TY - JOUR AB - Purpose To assess effects of an inpatient multicomponent occupational rehabilitation program compared to less comprehensive outpatient rehabilitation on sickness absence in persons with musculoskeletal- or mental health disorders. Methods Randomized clinical trial with parallel groups. Participants were individuals 18-60 years old on sick-leave for 2-12 months with a sick-leave diagnosis within the musculoskeletal, psychological or general and unspecified chapters of ICPC-2, identified in a national register. The inpatient program (4 + 4 days) consisted of Acceptance and Commitment Therapy (ACT), physical training and work-related problem-solving including creating a return to work plan and a workplace visit if considered relevant. The outpatient program consisted primarily of ACT (6 sessions during 6 weeks). Both programs were group based. Primary outcome was cumulated number of sickness absence days at 6 and 12 months follow-up. Secondary outcome was time until sustainable return to work. Results 168 individuals were randomized to the inpatient program (n = 92) or the outpatient program (n = 76). We found no statistically significant difference between the programs in median number of sickness absence days at 6 and 12 months follow-up. In the outpatient program 57% of the participants achieved sustainable return to work (median time 7 months), in the inpatient program 49% (log rank, p = 0.167). The hazard ratio for sustainable return to work was 0.74 (95% CI 0.48-1.32, p = 0.165), in favor of the outpatient program. Conclusions This study provided no support that the more comprehensive 4 + 4 days inpatient multicomponent occupational rehabilitation program reduced sickness absence compared to the outpatient rehabilitation program. AD - Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway. lene.aasdahl@ntnu.no. Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. lene.aasdahl@ntnu.no. Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway. Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Regional Center for health care improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Department of Community Medicine, UiT The Artic University of Norway, Tromso, Norway. Department of Public Health, Aarhus University, Aarhus, Denmark. Hysnes Rehabilitation Center, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. AN - 28401441 AU - Aasdahl, L. AU - Pape, K. AU - Vasseljen, O. AU - Johnsen, R. AU - Gismervik, S. AU - Halsteinli, V. AU - Fleten, N. AU - Nielsen, C. V. AU - Fimland, M. S. C1 - CONFLICT OF INTEREST: Marius Steiro Fimland was previously employed at Hysnes Rehabilitation Center, St. Olavs Hospital, and is currently employed at Department of Physical Medicine and Rehabilitation, St. Olavs Hospital. Sigmund Gismervik is employed at Department of Physical Medicine and Rehabilitation, St. Olavs Hospital. The other authors declare that they have no conflict of interest. ETHICAL APPROVAL: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. C2 - PMC5820389 CN - Medline 211026 DA - Mar DB - Medline DO - 10.1007/s10926-017-9708-z DP - NLM IS - 1 J2 - J Occup Rehabil KW - Acceptance and Commitment Therapy/*methods Adult Cognitive Behavioral Therapy/*methods Female Humans Male Mental Disorders/psychology/*rehabilitation Middle Aged Musculoskeletal Diseases/psychology/*rehabilitation *Return to Work Sick Leave/statistics & numerical data Surveys and Questionnaires Cognitive therapy Mental health Musculoskeletal diseases Return to work Sick leave L1 - internal-pdf://4184438090/1078-Aasdahl-2018.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Aasdahl, Lene Pape, Kristine Vasseljen, Ottar Johnsen, Roar Gismervik, Sigmund Halsteinli, Vidar Fleten, Nils Nielsen, Claus Vinther Fimland, Marius Steiro eng 238015/H20/Norges Forskningsrad/International 46056821/The Liason Committee between Central Norway Regional Health Authority and The Norwegian University of Science and Technology/International Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2017/04/13 J Occup Rehabil. 2018 Mar;28(1):170-179. doi: 10.1007/s10926-017-9708-z. PY - 2018 SN - 1573-3688 (Electronic) 1053-0487 (Print) 1053-0487 (Linking) SP - 170-179 ST - Effect of Inpatient Multicomponent Occupational Rehabilitation Versus Less Comprehensive Outpatient Rehabilitation on Sickness Absence in Persons with Musculoskeletal- or Mental Health Disorders: A Randomized Clinical Trial T2 - J Occup Rehabil TI - Effect of Inpatient Multicomponent Occupational Rehabilitation Versus Less Comprehensive Outpatient Rehabilitation on Sickness Absence in Persons with Musculoskeletal- or Mental Health Disorders: A Randomized Clinical Trial UR - https://www.ncbi.nlm.nih.gov/pubmed/28401441 VL - 28 ID - 1078 ER - TY - JOUR AB - Purpose 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. AD - Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Postboks 8905, 7491, Trondheim, Norway. lene.aasdahl@ntnu.no. Unicare Helsefort Rehabilitation Centre, Rissa, Norway. lene.aasdahl@ntnu.no. Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Postboks 8905, 7491, Trondheim, Norway. Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Unicare Helsefort Rehabilitation Centre, Rissa, Norway. Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. AN - 33765241 AU - Aasdahl, L. AU - Vasseljen, O. AU - Gismervik, S. O. AU - Johnsen, R. AU - Fimland, M. S. C1 - The authors declare that they have no competing interests. C2 - PMC8558177 CN - Medline 211026 DA - Dec DB - Medline DO - 10.1007/s10926-021-09969-4 DP - NLM ET - 20210325 IS - 4 J2 - J Occup Rehabil KW - *Acceptance and Commitment Therapy Adolescent Adult Follow-Up Studies Humans Inpatients *Mental Disorders Middle Aged Outpatients Sick Leave Young Adult Cognitive therapy Mental health Musculoskeletal diseases Return to work L1 - internal-pdf://2327286681/1080-Aasdahl-2021.pdf LA - English N1 - Aasdahl, Lene Vasseljen, Ottar Gismervik, Sigmund Ostgard Johnsen, Roar Fimland, Marius Steiro eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2021/03/26 J Occup Rehabil. 2021 Dec;31(4):721-728. doi: 10.1007/s10926-021-09969-4. Epub 2021 Mar 25. PY - 2021 SN - 1573-3688 (Electronic) 1053-0487 (Print) 1053-0487 (Linking) SP - 721-728 ST - Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders T2 - J Occup Rehabil TI - Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders UR - https://www.ncbi.nlm.nih.gov/pubmed/33765241 VL - 31 ID - 1080 ER - TY - JOUR AB - BACKGROUND: Musculoskeletal disorders (MSDs) are a frequent cause of work disability, accounting for productivity losses in industrialized societies equivalent to 1.3% of the U.S. gross national product. OBJECTIVE: To evaluate whether a population-based clinical program offered to patients with recent-onset work disability caused by MSDs is cost-effective. DESIGN: Randomized, controlled intervention study. The inclusion and follow-up periods each lasted 12 months. SETTING: Three health districts in Madrid, Spain. PATIENTS: All patients with MSD-related temporary work disability in 1998 and 1999. INTERVENTION: The control group received standard primary care management, with referral to specialized care if needed. The intervention group received a specific program, administered by rheumatologists, in which care was delivered during regular visits and included 3 main elements: education, protocol-based clinical management, and administrative duties. MEASUREMENTS: Efficacy variables were 1) days of temporary work disability and 2) number of patients with permanent work disability. All analyses were done on an intention-to-treat basis. RESULTS: 1,077 patients were included in the study, 7805 in the control group and 5272 in the intervention group, generating 16,297 episodes of MSD-related temporary work disability. These episodes were shorter in the intervention group than in the control group (mean, 26 days compared with 41 days; P < 0.001), and the groups had similar numbers of episodes per patient. Fewer patients received long-term disability compensation in the intervention group (n = 38 [0.7%]) than in the control group (n = 99 [1.3%]) (P < 0.005). Direct and indirect costs were lower in the intervention group than in the control group. To save 1 day of temporary work disability, 6.00 dollars had to be invested in the program. Each dollar invested generated a benefit of 11.00 dollars. The program's net benefit was in excess of 5 million dollars. LIMITATIONS: The study was unblinded. CONCLUSIONS: Implementation of the program, offered to the general population, improves short- and long-term work disability outcomes and is cost-effective. AD - Hospital Clinico San Carlos, Hospital Ramon y Cajal, Madrid, Spain. AN - 16172439 AU - Abasolo, L. AU - Blanco, M. AU - Bachiller, J. AU - Candelas, G. AU - Collado, P. AU - Lajas, C. AU - Revenga, M. AU - Ricci, P. AU - Lazaro, P. AU - Aguilar, M. D. AU - Vargas, E. AU - Fernandez-Gutierrez, B. AU - Hernandez-Garcia, C. AU - Carmona, L. AU - Jover, J. A. CN - Medline 211026 DA - Sep 20 DB - Medline DO - 10.7326/0003-4819-143-6-200509200-00005 DP - NLM ET - 2005/09/21 IS - 6 J2 - Ann Intern Med KW - *Absenteeism Adult Disabled Persons *Early Ambulation *Employment Ergonomics *Exercise Therapy Female Humans Male Middle Aged Musculoskeletal Diseases/*rehabilitation *Patient Education as Topic Patient Satisfaction Program Evaluation/economics Spain Treatment Failure Treatment Outcome L1 - internal-pdf://2147250554/1081-Abasolo-2005.pdf LA - English M3 - Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Abasolo, Lydia Blanco, Margarita Bachiller, Javier Candelas, Gloria Collado, Paz Lajas, Cristina Revenga, Marcelino Ricci, Patricia Lazaro, Pablo Aguilar, Maria Dolores Vargas, Emilio Fernandez-Gutierrez, Benjamin Hernandez-Garcia, Cesar