Long term sickness absence: General practitioners have crucial role but need political support

In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.

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From gradual erosion to revitalization: National Social Dialogue Institutions and policy effectiveness

European Journal of Industrial Relations ◽

10.1177/09596801211018318 ◽

2021 ◽

pp. 095968012110183

Author(s):

Igor Guardiancich ◽

Oscar Molina

Keyword(s):

Decision Making ◽

Problem Solving ◽

South Korea ◽

Industrial Relations ◽

Political Support ◽

Policy Effectiveness ◽

Substantial Evidence ◽

Social Dialogue ◽

Socioeconomic Issues

We explore the factors behind the long-term erosion of National Social Dialogue Institutions (NSDIs) to provide insights about the conditions for their revitalization. By applying policy analysis insights into the industrial relations field, we argue that limited policy effectiveness goes a long way towards explaining the erosion experienced by many NSDIs worldwide in recent years. Drawing on a global survey and on case studies of NSDIs in Brazil, Italy and South Korea, we show that these institutions’ policy effectiveness crucially depends on combinations of their problem-solving capacity, an encompassing mandate to deal with relevant socioeconomic issues and an enabling environment that grants the inclusion of social dialogue into decision making. With regard to rekindling their role, the article provides substantial evidence that two sub-dimensions of effectiveness are key: enjoying political support and having an ‘effective mandate’ as opposed to relying on just a formal remit to deal with socioeconomic issues of interest.

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Exploring expected and perceived facilitators and barriers of an indicated prevention strategy to prevent future long-term sickness absence; a qualitative study among employers and employees

BMC Public Health ◽

10.1186/s12889-021-10322-w ◽

2021 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Sophie H. Klasen ◽

Ludovic G. P. M. van Amelsvoort ◽

Inge Houkes ◽

Nicole W. H. Jansen ◽

IJmert Kant

Keyword(s):

Qualitative Study ◽

Sickness Absence ◽

Early Treatment ◽

Prevention Strategy ◽

Health Complaints ◽

Health Culture ◽

Indicated Prevention ◽

Work Related ◽

Facilitators And Barriers

Abstract Background An indicated prevention strategy (IPS), consisting of a screening questionnaire and early treatment, was found to be effective for the prevention of future long-term sickness absence (LTSA) in two large Dutch RCT’s. This IPS aims to detect employees who have a high risk to become absent, and subsequently offer them early treatment. Despite the overall effectiveness, only a few companies have implemented this strategy so far. This suggests that companies may not be convinced of the (cost) effectiveness of this strategy yet. In companies where IPS has been implemented, screenings uptake and adherence to early treatment appeared to be moderate, indicating that both employees and employers might perceive barriers. Methods The aim of this qualitative study was to explore the expected and perceived facilitators and barriers for the implementation of the IPS. Semi-structured interviews were conducted with 9 employers and 11 employees (acquainted and unacquainted with IPS) from large companies. Purposive sampling was used to recruit participants. All interviews were transcribed and analyzed thematically. Results The employers believed they were primarily responsible for psychological and work-related health complaints and SA, while the employees felt responsible for health complaints related to their lifestyle. According to the employees, the responsibility of the employer was solely related to work-related health. This finding exposed a relation with the health culture, which was solely based on creating a safe work environment, omitting psychological health issues. The efficacy of this IPS regarding reducing SA was estimated positive, however, the efficacy regarding LTSA was questioned. Fear of a privacy breach was often mentioned by the respondents as an important barrier. Conclusions This study showed that the health culture within a company may be important for the perceived responsibility towards SA and health. A health culture which primarily focuses on physical complaints may raise barriers for the adoption and implementation of this preventive strategy. Participant’ perceptions of the nature of LTSA and the fact that not all participants were familiar with the exact content and phasing of IPS may have doubted the efficacy regarding LTSA. This study provides important clues for future and improved implementation of IPS.

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Time efficient interventions by general practitioners curb benzodiazepine consumption among long-term users

Evidence-Based Mental Health ◽

10.1136/eb-2014-101934 ◽

2014 ◽

Vol 18 (1) ◽

pp. 30-30

Author(s):

Cara Tannenbaum

Keyword(s):

General Practitioners

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Long-term sickness absence in the workplace: causes of sickness absence and their predictors

Acta Psychiatrica Scandinavica ◽

10.1111/acps.12104 ◽

2013 ◽

Vol 128 (1) ◽

pp. 98-99

Author(s):

T. Kawada

Keyword(s):

Sickness Absence

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Does workplace social capital protect against long-term sickness absence? Linking workplace aggregated social capital to sickness absence registry data

Scandinavian Journal of Public Health ◽

10.1177/1403494817721672 ◽

2017 ◽

Vol 46 (3) ◽

pp. 290-296 ◽

Cited By ~ 9

Author(s):

Anne-Sophie K. Hansen ◽

Ida E. H. Madsen ◽

Sannie Vester Thorsen ◽

Ole Melkevik ◽

Jakob Bue Bjørner ◽

...

Keyword(s):

Social Capital ◽

Private Sector ◽

Sickness Absence ◽

Collective Good ◽

Standard Deviation Increase ◽

Individual Level ◽

The Individual ◽

Adjusted Model ◽

Workplace Social Capital

Aims: Most previous prospective studies have examined workplace social capital as a resource of the individual. However, literature suggests that social capital is a collective good. In the present study we examined whether a high level of workplace aggregated social capital (WASC) predicts a decreased risk of individual-level long-term sickness absence (LTSA) in Danish private sector employees. Methods: A sample of 2043 employees (aged 18–64 years, 38.5% women) from 260 Danish private-sector companies filled in a questionnaire on workplace social capital and covariates. WASC was calculated by assigning the company-averaged social capital score to all employees of each company. We derived LTSA, defined as sickness absence of more than three weeks, from a national register. We examined if WASC predicted employee LTSA using multilevel survival analyses, while excluding participants with LTSA in the three months preceding baseline. Results: We found no statistically significant association in any of the analyses. The hazard ratio for LTSA in the fully adjusted model was 0.93 (95% CI 0.77–1.13) per one standard deviation increase in WASC. When using WASC as a categorical exposure we found a statistically non-significant tendency towards a decreased risk of LTSA in employees with medium WASC (fully adjusted model: HR 0.78 (95% CI 0.48–1.27)). Post hoc analyses with workplace social capital as a resource of the individual showed similar results. Conclusions: WASC did not predict LTSA in this sample of Danish private-sector employees.

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