Return-to-work support programs for workers on sick leave: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to analyze the effects of workplace interventions (WI) on clinical outcomes related to low back pain (LBP) in a worker population, and to assess socio-economic parameters as participants on sick leave, days of sick leave, and return to work following WI. A systematic literature search was performed to select randomized clinical trials that investigated the effectiveness of WI on return to work, sick leave, and working capacity of workers affected by nonspecific LBP. Fourteen articles were included in the review and meta-analysis. The meta-analysis showed improvements in pain (p = 0.004), disability (p = 0.0008), fear-avoidance for psychical activity (p = 0.004), and quality of life (p = 0.001 for physical scale and p = 0.03 for mental scale) for patients who underwent WI compared to controls. Moreover, the pain reduction following WI was statistically significant in the healthcare workers’ group (p = 0.005), but not in the other workers’ group. The participants on sick leave and the number of days of sick leave decreased in the WI group without statistical significance (p = 0.85 and p = 0.10, respectively). Finally, LBP recurrence was significantly reduced in the WI group (p = 0.006). WI led to a significant improvement of clinical outcomes in a workers’ population affected by LBP.

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Interventions for enhancing return to work in individuals with a common mental illness: systematic review and meta-analysis of randomized controlled trials

Psychological Medicine ◽

10.1017/s0033291716002269 ◽

2016 ◽

Vol 46 (16) ◽

pp. 3263-3274 ◽

Cited By ~ 40

Author(s):

Y. T. Nigatu ◽

Y. Liu ◽

M. Uppal ◽

S. McKinney ◽

S. Rao ◽

...

Keyword(s):

Systematic Review ◽

Sick Leave ◽

Return To Work ◽

Randomized Controlled Trials ◽

Common Mental Disorders ◽

Meta Analysis ◽

Intervention Group ◽

Control Group ◽

Controlled Trials ◽

Randomized Controlled

Common mental disorders (CMDs) are highly prevalent in the working population, and are associated with long-term sickness absence and disability. Workers on sick leave with CMDs would benefit from interventions that enable them to successfully return to work (RTW). However, the effectiveness of RTW interventions for workers with a CMD is not well studied. The objective of this review is to assess the effectiveness of existing workplace and clinical interventions that were aimed at enhancing RTW. A systematic review of studies of interventions for improving RTW in workers with a CMD was conducted. The main outcomes were proportion of RTW and sick-leave duration until RTW. Randomized controlled trials (RCTs) were identified from Medline/PubMed, PsycINFO, EMBASE, SocINDEX, and Human resource and management databases from January 1995 to 2016. Two authors independently selected studies, assessed risk of bias and extracted data. We pooled studies that we deemed sufficiently homogeneous in different comparison groups and assessed the overall quality of the evidence. We reviewed 2347 abstracts from which 136 full-text articles were reviewed and 16 RCTs were included in the analysis. Combined results from these studies suggested that the available interventions did not lead to improved RTW rates over the control group [pooled risk ratio 1.05, 95% confidence interval (CI) 0.97–1.12], but reduced the number of sick-leave days in the intervention group compared to the control group, with a mean difference of −13.38 days (95% CI −24.07 to −2.69).

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Return to Work After Primary Rotator Cuff Repair: A Systematic Review and Meta-analysis

The American Journal of Sports Medicine ◽

10.1177/0363546520975426 ◽

2021 ◽

pp. 036354652097542

Author(s):

Eric D. Haunschild ◽

Ron Gilat ◽

Ophelie Lavoie-Gagne ◽

Michael C. Fu ◽

Tracy Tauro ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Return To Work ◽

