study covering all employed persons in Norway(1 176 681 women and 1 330 082 men) based on claims data from all regular GPs merged with individual sociodemographic data from public registers was performed. Participants were employed patients without any GP consultation during the previous 3 months who consulted a GP with a diagnosis of a MSK condition. Those not on sick leave and with a known GP affiliation were included in the analyses. Outcomes were incidence, proportion sickness certified and proportion on sick leave after 16 days, according to the diagnosis, ORs with 95% CIs for sickness certified and for sick leave exceeding 16 days and HRs with 95% CIs for RTW.ResultsOne-year incidence of MSK episodes was 159/1000 among employed women and 156/1000 among employed men. 27.1% of the women and 28.2% of the men were sickness certified in the initial consultation. After 16 days, 10.5% of women and 9.9% of men were still on sick leave. Upper limb problems were most frequent. After adjustments, medium/high education predicted a lower risk of absence from work due to sickness and rapid RTW after 16 days. Back pain, fractures and female gender carried a higher risk of sickness certification but faster RTW. Older age was associated with less initial certification, more sick leave exceeding 16 days and slower RTW. Male patients with male GPs had a lower risk of sickness absence, which was similar to patients with GPs born in Norway and GPs with many patients. After 16 days, GP variables had no effect on RTW.ConclusionUpper limb problems and GPs as stakeholders in ‘the inclusive workplace’ strategy need more attention.

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Improving motivation and goal setting for return to work in a population on sick leave: A controlled study

Scandinavian Journal of Public Health ◽

10.1080/14034940600868598 ◽

2007 ◽

Vol 35 (1) ◽

pp. 86-94 ◽

Cited By ~ 7

Author(s):

Birgit Drews ◽

Claus V. Nielsen ◽

Mette S. Rasmussen ◽

Jakob Hjort ◽

Jens P. Bonde

Keyword(s):

Sick Leave ◽

Return To Work ◽

Goal Setting ◽

Cox Regression ◽

Low Cost ◽

Controlled Study ◽

Standard Case ◽

Gainful Employment ◽

One Year ◽

Standard Case Management

Aim: Limited knowledge precludes evidence-based interventions targeting return to work among employees on sick leave. The objective of this study was to examine the vocational effect of an intervention focused on motivation, goal setting, and planning of return to work. Design and methods: A total of 2,795 people, across 6 municipalities, on sick leave for at least 21 days received a questionnaire; 1,256 with a self-assessed poor prognosis for fast return to work were eligible for the study. An examination by a specialist in social medicine, followed by additional counselling by a social worker, was offered to 510 residents in two municipalities and accepted by 264 (52%). The goal was to enhance motivation, goal setting, and planning of return to work. Residents in the remaining municipalities (n=746) received the standard case management offered by the municipalities; 845 (67%) persons completed a follow-up questionnaire gathering data on general health and employment status. The duration of the sick leave was analysed by Cox regression, and the chance of being gainfully employed was analysed by logistic regression analysis, both adjusted for several covariates. Results: The intervention neither shortened sick leave periods nor increased the likelihood of gainful employment after one year (OR 0.76; 95% CI 0.45—1.28). Conclusions: A low-cost counselling programme addressing motivation, goal setting, and planning of return to work did not improve vocational outcomes or reduce the duration of sick leave.

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Sick leave in patients with prostate cancer before, during, and after radiotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.153 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 153-153

Author(s):

Joen Sveistrup ◽

Peter Meidahl Petersen ◽

Ole Steen Mortensen ◽

Svend Aage Engelholm

Keyword(s):