Carmona, Loreto Jover, Juan A eng Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't 2005/09/21 Ann Intern Med. 2005 Sep 20;143(6):404-14. doi: 10.7326/0003-4819-143-6-200509200-00005. PY - 2005 SN - 1539-3704 (Electronic) 0003-4819 (Linking) SP - 404-14 ST - A health system program to reduce work disability related to musculoskeletal disorders T2 - Ann Intern Med TI - A health system program to reduce work disability related to musculoskeletal disorders UR - https://www.ncbi.nlm.nih.gov/pubmed/16172439 VL - 143 ID - 1081 ER - TY - JOUR AB - STUDY DESIGN: Population-based randomized controlled trial. OBJECTIVE: To assess the effectiveness of workplace intervention and graded activity, separately and combined, for multidisciplinary rehabilitation of low back pain (LBP). SUMMARY OF BACKGROUND DATA: Effective components for multidisciplinary rehabilitation of LBP are not yet established. METHODS: Participants sick-listed 2 to 6 weeks due to nonspecific LBP were randomized to workplace intervention (n = 96) or usual care (n = 100). Workplace intervention consisted of workplace assessment, work modifications, and case management involving all stakeholders. Participants still sick-listed at 8 weeks were randomized for graded activity (n = 55) or usual care (n = 57). Graded activity comprised biweekly 1-hour exercise sessions based on operant-conditioning principles. Outcomes were lasting return to work, pain intensity and functional status, assessed at baseline, and at 12, 26, and 52 weeks after the start of sick leave. RESULTS: Time until return to work for workers with workplace intervention was 77 versus 104 days (median) for workers without this intervention (P = 0.02). Workplace intervention was effective on return to work (hazard ratio = 1.7; 95% CI, 1.2-2.3; P = 0.002). Graded activity had a negative effect on return to work (hazard ratio = 0.4; 95% CI, 0.3-0.6; P < 0.001) and functional status. Combined intervention had no effect. CONCLUSION: Workplace intervention is advised for multidisciplinary rehabilitation of subacute LBP. Graded activity or combined intervention is not advised. AD - Body@Work, Research Centre Physical Activity, Work and Health, Amsterdam, The Netherlands. h.anema@vumc.nl AN - 17268258 AU - Anema, J. R. AU - Steenstra, I. A. AU - Bongers, P. M. AU - de Vet, H. C. AU - Knol, D. L. AU - Loisel, P. AU - van Mechelen, W. CN - Medline 211026 DA - Feb 1 DB - Medline DO - 10.1097/01.brs.0000253604.90039.ad DP - NLM IS - 3 J2 - Spine KW - Acute Disease Adult Female Follow-Up Studies Humans Low Back Pain/*epidemiology/*rehabilitation Male Middle Aged Occupational Diseases/*epidemiology/*rehabilitation *Occupational Health Services/methods Sick Leave Single-Blind Method Workplace L1 - internal-pdf://1869490756/1154-Anema-2007.pdf LA - English M3 - Comparative Study Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Anema, Johannes R Steenstra, Ivan A Bongers, Paulien M de Vet, Henrica C W Knol, Dirk L Loisel, Patrick van Mechelen, Willem eng Comparative Study Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2007/02/03 Spine (Phila Pa 1976). 2007 Feb 1;32(3):291-8; discussion 299-300. doi: 10.1097/01.brs.0000253604.90039.ad. PY - 2007 SN - 1528-1159 (Electronic) 0362-2436 (Linking) SP - 291-8; discussion 299-300 ST - Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both? A randomized controlled trial T2 - Spine (Phila Pa 1976) TI - Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both? A randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/17268258 VL - 32 ID - 1154 ER - TY - JOUR AB - OBJECTIVES: Workers with common mental disorders (CMDs) frequently experience recurrent sickness absence but scientifically evaluated interventions to prevent recurrences are lacking. The objectives of this study are to evaluate the cost-effectiveness and cost-benefit of a problem solving intervention aimed at preventing recurrent sickness absence in workers with CMDs compared to care as usual. METHODS: An economic evaluation was conducted alongside a cluster-randomised controlled trial with 12 months follow-up. Treatment providers were randomised to either a 2-day training in the SHARP-at work intervention, i.e. a problem solving intervention, or care as usual. Effect outcomes were the incidence of recurrent sickness absence and time to recurrent sickness absence. Self-reported health care utilisation was measured by questionnaires. A cost-effectiveness analysis (CEA) from the societal perspective and a cost-benefit analysis (CBA) from the employer's perspective were conducted. RESULTS: The CEA showed that the SHARP-at work intervention was more effective but also more expensive than care as usual. The CBA revealed that employer's occupational health care costs were significantly higher in the intervention group compared to care as usual. Overall, the SHARP-at work intervention showed no