Rotator Cuff Repair ◽

Meta Analysis ◽

Work Outcomes ◽

Workers Compensation ◽

Work Intensity ◽

Rates Of Return ◽

Cuff Repair

Background: Rotator cuff tears are a prevalent pathology in injured workers, causing significant economic ramifications and time away from work. To date, published articles on work outcomes after rotator cuff repair have not been cumulatively assessed and analyzed. Purpose: To systematically review reports on return to work after rotator cuff repair and perform a meta-analysis on factors associated with improved work outcomes. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic review of return-to-work investigations was performed using PubMed, Embase, and the Cochrane Database of Systematic Reviews in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Individual studies reporting rates of return to previous work with level of evidence 1 to 4 were independently screened by 2 authors for inclusion, and study quality was assessed using the Methodologic Index for Non-randomized Studies and Newcastle-Ottawa Scale. Work outcome data were synthesized and analyzed using random effects modeling to identify differences in rates of return to previous work as a function of operative technique, work intensity, and workers’ compensation status. Results: Thirteen retrospective investigations comprising 1224 patients who underwent rotator cuff repair met inclusion criteria for this investigation. Across all investigations, a weighted average of 62.3% of patients returned to previous level of work at 8.15 ± 2.7 months (mean ± SD) after surgery. Based on random effects modeling, higher rates of return to previous work were identified with decreasing work intensity ( P < .001), while rates were similar between open and arthroscopic repair technique ( P = .418) and between workers’ compensation and non–workers’ compensation cohorts ( P = .089). All shoulder pain and functional outcome assessments demonstrated significant improvements at final follow-up when compared with baseline across all investigations. Conclusion: The majority of injured workers undergoing rotator cuff repair return to previous work at approximately 8 months after surgery. Despite this, >35% of patients are unable to return to their previous work level after their repair procedure. Similar rates of return to work can be anticipated regardless of workers’ compensation status and operative technique, while patients in occupations with higher physical intensity experience inferior work outcomes.

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Return-to-work support for employees with mental health problems: Identifying and responding to key challenges of sick leave

British Journal of Occupational Therapy ◽

10.1177/0308022615627176 ◽

2016 ◽

Vol 79 (5) ◽

pp. 275-283 ◽

Cited By ~ 8

Author(s):

Josh Cameron ◽

Gaynor Sadlo ◽

Angie Hart ◽

Carl Walker

Keyword(s):

Mental Health ◽

Sick Leave ◽

Return To Work ◽

Mental Health Problems ◽

Health Problems ◽

Work Support

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Interventions to facilitate return to work in adults with chronic non-malignant pain: a protocol for a systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-040962 ◽

2020 ◽

Vol 10 (11) ◽

pp. e040962

Author(s):

Mathilda Björk ◽

Björn Gerdle ◽

Gunilla Liedberg ◽

Frida Svanholm ◽

Marco Solmi ◽

...

Keyword(s):

Systematic Review ◽

Return To Work ◽

Meta Analysis ◽

Indirect Evidence ◽

Controlled Trials ◽

Analysis Tool ◽

Cochrane Central Register ◽

Full Time ◽

Private Patient

IntroductionWork absenteeism due to chronic non-malignant pain (CNMP) is a major societal and individual cause of concern that requires effective treatments.ObjectiveWe present a protocol for a systematic review and network meta-analysis (NMA) aiming to compare available interventions for return to work (RTW) in adults with CNMP.Methods and analysisPubMed, Embase, PsycINFO, Web of Knowledge and Cochrane Central Register of Controlled Trials databases will be searched till 31 August 2020 for randomised controlled trials (RCTs) examining interventions for RTW outcomes among patients with CNMP. Two independent investigators will search the databases, perform data extraction and assess the methodological quality of the selected RCTs. The primary outcome will be RTW, if possible, full-time or part-time after work absence due to chronic pain from baseline to the last available follow-up. Secondary outcomes will include self-reported workability or work capacity, or self-reported physical functioning and quality of life as measured by any validated scale. Pairwise meta-analysis and NMA will be conducted for each outcome using a random-effects model. For the primary outcomes, we will also obtain the ranking of all competing interventions within each NMA using surface under the cumulative ranking curve. The assumption of coherence (ie, that direct and indirect evidence are in statistical agreement) will be examined using both a local and a global approach. We will also conduct subgroup and meta-regression analyses, whenever feasible, to investigate the unexplained variation in effect size. The comparison-adjusted funnel plot will be used to evaluate small-study effects. The overall quality of evidence will be rated with the Confidence in Network Meta-Analysis tool. Data analysis will be conducted using Stata V.16.0.Ethics and disseminationThis systematic review does not require ethical approval since it will not disseminate any private patient data. The results of this study will be disseminated through peer-reviewed publication.PROSPERO registration numberCRD42020171429.