Prostate Cancer ◽

Sick Leave ◽

Return To Work ◽

Intensity Modulated Radiotherapy ◽

Social Benefits ◽

Job Market ◽

Intensity Modulated ◽

Returning To Work ◽

One Year ◽

Age Range

153 Background: Returning to work following cancer treatment is a sign of recovery. Side-effects might result in sick leave rendering patients unable to work. The purpose of this study was to determine the pattern of sick leave in patients with prostate cancer (PCa) before, during and after definitive radiotherapy. Methods: The Danish DREAM-database contains information on all social benefits paid out to Danish citizens. Based on the DREAM-database it is possible to assess whether a patient is working, on sick leave, or retired. Data on 427 of 473 Danish citizens, treated with definitive intensity-modulated radiotherapy for PCa at our center between January 1 2005 and May 1 2010, were obtained from the DREAM-database. Of the 427 patients 118 patients were working or available to the job market at the start of radiotherapy. Of the 118 patients 59 patients were on sick leave at some point during the course of radiotherapy and they followed in the DREAM-database from one year prior to radiotherapy until one year after the treatment. The median age was 60 (age, range 49–65). Based on the data from the database the 59 patients were divided into the four categories “Working or unemployed”, “Sick leave”, “Retirement” or “Dead”. Furthermore, the patients’ statuses after sick leave were determined. Results: The results are shown in the table. Nearly all patients (91.5%) return to work following sick leave. One year after radiotherapy 64.4% of the patients are working, and 13.6% are on sick leave. Conclusions: The vast majority of patients that are on sick leave during the course of radiotherapy for PCa return to work. However, one year after RT only 64 % are working or available for work indicating that the return to work for a lot of the patients is relatively short-lasting. Further research is needed to clarify why. [Table: see text]

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Predictors for Return to Work in Subjects with Mild Traumatic Brain Injury

Behavioural Neurology ◽

10.1155/2016/8026414 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 17

Author(s):

Eirik Vikane ◽

Torgeir Hellstrøm ◽

Cecilie Røe ◽

Erik Bautz-Holter ◽

Jörg Aßmus ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Psychological Distress ◽

Brain Injury ◽

Sick Leave ◽

Return To Work ◽

Mild Traumatic Brain Injury ◽

Self Report ◽

University Hospitals ◽

Global Functioning ◽

One Year

Objective. To predict return to work (RTW) at 12 months for patients who either were sick-listed or were at risk to be sick-listed with persistent postconcussion symptoms (PCS) at six to eight weeks after injury.Method. A prospective cohort study of 151 patients with mild traumatic brain injury (MTBI) admitted consecutively to outpatient clinics at two University Hospitals in Norway. The study was conducted as part of a randomised clinical trial. Injury characteristics were obtained from the medical records. Sick leave data from one year before to one year after MTBI were obtained from the Norwegian Labour and Welfare Service. Self-report questionnaires were used to obtain demographic and symptom profiles.Results. We observed a significant negative association between RTW at 12 months and psychological distress, global functioning, and being sick-listed at two months after MTBI, as well as having been sick-listed the last year before injury.Conclusion. Psychological distress, global functioning postinjury, and the sick leave trajectory of the subjects were negative predictors for RTW. These findings should be taken into consideration when evaluating future vocational rehabilitation models.

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Development of a short form of the Hong Kong Chinese orebro musculoskeletal pain screening questionnaire

Hong Kong Physiotherapy Journal ◽

10.1142/s1013702519500057 ◽

2019 ◽

Vol 39 (01) ◽

pp. 57-66

Author(s):

Raymond C. C. Tsang ◽

Edwin W. C. Lee ◽

Jamie S. Y. Lau ◽

Susane S. F. Kwong ◽

Eric M. L. So ◽

...

Keyword(s):

