Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions

Background Sick leave due to musculoskeletal pain, particularly in the neck/shoulders and back, is one of the major public health problems in Western countries such as Sweden. The aim of this study was to identify predictors of return to work (RTW) among women on sick leave due to long-term neck/shoulder and/or back pain. Methods This was a prospective cohort study with a 1-year follow-up. The study participants were recruited from a local Swedish Social Insurance Agency register and had all been on sick leave for ≥ 1 month due to long-term (≥ 3 months) neck/shoulder and/or back pain. Data on predictors and outcome were collected using a self-administered questionnaire. A total of 208 women aged 23–64 years were included at baseline, and 141 responded at the 1-year follow-up. Cluster analyses were performed to identify one predictor from each cluster for use in the regression model. Results At the 1-year follow-up, 94 of the 141 women had RTW and 47 had not. Women who engaged in more coping through increasing behavioral activities (OR: 1.14, 95% CI: 1.03–1.25) and those who more strongly believed they would return to the same work within 6 months (OR: 1.22, 95% CI: 1.10–1.37) had an increased probability of RTW. Receiving more social support outside work (OR: 0.50, 95% CI: 0.28–0.92) decreased the odds of RTW at the 1-year follow-up. Conclusions Behavioral activities, beliefs about returning to the same work, and social support outside work were predictors of RTW at the 1-year follow-up. Healthcare professionals should consider these predictors in their efforts to prevent prolonged sick leave and to promote RTW in this population.

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The Effects of Workplace Interventions on Low Back Pain in Workers: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312614 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12614

Author(s):

Fabrizio Russo ◽

Giuseppe Francesco Papalia ◽

Gianluca Vadalà ◽

Luca Fontana ◽

Sergio Iavicoli ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Sick Leave ◽

Return To Work ◽

Clinical Outcomes ◽

Meta Analysis ◽

Low Back ◽

Workplace Interventions ◽

Physical Scale

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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Factors associated with return to work among people on work absence due to long-term neck or back pain: a narrative systematic review

BMJ Open ◽

10.1136/bmjopen-2016-014939 ◽

2017 ◽

Vol 7 (6) ◽

pp. e014939 ◽

Cited By ~ 11

Author(s):

Mamunur Rashid ◽

Marja-Leena Kristofferzon ◽

Annika Nilsson ◽

Marina Heiden

Keyword(s):

Systematic Review ◽

Back Pain ◽

Return To Work ◽

Work Absence ◽

Factors Associated

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Determining what constitutes an effective psychosocial ‘return to work’ intervention: a systematic review and narrative synthesis

BMC Public Health ◽

10.1186/s12889-021-11898-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anthony Venning ◽

Tassia K. Oswald ◽

Jeremy Stevenson ◽

Nicci Tepper ◽

Leva Azadi ◽

...

Keyword(s):

Systematic Review ◽

Sick Leave ◽

Return To Work ◽

High Intensity ◽

Grey Literature ◽

Narrative Synthesis ◽

High Quality ◽

High Quality Research ◽

Randomised Controlled

Abstract Purpose Work can offer a myriad of social and health benefits. Long-term sick leave can be detrimental to employers, individuals, families, and societies. The burden of long-term sick leave has motivated the development of return to work (RTW) interventions. This study sought to determine what constitutes an effective psychosocial RTW intervention, which included exploring whether the level of intervention intensity and intervention characteristics matter to RTW outcomes. Methods A systematic review and narrative synthesis were undertaken. Studies were identified through six databases (Ovid Medline, CINAHL (EBSCOhost), PsycInfo (Ovid), ProQuest, Scopus, and Google Scholar) between 2011 and 3 September 2019. Randomised controlled trials (RCTs) or reviews published in English were eligible for inclusion if they targeted adults who were on sick leave/unemployed trying to return to full-capacity employment, had at least one structured psychosocial RTW intervention, and assessed RTW. Study quality was assessed using checklists from the Joanna Briggs Institute. Results Database searching yielded 12,311 records. Eighteen RCTs (comprising 42 intervention/comparison groups), seven reviews (comprising 153 studies), and five grey literature documents were included. Included studies were of moderate-to-high quality. Research was primarily conducted in Europe and focused on psychological or musculoskeletal problems. RTW outcomes included RTW status, time until RTW, insurance claims, and sick days. Participating in a RTW program was superior to care-as-usual. RTW outcomes were similar between diverse interventions of low, moderate, and high intensity. Common foundational characteristics seen across effective RTW interventions included a focus on RTW, psychoeducation, and behavioural activation. Conclusions Evidence suggests that a low intensity approach to RTW interventions may be an appropriate first option before investment in high intensity, and arguably more expensive interventions, as the latter appear to provide limited additional benefit. More high-quality RCTs, from diverse countries, are needed to provide stronger evidence.

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Do work ability and life satisfaction matter for return to work? Predictive ability of the work ability index and life satisfaction questionnaire among women with long-term musculoskeletal pain

BMC Public Health ◽

10.1186/s12889-021-10510-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mamunur Rashid ◽

Marina Heiden ◽

Annika Nilsson ◽

Marja-Leena Kristofferzon

Keyword(s):