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Return to work after shoulder arthroplasty: a systematic review and meta-analysis

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2018.12.011 ◽

2019 ◽

Vol 28 (5) ◽

pp. 998-1008 ◽

Cited By ~ 4

Author(s):

Michael E. Steinhaus ◽

Anirudh K. Gowd ◽

Daniel J. Hurwit ◽

Adam C. Lieber ◽

Joseph N. Liu

Keyword(s):

Systematic Review ◽

Return To Work ◽

Shoulder Arthroplasty ◽

Meta Analysis

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Absence from work and return to work in people with back pain: a systematic review and meta-analysis

Occupational and Environmental Medicine ◽

10.1136/oemed-2013-101571 ◽

2013 ◽

Vol 71 (6) ◽

pp. 448-456 ◽

Cited By ~ 67

Author(s):

Gwenllian Wynne-Jones ◽

Jemma Cowen ◽

Joanne L Jordan ◽

Olalekan Uthman ◽

Chris J Main ◽

...

Keyword(s):

Systematic Review ◽

Back Pain ◽

Return To Work ◽

Meta Analysis ◽

Absence From Work

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Rehabilitation interventions to support return to work for women with breast cancer: a systematic review and meta-analysis

10.21203/rs.3.rs-250979/v1 ◽

2021 ◽

Author(s):

Naomi Algeo ◽

Kathleen Bennett ◽

Deirdre Connolly

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Return To Work ◽

Usual Care ◽

Breast Cancer Survivors ◽

Meta Analysis ◽

Work Outcomes ◽

Cochrane Central Register ◽

Specific Content ◽

Significant Difference

Abstract Background Research recommends the development and evaluation of interventions to support women with breast cancer in returning to, or managing, work. Despite this, there has historically been a paucity of rehabilitation interventions to support women with breast cancer to maintain or return to their work role. The aim of this systematic review was to examine key characteristics of rehabilitation interventions, and their effectiveness on work outcomes for women with breast cancer, compared to usual care. Methods A systematic review was conducted of controlled studies of rehabilitation interventions with work outcomes for women with breast cancer. Six databases were systematically searched: EMBASE, Web of Science, MEDLINE (OVID), CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Results are presented either as pooled odds ratio (OR) or pooled effect size (hedges g) between groups, with 95% confidence intervals (CI). Narrative synthesis was conducted on intervention outcomes not suitable for meta-analysis. Results Five thousand, five hundred and thirty-five studies were identified. Nine out of 28 abstracts met inclusion criteria. Heterogeneity of interventions and outcomes precluded meta-analysis for most outcomes. Of the interventions included in meta-analysis, no significant differences compared to usual care were found for sick leave (2 studies (12 months); OR 1.11 (95% CI: 0.66 to 1.87), number of sick days taken (2 studies (six months); difference in effect: -0.08, (95% CI: -0.48 to 0.38) or working hours (2 studies (12 months); 0.19, (95% CI: -0.20 to 0.64). Only one study, with a multidisciplinary intervention, showed a significant difference for work outcomes when compared to usual care. Work-specific content featured in three interventions only, none of which provided conclusive evidence for improvement in work outcomes. Enhanced physical and psychological sequalae, and quality of life was observed in some studies. Conclusion There remains a lack of effective and methodologically rigorous rehabilitation intervention studies for breast cancer survivors. The development and evaluation of effective rehabilitation interventions to support return to work is warranted.

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