economic benefit compared to care as usual. CONCLUSIONS: As implementation of the SHARP-at work intervention might require additional investments, health care policy makers need to decide if these investments are worthwhile considering the results that can be accomplished in reducing recurrent sickness absence. AD - Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. i.arends@umcg.nl AN - 23951270 AU - Arends, I. AU - Bultmann, U. AU - van Rhenen, W. AU - Groen, H. AU - van der Klink, J. J. C1 - Competing Interests: The authors have declared that no competing interests exist. C2 - PMC3741213 CN - Medline 211026 DB - Medline DO - 10.1371/journal.pone.0071937 DP - NLM ET - 20130812 IS - 8 J2 - PLoS ONE KW - Adult Cost-Benefit Analysis Efficiency, Organizational/economics Female Health Care Costs Humans Male Mental Disorders/*economics/epidemiology Middle Aged Occupational Health Services/economics *Problem Solving Program Evaluation Sick Leave/*economics L1 - internal-pdf://3512191499/1175-Arends-2013.pdf LA - English M3 - Research Support, Non-U.S. Gov't N1 - Arends, Iris Bultmann, Ute van Rhenen, Willem Groen, Henk van der Klink, Jac J L eng Research Support, Non-U.S. Gov't 2013/08/21 PLoS One. 2013 Aug 12;8(8):e71937. doi: 10.1371/journal.pone.0071937. eCollection 2013. PY - 2013 SN - 1932-6203 (Electronic) 1932-6203 (Linking) SP - e71937 ST - Economic evaluation of a problem solving intervention to prevent recurrent sickness absence in workers with common mental disorders T2 - PLoS One TI - Economic evaluation of a problem solving intervention to prevent recurrent sickness absence in workers with common mental disorders UR - https://www.ncbi.nlm.nih.gov/pubmed/23951270 VL - 8 ID - 1175 ER - TY - JOUR AB - OBJECTIVES: Workers with common mental disorders (CMDs) frequently experience recurrent sickness absence but interventions to prevent this are lacking. The goal of this study was to evaluate the effectiveness of the Stimulating Healthy participation And Relapse Prevention at work intervention in preventing recurrent sickness absence in workers who returned to work after sickness absence due to CMDs. METHODS: We performed a cluster-randomised controlled trial with 3 months, 6 months and 12 months follow-up. Treatment providers were randomised to either a 2-day training in the Stimulating Healthy participation And Relapse Prevention at work intervention, that is, a problem-solving intervention, or usual care. Primary outcome measures were the incidence of recurrent sickness absence and time to recurrent sickness absence. Secondary outcome measures were mental health complaints, work functioning and coping behaviour. RESULTS: 80 participants were randomised in the intervention group and 78 in the control group. The adjusted OR for the incidence of recurrent sickness absence was 0.40 (95% CI 0.20 to 0.81) and the adjusted HR for time to recurrent sickness absence was 0.53 (95% CI 0.33 to 0.86) for the intervention group compared with care as usual. CONCLUSIONS: This study demonstrates the 12-month effectiveness of a problem-solving intervention for reducing recurrent sickness absence in workers with CMDs and emphasises the importance of continuous attention in the post return to work phase for workers who have been on sickness absence due to CMDs. AD - Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen/University of Groningen, Groningen, The Netherlands. AN - 24158311 AU - Arends, I. AU - van der Klink, J. J. AU - van Rhenen, W. AU - de Boer, M. R. AU - Bultmann, U. CN - Medline 211026 DA - Jan DB - Medline DO - 10.1136/oemed-2013-101412 DP - NLM ET - 20131024 IS - 1 J2 - Occup Environ Med KW - *Absenteeism Adaptation, Psychological Adult Female Humans Incidence Male *Mental Disorders/complications Middle Aged Occupational Health Services/*methods Odds Ratio Problem Solving *Return to Work *Sick Leave Treatment Outcome L1 - internal-pdf://2684893286/1177-Arends-2014.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Arends, Iris van der Klink, Jac J L van Rhenen, Willem de Boer, Michiel R Bultmann, Ute eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2013/10/26 Occup Environ Med. 2014 Jan;71(1):21-9. doi: 10.1136/oemed-2013-101412. Epub 2013 Oct 24. PY - 2014 SN - 1470-7926 (Electronic) 1351-0711 (Linking) SP - 21-9 ST - Prevention of recurrent sickness absence in workers with common mental disorders: results of a cluster-randomised controlled trial T2 - Occup Environ Med TI - Prevention of recurrent sickness absence in workers with common mental disorders: results of a cluster-randomised controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/24158311 VL - 71 ID - 1177 ER - TY - JOUR AB - OBJECTIVE: Mental health problems often affect functioning to such an extent that they result in sick leave. The worldwide reported prevalence of mental health problems in the working population is 10%-18%. In