Life Satisfaction ◽

Back Pain ◽

Sick Leave ◽

Work Ability ◽

Work Ability Index ◽

Discriminative Ability ◽

Satisfaction Questionnaire ◽

Ability Index

Abstract Background Impaired work ability and reduced life satisfaction due to long-term musculoskeletal pain, particularly in neck, shoulders and back, are considered occupational health problems that can result in workers taking sick leave. The aim of the study was to determine whether work ability and life satisfaction predict return to work (RTW) among women with long-term neck/shoulder and/or back pain, and to assess the ability of the Work Ability Index (WAI) and the Life Satisfaction Questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW (NRTW). Methods This is a cohort study with 1-year follow-up. A survey was sent to 600 women receiving sick leave benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and life satisfaction predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and the LiSat-11 for women who did RTW and those who did NRTW, receiver operating characteristic curves were fitted. Results Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04–1.22). Life satisfaction was not significant. The WAI at baseline adequately discriminated between RTW and NRTW after 1 year (Area under curve 0.78, 95% CI: 0.70–0.86), but the LiSat-11 did not. Conclusions This study supports a relationship between work ability and RTW among women on sick leave for long-term neck/shoulder and/or back pain. The results indicate that the WAI, but not the LiSat-11, can discriminate between RTW and NRTW in the population under study. Although the discriminative ability of the WAI needs to be verified in new samples before it can be recommended for use in rehabilitation settings, we suggest that healthcare professionals consider how women perceive their work ability in order to better support them in their RTW.

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Intervertebral disc therapies for non-specific chronic low back pain: a systematic review and meta-analysis

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x211028001 ◽

2021 ◽

Vol 13 ◽

pp. 1759720X2110280

Author(s):

Camille Daste ◽

Stéphanie Laclau ◽

Margaux Boisson ◽

François Segretin ◽

Antoine Feydy ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Intervertebral Disc ◽

Chronic Low Back Pain ◽

Meta Analysis ◽

Activity Limitations ◽

Low Back ◽

Short Term

Objectives: We aim to evaluate the benefits and harms of intervertebral disc therapies (IDTs) in people with non-specific chronic low back pain (NScLBP). Methods: We conducted a systematic review and meta-analysis of randomized trials of IDTs versus placebo interventions, active comparators or usual care. EMBASE, MEDLINE, CENTRAL and CINHAL databases and conference abstracts were searched from inception to June 2020. Two independent investigators extracted data. The primary outcome was LBP intensity at short term (1 week–3 months), intermediate term (3–6 months) and long term (after 6 months). Results: Of 18 eligible trials (among 1396 citations), five assessed glucocorticoids (GCs) IDTs and were included in a quantitative synthesis; 13 assessed other products including etanercept ( n = 2), tocilizumab ( n = 1), methylene blue ( n = 2), ozone ( n = 2), chymopapaine ( n = 1), glycerol ( n = 1), stem cells ( n = 1), platelet-rich plasma ( n = 1) and recombinant human growth and differentiation factor-5 ( n = 2), and were included in a narrative synthesis. Standardized mean differences (95% CI) for GC IDTs for LBP intensity and activity limitations were −1.33 (−2.34; −0.32) and −0.76 (−1.85; 0.34) at short term, −2.22 (−5.34; 0.90) and −1.60 (−3.51; 0.32) at intermediate term and −1.11 (−2.91; 0.70) and −0.63 (−1.68; 0.42) at long term, respectively. Odds ratios (95% CI) for serious and minor adverse events with GC IDTs were 1.09 (0.25; 4.65) and 0.97 (0.49; 1.91). Conclusion: GC IDTs are associated with a reduction in LBP intensity at short term in people with NScLBP. Positive effects are not sustained. IDTs have no effect on activity limitations. Our conclusions are limited by high heterogeneity and a limited methodological quality across studies. Registration PROSPERO: CRD42019106336.

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

SANGYO EISEIGAKU ZASSHI ◽

10.1539/sangyoeisei.2018-008-a ◽

2018 ◽

Vol 60 (6) ◽

pp. 169-179

Author(s):

Shotaro Doki ◽

Satoru Harano ◽

Kayoko Shinada ◽

Atsushi Ohyama ◽

Noriko Kojimahara

Keyword(s):

Systematic Review ◽

Sick Leave ◽

Return To Work ◽

Meta Analysis ◽

Support Programs ◽

Work Support

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Return to work following meningioma surgery: a Swedish nationwide registry-based matched cohort study

Neuro-Oncology Practice ◽

10.1093/nop/npz066 ◽

2019 ◽

Vol 7 (3) ◽

pp. 320-328 ◽

Cited By ~ 1

Author(s):

Erik Thurin ◽

Alba Corell ◽

Sasha Gulati ◽

Anja Smits ◽

Roger Henriksson ◽

...

Keyword(s):

Sick Leave ◽

Return To Work ◽

Previous History ◽

Tumor Grade ◽

Neurological Impairment ◽

Neurological Deficits ◽

Intracranial Meningioma ◽

Patients Âgés ◽

Meningioma Surgery

Abstract Background Meningioma is the most common primary intracranial tumor. It is usually slow growing and benign, and surgery is the main treatment modality. There are limited data on return to work following meningioma surgery. The objective of this study was to determine the patterns of sick-leave rate prior to surgery, and up to 2 years after, in patients compared to matched controls. Methods Data on patients ages 18 to 60 years with histologically verified intracranial meningioma between 2009 and 2015 were identified in the Swedish Brain Tumor Registry (SBTR) and linked to 3 national registries after 5 matched controls were assigned to each patient. Results We analyzed 956 patients and 4765 controls. One year prior to surgery, 79% of meningioma patients and 86% of controls were working (P < .001). The proportion of patients at work 2 years after surgery was 57%, in contrast to 84% of controls (P < .001). Statistically significant negative predictors for return to work in patients 2 years after surgery were high (vs low) tumor grade, previous history of depression, amount of sick leave in the year preceding surgery, and surgically acquired neurological deficits. Conclusion There is a considerable risk for long term sick leave 2 years after meningioma surgery. Neurological impairment following surgery was a modifiable risk factor increasing the risk for long-term sick leave. More effective treatment of depression may facilitate return to work in this patient group.

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