Hong Kong ◽

Construct Validity ◽

Sick Leave ◽

Return To Work ◽

Musculoskeletal Pain ◽

Predictive Validity ◽

Short Form ◽

Hong Kong Chinese ◽

Measurement Properties ◽

One Year

Background: The Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ) is a valid screening tool to identify those musculoskeletal patients at risk of developing chronicity and disability. A Hong Kong Chinese version of the OMPSQ (COMPSQ-HK) was developed with satisfactory construct validity and predictive validity. Objective: The aim of this study was to develop a 10-item short form of the COMPSQ-HK (COMPSQ-HK10) and examine its measurement properties. Methods: The 10 items were identified from the suggestion by the original author of OMPSQ. The data of the 10 items were extracted from the main study to develop the COMPSQ-HK conducted from 2010 to 2013. The internal consistency using Cronbach’s alpha, test–retest reliability examining intraclass correlation coefficient (ICC[Formula: see text]), minimum detectable change and 95% limits of agreement, construct validity by correlating COMPSQ-HK10 with pain, disability score, kinesiophobia score and Medical Outcomes Study Short Form 12, and predictive validity investigating receiver operating characteristic (ROC) curve analyses with sick leave [Formula: see text] days and return-to-work status at one year were calculated. Results: A total of 305 back patients and 160 neck patients were recruited with about 30% of patients lost to follow-up at one year. Both the internal consistency (Cronbach’s alpha as 0.732 to 0.757) and test–retest reliabilities (ICC[Formula: see text] as 0.868 for both back and neck patients) were satisfactory. The correlations between COMPSQ-HK10 and COMPSQ-HK for back and neck patients were excellent (Pearson [Formula: see text] as 0.919 and 0.896, respectively, [Formula: see text]). The areas under the ROC curves for back and neck patients were similar for COMPSQ-HK10 and COMPSQ-HK, ranging from 0.603 to 0.712. A cut-off score of 54 of COMPSQ-HK10 was recommended in predicting “sick leave of more than 60 days at one year” and “return to work for at least four consecutive weeks at one year”. Conclusion: The COMPSQ-HK10 has comparable measurement properties with the COMPSQ-HK. It is recommended to use the COMPSQ-HK10 for routine screening to identify patients of back and neck pain at risk of developing chronic pain and disability.

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A Rapidly Growing Epidermoid Cyst in an Intrapancreatic Accessory Spleen Treated by Laparoscopic Spleen-Preserving Distal Pancreatectomy: Case Report

International Surgery ◽

10.9738/intsurg-d-14-00278.1 ◽

2019 ◽

Vol 103 (9-10) ◽

pp. 482-488 ◽

Cited By ~ 1

Author(s):

Yusuke Kumamoto ◽

Takashi Kaizu ◽

Hiroshi Tajima ◽

Hidefumi Kubo ◽

Ryo Nishiyama ◽

...

Keyword(s):

Distal Pancreatectomy ◽

Epidermoid Cyst ◽

Malignant Tumors ◽

Accessory Spleen ◽

Histopathological Diagnosis ◽

Low Grade ◽

Intrapancreatic Accessory Spleen ◽

Spleen Preserving ◽

One Year ◽

Enhanced Computed Tomography

Epidermoid cysts arising in an intrapancreatic accessory spleen are exceedingly rare; furthermore, the natural course of them is hardly known. We report a case correctly diagnosed with epidermoid cyst in an intrapancreatic accessory spleen, followed by 1 year of observation, that underwent surgical treatment. The patient presented with diarrhea. Contrast-enhanced computed tomography (CT) revealed a pancreatic cyst 20 mm in diameter, surrounded by a solid component showing the same enhancement as the spleen, suggesting the presence of an epidermoid cyst in an intrapancreatic accessory spleen. One year later, back discomfort developed and a CT scan revealed that the cyst had grown to 38 mm in diameter. To obtain a definitive diagnosis, we performed a laparoscopic spleen-preserving distal pancreatectomy. The histopathological diagnosis was compatible with an epidermoid cyst in an intrapancreatic accessory spleen, which is benign. The postoperative course was uneventful. This case demonstrates that an epidermoid cyst arising in an intrapancreatic accessory spleen can rapidly grow, even if it is benign. Laparoscopic spleen-preserving distal pancreatectomy can be a useful procedure, with the advantages of low invasiveness and organ preservation, for the treatment of benign or low-grade malignant tumors located in the pancreatic body or tail.

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Return to Work in Employees on Sick Leave due to Neck or Shoulder Pain: A Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention with One-Year Register-Based Follow-Up

Journal of Occupational Rehabilitation ◽

10.1007/s10926-017-9727-9 ◽

2017 ◽

Vol 28 (2) ◽

pp. 346-356 ◽

Cited By ~ 6

Author(s):

Line Thorndal Moll ◽

Ole Kudsk Jensen ◽

Berit Schiøttz-Christensen ◽

Christina Malmose Stapelfeldt ◽

David Høyrup Christiansen ◽

...