developed countries, mental health problems are one of the main grounds for receiving disability benefits. In up to 90% of cases the cause is stress-related, and health-care utilisation is mainly restricted to primary care. The aim of this study was to assess the effectiveness of our Minimal Intervention for Stress-related mental disorders with Sick leave (MISS) in primary care, which is intended to reduce sick leave and prevent chronicity of symptoms. DESIGN: Cluster-randomised controlled educational trial. SETTING: Primary health-care practices in the Amsterdam area, The Netherlands. PARTICIPANTS: A total of 433 patients (MISS n = 227, usual care [UC] n = 206) with sick leave and self-reported elevated level of distress. INTERVENTIONS: Forty-six primary care physicians were randomised to either receive training in the MISS or to provide UC. Eligible patients were screened by mail. OUTCOME MEASURES: The primary outcome measure was duration of sick leave until lasting full return to work. The secondary outcomes were levels of self-reported distress, depression, anxiety, and somatisation. RESULTS: No superior effect of the MISS was found on duration of sick leave (hazard ratio 1.06, 95% confidence interval 0.87-1.29) nor on severity of self-reported symptoms. CONCLUSIONS: We found no evidence that the MISS is more effective than UC in our study sample of distressed patients. Continuing research should focus on the potential beneficial effects of the MISS; we need to investigate which elements of the intervention might be useful and which elements should be adjusted to make the MISS effective. AD - Institute for Research in Extramural Medicine, VU University Medical Center Amsterdam, Amsterdam, The Netherlands. IM_Bakker@hotmail.com AN - 17549228 AU - Bakker, I. M. AU - Terluin, B. AU - van Marwijk, H. W. AU - van der Windt, D. A. AU - Rijmen, F. AU - van Mechelen, W. AU - Stalman, W. A. C1 - Competing Interests: The authors have declared that no competing interests exist. C2 - PMC1885369 CN - Medline 211026 DA - Jun 1 DB - PubMed-not-MEDLINE DO - 10.1371/journal.pctr.0020026 DP - NLM ET - 20070601 IS - 6 J2 - PLoS Clin Trials L1 - internal-pdf://4289254072/1227-Bakker-2007.pdf LA - English N1 - Bakker, Ingrid M Terluin, Berend van Marwijk, Harm W J van der Windt, Danielle A W M Rijmen, Frank van Mechelen, Willem Stalman, Wim A B eng England 2007/06/06 PLoS Clin Trials. 2007 Jun 1;2(6):e26. doi: 10.1371/journal.pctr.0020026. PY - 2007 SN - 1555-5887 (Electronic) 1555-5887 (Linking) SP - e26 ST - A cluster-randomised trial evaluating an intervention for patients with stress-related mental disorders and sick leave in primary care T2 - PLoS Clin Trials TI - A cluster-randomised trial evaluating an intervention for patients with stress-related mental disorders and sick leave in primary care UR - https://www.ncbi.nlm.nih.gov/pubmed/17549228 VL - 2 ID - 1227 ER - TY - JOUR AB - BACKGROUND: More than 50% of breast cancer patients are diagnosed before the age of 65. Returning to work after treatment is, therefore, of interest for both the individual and society. The aim was to study the effect of support group intervention on sick leave and health care utilization in economic terms. MATERIAL AND METHODS: Of 382 patients with newly diagnosed breast cancer, 191 + 191 patients were randomized to an intervention group or to a routine control group, respectively. The intervention group received support intervention on a residential basis for one week, followed by four days of follow-up two months later. The support intervention included informative-educational sections, relaxation training, mental visualization and non-verbal communication. Patients answered a questionnaire at baseline, two, six and 12 months about sick leave and health care utilization. RESULTS: There was a trend towards longer sick leave and more health care utilization in the intervention group. The difference in total costs was statistically significantly higher in the intervention group after 12 months (p = 0.0036). CONCLUSION: Costs to society were not reduced with intervention in its present form. AD - Department of Oncology, Vastmanland's County Hospital, Vasteras, Sweden. helena.granstam-bjorneklett@ltv.se AN - 23106175 AU - Bjorneklett, H. G. AU - Rosenblad, A. AU - Lindemalm, C. AU - Ojutkangas, M. L. AU - Letocha, H. AU - Strang, P. AU - Bergkvist, L. CN - Medline 211026 DA - Jan DB - Medline DO - 10.3109/0284186X.2012.734921 DP - NLM ET - 20121029 IS - 1 J2 - Acta Oncol KW - Adult Aged Aged, 80 and over Breast Neoplasms/*therapy Female Health Services/*economics/*statistics & numerical data Humans Imagery, Psychotherapy Middle Aged Nonverbal Communication Patient Education as Topic Prospective Studies Relaxation Therapy *Self-Help Groups Sick Leave/*economics/*statistics & numerical data Sweden/epidemiology L1 - internal-pdf://1636030275/1311-Bjorneklett-2013.