scholarly journals Faster return to work after psychiatric consultation for sicklisted employees with common mental disorders compared to care as usual. A randomized clinical trial

Author(s):  
Christina Van der Feltz-Cornelis
Author(s):  
Lene Aasdahl ◽  
Ottar Vasseljen ◽  
Sigmund Østgård Gismervik ◽  
Roar Johnsen ◽  
Marius Steiro Fimland

AbstractPurpose There is a lack of results on long-term effects of return to work interventions. We previously reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective in reducing sickness absence and facilitating return to work (RTW) at 12 months follow-up compared to an outpatient program that consisted mainly of Acceptance and Commitment Therapy (O-ACT). We now report the 2-year outcome data. Methods A randomized clinical trial with parallel groups. Participants were 18–60 years old, sick listed with musculoskeletal, common mental or general/unspecified disorders. I-MORE lasted 3.5 weeks and consisted of ACT, physical training and work-related problem solving. O-ACT consisted mainly of 6 weekly sessions (2.5 h. each) of ACT in groups. Outcomes were cumulated number of days on medical benefits and time until sustainable RTW (1 month without medical benefits) during 2-years of follow-up, measured by registry data. Results For the 166 randomized participants, the median number of days on medical benefits was 159 (IQR 59–342) for I-MORE vs 249 days (IQR 103–379; Mann–Whitney U test, p = 0.07), for O-ACT. At 2 years, 40% in I-MORE received long-term benefits (work assessment allowance) vs 51% in O-ACT. The crude hazard ratio (HR) for sustainable RTW was 1.59 (95% CI 1.04–2.42, p = 0.03) and the adjusted HR 1.77 (95% CI 1.14–2.75, p = 0.01), in favor of I-MORE. Conclusions The 2-year outcomes show that I-MORE had long-term positive effects on increasing work participation for individuals sick listed with musculoskeletal and mental disorders. Further follow-up and economic evaluations should be performed.


Author(s):  
Andrea Gragnano ◽  
Patrizia Villotti ◽  
Christian Larivière ◽  
Alessia Negrini ◽  
Marc Corbière

AbstractPurpose Individual psychosocial factors are crucial in the return to work (RTW) process of workers with musculoskeletal disorders (MSDs) and common mental disorders (CMDs). However, the quality and validity of the questionnaires used to measure these factors have rarely been investigated. The present systematic search and literature review aims at identifying, categorizing, and evaluating the questionnaires (measurement tools) used to measure individual psychosocial factors related to the perception of the personal condition and motivation to RTW that are predictive of successful RTW among workers with MSDs or CMDs. Methods Through a systematic search on PubMed, Web of Science, and PsycINFO library databases and grey literature, we identified the individual psychosocial factors predictive of successful RTW among these workers. Then, we retrieved the questionnaires used to measure these factors. Finally, we searched for articles validating these questionnaires to describe them exhaustively from a psychometric and practical point of view. Results: The review included 76 studies from an initial pool of 2263 articles. Three common significant predictors of RTW after MSDs and CMDs emerged (i.e., RTW expectations, RTW self-efficacy, and work ability), two significant predictors of RTW after MSDs only (i.e., work involvement and the self-perceived connection between health and job), and two significant predictors of RTW after CMDs only (i.e., optimism and pessimism). We analyzed 30 questionnaires, including eight multiple-item scales and 22 single-item measures. Based on their psychometric and practical properties, we evaluated one of the eight multiple-item scales as questionable and five as excellent. Conclusions: With some exceptions (i.e., self-efficacy), the tools used to measure individual psychosocial factors show moderate to considerable room for improvement.


2012 ◽  
Vol 57 (4) ◽  
pp. 280-289 ◽  
Author(s):  
David J. Martin ◽  
Robert A. Chernoff ◽  
Michael Buitron ◽  
W. Scott Comulada ◽  
Li-Jung Liang ◽  
...  

2015 ◽  
Vol 25 (3) ◽  
pp. 627-637 ◽  
Author(s):  
Kerstin Ekberg ◽  
Charlotte Wåhlin ◽  
Jan Persson ◽  
Lars Bernfort ◽  
Birgitta Öberg

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Karlijn M. van Beurden ◽  
Jac J. L. van der Klink ◽  
Evelien P. M. Brouwers ◽  
Margot C. W. Joosen ◽  
Jolanda J. P. Mathijssen ◽  
...  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Nordling ◽  
L Nordeman ◽  
I M Skoglund ◽  
C Björkelund ◽  
G Hensing

Abstract Background In the sickness absence and return-to-work process communication between stakeholders is beneficial but difficult to achieve. Addressing work-related issues early in the process could support decision making. The aim of this study was to test if early systematic communication about work and health between physician, patient/employee and employer facilitated by a communication tool, the Capacity Note, was feasible for patients with common mental disorders (CMD) in primary care. Methods In a pragmatic trial, physicians at primary health care centers (PHCCs) were randomized to control/intervention physician and were responsible for identifying eligible patients. In addition to usual care, intervention patients used the Capacity Note with their physician and were then instructed to use it with their employer and return it to the physician. Control patients received usual care. A study log book and sick leave data for each PHCC were used for process evaluation purposes. Results Eighteen of 24 PHCCs in the region were contacted; eight participated. At study start, 434 patients filled the basic inclusion criteria. Of these, 93 were identified as eligible by the physicians and were asked to participate. Around 40% declined participation, most commonly due to lack of energy or hesitation to talk to the employer. The final sample included 56 patients. Of the 28 intervention patients nine (32%) completed the intervention. Conclusions The study was negatively affected by suboptimal research conditions in primary care (e.g. severe time constraints). Also, the patients' hesitation to participate highlights the sensitivity of the topic and the difficulties in doing research in this vulnerable patient group. Thus, the feasibility was hampered by both organizational and patient related factors. It is of utmost importance to improve possibilities for social psychiatric research in primary care given the high prevalence of CMD and associated reduced capacity to work. Key messages Discussing health-related issues with the employer was seen as a sensitive matter among patients with common mental disorders. Research on best practices for sickness certification and return-to-work was difficult to achieve due to both personal and organizational factors.


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