Keyword(s):

Clinical Trial ◽

Sick Leave ◽

Return To Work ◽

Randomized Clinical Trial ◽

Shoulder Pain ◽

Brief Intervention ◽

One Year

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Comparing two interdisciplinary occupational rehabilitation programs for employees on sick leave: a mixed-method design study protocol

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03994-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Monica Eftedal ◽

Torill H. Tveito ◽

Ulrik Gensby ◽

M. Kamrul Islam ◽

Stein Atle Lie ◽

...

Keyword(s):

Sick Leave ◽

Return To Work ◽

Mixed Method ◽

Common Mental Disorders ◽

Inpatient Rehabilitation ◽

Occupational Rehabilitation ◽

Rehabilitation Program ◽

Interdisciplinary Teams ◽

Full Time ◽

Rehabilitation Programs

Abstract Background Musculoskeletal disorders (MSDs) and common mental disorders (CMDs) are the most frequent reasons for long-term sick leave and work disability. Occupational rehabilitation programs are used to help employees return to work (RTW). However, knowledge regarding the effect of these programs is scarce, and even less is known about which programs are best suited for which patients. This study aims to compare the RTW results of two interdisciplinary occupational rehabilitation programs in Norway, as well as to examine the delivery and reception of the two programs and explore the active mechanisms of the participants’ RTW processes. Methods/design We will use a mixed-method convergent design to study the main outcome. Approximately 600 participants will be included in the study. Eligible study participants will be aged 18–60 years old and have been on sick leave due to MSDs, CMDs, or both for at least 6 weeks. Interdisciplinary teams at both participating clinics will deliver complex occupational rehabilitation programs. The inpatient rehabilitation program has a duration of 4 weeks and is full time. The outpatient program has a duration of 3 months and involves weekly sessions. The primary outcome is RTW. Secondary outcomes are differences in the incremental cost for an averted sick leave day, cost utility/benefit, and differences between the programs regarding improvements in known modifiable obstacles to RTW. Subgroup analyses are planned. The researchers will be blinded to the intervention groups when analyzing the quantitative RTW data. Discussion This study aims to provide new insights regarding occupational rehabilitation interventions, treatment targets, and outcomes for different subgroups of sick-listed employees and to inform discussions on the active working mechanisms of occupational rehabilitation and the influence of context in the return-to-work process. Trial registration Current controlled trials ISRCTN12033424, 15.10.2014, retrospectively registered.

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Health insurance utilisation after ischaemic stroke in Sweden: a retrospective cohort study in a system of universal healthcare and social insurance

BMJ Open ◽

10.1136/bmjopen-2020-043826 ◽

2021 ◽

Vol 11 (3) ◽

pp. e043826

Author(s):

Carl Willers ◽

Emma Westerlind ◽

Fredrik Borgström ◽

Mia von Euler ◽

Katharina S Sunnerhagen

Keyword(s):

Sick Leave ◽

Ischaemic Stroke ◽

Disability Pension ◽

Social Insurance ◽

Productivity Loss ◽

Indirect Costs ◽

Universal Healthcare ◽

Income Groups ◽

Life Years ◽

Absence From Work

BackgroundStroke is one of the largest single-condition sources of the global burden of non-communicable disease in terms of disability-adjusted life-years and monetary costs, directly as well as indirectly in terms of informal care and productivity loss. The objective was to assess the population afflicted with ischaemic stroke in working age in the context of universal healthcare and social insurance; to estimate the levels of absence from work, the indirect costs related to that and to assess the associated patient characteristics.MethodsThis was a retrospective register-based study; all individuals registered with an ischaemic stroke during 2008–2011 in seven Swedish regions, covering the largest cities as well as more rural areas, were included. Individual-level data were used to compute net days of sick leave and disability pension, indirect costs due to productivity loss and to perform regression analysis on net absence from work to assess the associated factors. Costs related to productivity loss were estimated using the human capital approach.ResultsWomen had significantly fewer net days of sick leave and disability pension than men after multivariable adjustment, and high-income groups had higher levels of sick leave than low-income groups. There were no significant differences for participants regarding educational level, region of birth or civil status. Indirect monetary costs amounted to €17 400 per stroke case during the first year, totalling approximately €169 million in Sweden.ConclusionThe individual’s burden of stroke is heavy in terms of morbidity, and the related productivity loss for society is immense. Income-group differences point to a socioeconomic gradient in the utilisation of the Swedish social insurance.

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