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Bjorneklett, Helena Granstam Rosenblad, Andreas Lindemalm, Christina Ojutkangas, Marja-Leena Letocha, Henry Strang, Peter Bergkvist, Leif eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2012/10/31 Acta Oncol. 2013 Jan;52(1):38-47. doi: 10.3109/0284186X.2012.734921. Epub 2012 Oct 29. PY - 2013 SN - 1651-226X (Electronic) 0284-186X (Linking) SP - 38-47 ST - A randomized controlled trial of support group intervention after breast cancer treatment: results on sick leave, health care utilization and health economy T2 - Acta Oncol TI - A randomized controlled trial of support group intervention after breast cancer treatment: results on sick leave, health care utilization and health economy UR - https://www.ncbi.nlm.nih.gov/pubmed/23106175 VL - 52 ID - 1311 ER - TY - JOUR AB - BACKGROUND: Depression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Our aim was to study clinical effectiveness of a care manager intervention in management of primary care patients with depression in Sweden. METHODS: In a pragmatic cluster randomized controlled trial 23 primary care centers (PCCs), urban and rural, included patients aged >/= 18 years with a new (< 1 month) depression diagnosis. Intervention consisted of Care management including continuous contact between care manager and patient, a structured management plan, and behavioral activation, altogether around 6-7 contacts over 12 weeks. Control condition was care as usual (CAU). OUTCOME MEASURES: Depression symptoms (measured by Mongomery-Asberg depression score-self (MADRS-S) and BDI-II), quality of life (QoL) (EQ-5D), return to work and sick leave, service satisfaction, and antidepressant medication. Data were analyzed with the intention-to-treat principle. RESULTS: One hundred ninety two patients with depression at PCCs with care managers were allocated to the intervention group, and 184 patients at control PCCs were allocated to the control group. Mean depression score measured by MADRS-S was 2.17 lower in the intervention vs. the control group (95% CI [0.56; 3.79], p = 0.009) at 3 months and 2.27 lower (95% CI [0.59; 3.95], p = 0.008) at 6 months; corresponding BDI-II scores were 1.96 lower (95% CI [- 0.19; 4.11], p = 0.07) in the intervention vs. control group at 6 months. Remission was significantly higher in the intervention group at 6 months (61% vs. 47%, p = 0.006). QoL showed a steeper increase in the intervention group at 3 months (p = 0.01). During the first 3 months, return to work was significantly higher in the intervention vs. the control group. Patients in the intervention group were more consistently on antidepressant medication than patients in the control group. CONCLUSIONS: Care managers for depression treatment have positive effects on depression course, return to work, remission frequency, antidepressant frequency, and quality of life compared to usual care and is valued by the patients. TRIAL REGISTRATION: Identifier: NCT02378272 . February 2, 2015. Retrospectively registered. AD - Department of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Cecilia.bjorkelund@allmed.gu.se. Department of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 454, 40530, Goteborg, Sweden. Cecilia.bjorkelund@allmed.gu.se. Department of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. School of Education, Health and Social Studies, Dalarna University, Falun, Sweden. Region Vastra Gotaland, Narhalsan Research and Development Primary Health Care, Gothenburg, Sweden. Health Metrics Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Department of Public Health and Caring Sciences - Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden. Department of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden. Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden. AN - 29426288 AU - Björkelund, C. AU - Svenningsson, I. AU - Hange, D. AU - Udo, C. AU - Petersson, E. L. AU - Ariai, N. AU - Nejati, S. AU - Wessman, C. AU - Wikberg, C. AU - Andre, M. AU - Wallin, L. AU - Westman, J. C1 - ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The Regional Ethical Review Board in Gothenburg, Sweden approved this study (Dnr 903-13; January 2, 2014; complementary approval for Dalarna January 7, 2015 (T975-14)). Consent to participate: Prior to inclusion and after receiving oral and written information about the study, participants provided written informed consent. Written permission for conduct of study was obtained from the head of the regional primary care health authority and all participating PCCs, which includes conduct of personnel at the PCCs. Oral informed consent was also obtained from GPs and nurses at the participating PCCs. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: All authors declare that they have no competing interest. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. C2 - PMC5807835 CN - Medline 211026 DA - Feb 9 DB - Medline DO - 10.1186/s12875-018-0711-z DP - NLM ET - 20180209 IS - 1 J2 - BMC Fam Pract KW - Adult Antidepressive Agents/therapeutic use *Case Management Depression/therapy Depressive Disorder/*therapy Female Humans Male Middle Aged Patient Care Management/*organization & administration Patient Reported Outcome Measures *Patient Satisfaction *Primary Health Care Remission Induction Surveys and Questionnaires Sweden Care manager Collaborative care Depression Primary care Quality-of- life Sick-leave L1 - internal-pdf://0156433530/1309-Bjorkelund-2018.pdf LA - English M3 - Multicenter Study Pragmatic Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Bjorkelund, Cecilia Svenningsson, Irene Hange, Dominique Udo, Camilla Petersson, Eva-Lisa Ariai, Nashmil Nejati, Shabnam Wessman, Catrin Wikberg, Carl Andre, Malin Wallin, Lars Westman, Jeanette eng Multicenter Study Pragmatic Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2018/02/11 BMC Fam Pract. 2018 Feb 9;19(1):28. doi: 10.1186/s12875-018-0711-z. PY - 2018 SN - 1471-2296 (Electronic) 1471-2296 (Linking) SP - 28 ST - Clinical effectiveness of care managers in collaborative care for patients with depression in Swedish primary health care: a pragmatic cluster randomized controlled trial T2 - BMC Fam Pract TI - Clinical effectiveness of care managers in collaborative care for patients with depression in Swedish primary health care: a pragmatic cluster randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/29426288 VL - 19 ID - 1309 ER - TY - JOUR AB - This study is a long-term follow-up of a previously published study that used the internet in the rehabilitation of people on long-term sick leave owing to chronic pain and/or burnout. The follow-up was to assess the effects over time of this kind of rehabilitation. The goals of the first study were to improve the participants' health and work capacity. Sixty people were randomly assigned to either a treatment or a waiting-list group. A 20-week rehabilitation programme based on 19 films on different themes was supplemented with written material and a dialogue over the internet. Fifty participants, 25 in each group, were followed up for 1 year after programme completion. They were administered the same questionnaire (SF-36, HAD, Stress Barometer) that they had taken immediately before (pre) and after (post) the rehabilitation programme. No significant differences were found regarding stress and health between the treatment and waiting-list groups at the time of the 12-month follow-up. Significant group differences were, however, seen in work capacity (number of hours worked per week): 52% of the participants in the treatment group reported an increased work capacity, compared with only 13% in the waiting-list group (P=0.005). Rehabilitation of people on long-term sick leave, which is carried out over the internet seems to complement other rehabilitation programmes as well. AD - Certec, Division of Rehabilitation Engineering Research, Department of Design Sciences, Lund University and Department of Public Health and Caring Sciences, Health Service Research, Uppsala University, Sweden. gunilla.brattberg@varkstaden.se AN - 17762769 AU - Brattberg, G. CN - Medline 211026 DA - Sep DB - Medline DO - 10.1097/MRR.0b013e32829fa545 DP - NLM IS - 3 J2 - Int J Rehabil Res KW - Adult Anxiety/psychology Burnout, Professional/*rehabilitation Chronic Disease Depression/psychology Female Follow-Up Studies Health Status Humans *Internet Male Middle Aged Pain/*rehabilitation Stress, Psychological/psychology Sweden Work L1 - internal-pdf://0691639959/1367-Brattberg-2007.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Brattberg, Gunilla eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2007/09/01 Int J Rehabil Res. 2007 Sep;30(3):231-4. doi: 10.1097/MRR.0b013e32829fa545. PY - 2007 SN - 0342-5282 (Print) 0342-5282 (Linking) SP - 231-4 ST - Internet-based rehabilitation for individuals with chronic pain and burnout II: a long-term follow-up T2 - Int J Rehabil Res TI - Internet-based rehabilitation for individuals with chronic pain and burnout II: a long-term follow-up UR - https://www.ncbi.nlm.nih.gov/pubmed/17762769 VL - 30 ID - 1367 ER - TY - JOUR AB - OBJECTIVE: This randomized clinical trial was performed to compare the effect of a new multidisciplinary intervention (MI) programme to a brief intervention (BI) programme on return to work (RTW), fully and partly, at a 12-month and 24-month follow-up in patients on long-term sick leave due to musculoskeletal pain. METHODS: Patients (n = 284, mean age 41.3 years, 53.9 % women) who were sick-listed with musculoskeletal pain and referred to a specialist clinic in physical rehabilitation were randomized to MI (n = 141) or BI (n = 143). The MI included the use of a visual educational tool, which facilitated patient-therapist communication and self-management. The MI also applied one more profession, more therapist time and a comprehensive focus on the psychosocial factors, particularly the working conditions, compared to a BI. The main features of the latter are a thorough medical, educational examination, a brief cognitive assessment based on the non-injury model, and a recommendation to return to normal activity as soon as possible. RESULTS: The number of patients with full-time RTW developed similarly in the two groups. The patients receiving MI had a higher probability to partly RTW during the first 7 months of the follow-up compared to the BI-group. CONCLUSIONS: There were no differences between the groups on full-time RTW during the 24 months. However, the results indicate that MI hastens the return to work process in long-term sick leave through the increased use of partial sick leave. TRIAL REGISTRATION: http://www.clinicaltrials.gov with the registration number NCT01346423. AD - Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Ottestad, Norway. randi.brendbekken@sykehuset-innlandet.no. Department of Sport and Physical Activity, Bergen University College, Uni Research Health, Bergen, Norway. Department of Economics, University of Bergen, Bergen, Norway. Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway. Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Ottestad, Norway. Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Bergen, Norway. AN - 26910406 AU - Brendbekken, R. AU - Eriksen, H. R. AU - Grasdal, A. AU - Harris, A. AU - Hagen, E. M. AU - Tangen, T. C2 - PMC5306180 CN - Medline 211026 DA - Mar DB - Medline DO - 10.1007/s10926-016-9634-5 DP - NLM IS - 1 J2 - J Occup Rehabil KW - Adult Chronic Pain/diagnosis/*rehabilitation Disability Evaluation Female Humans Male Musculoskeletal Pain/diagnosis/*rehabilitation Patient Care Team Rehabilitation, Vocational/*methods *Return to Work Sick Leave Chronic pain Coping Return to work Work disability L1 - internal-pdf://1289023326/1370-Brendbekken-2017.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Brendbekken, Randi Eriksen, Hege R Grasdal, Astrid Harris, Anette Hagen, Eli M Tangen, Tone eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2016/02/26 J Occup Rehabil. 2017 Mar;27(1):82-91. doi: 10.1007/s10926-016-9634-5. PY - 2017 SN - 1573-3688 (Electronic) 1053-0487 (Print) 1053-0487 (Linking) SP - 82-91 ST - Return to Work in Patients with Chronic Musculoskeletal Pain: Multidisciplinary Intervention Versus Brief Intervention: A Randomized Clinical Trial T2 - J Occup Rehabil TI - Return to Work in Patients with Chronic Musculoskeletal Pain: Multidisciplinary Intervention Versus Brief Intervention: A Randomized Clinical Trial UR - https://www.ncbi.nlm.nih.gov/pubmed/26910406 VL - 27 ID - 1370 ER - TY - JOUR AB - OBJECTIVE: To assess the predictive effect of a multidisciplinary intervention programme, pain, work-related factors and health, including anxiety/depression and beliefs, on return-to-work for patients sick-listed due to musculoskeletal pain. DESIGN: A randomized clinical study. METHODS: A total of 284 patients were randomized to either a multidisciplinary intervention programme (n = 141) or to a less resource-demanding brief intervention (n = 143). Work participation was estimated monthly from register data for 12 months. Return-to-work was defined as increased work participation in 3 consecutive months. RESULTS: In the adjusted model, return-to-work by 3 months was associated with a multidisciplinary intervention programme (odds ratio (OR) = 2.7, 95% confidence interval (95% CI) = 1.1-6.9), the factor "belief that work was cause of the pain" (OR = 2.2, 95% CI = 1.1-4.3), anxiety and depression (OR = 0.5, 95% CI = 0.2-0.98), and by an interaction between the multidisciplinary intervention and perceived support at work (OR = 0.3, 95% CI = 0.1-0.9). At 12 months, only duration of sick leave was associated with return-to-work (OR = 0.6, 95% CI = 0.5-0.8). CONCLUSION: Multidisciplinary intervention may hasten return-to-work and benefit those who perceive low support at work, but at 12 months only duration of sick leave at baseline was associated with return-to-work. AD - Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, NO-2312 Ottestad, Norway. randi.brendbekken@sykehuset-innlandet.no. AN - 29206274 AU - Brendbekken, R. AU - Vaktskjold, A. AU - Harris, A. AU - Tangen, T. CN - Medline 211026 DA - Feb 13 DB - Medline DO - 10.2340/16501977-2296 DP - NLM IS - 2 J2 - J Rehabil Med KW - Adult Female Humans Male Musculoskeletal Pain/*complications Prognosis Return to Work/*statistics & numerical data Sick Leave/*statistics & numerical data Treatment Outcome L1 - internal-pdf://1118241872/1371-Brendbekken-2018.pdf LA - English M3 - Randomized Controlled Trial N1 - Brendbekken, Randi Vaktskjold, Arild Harris, Anette Tangen, Tone eng Randomized Controlled Trial Sweden 2017/12/06 J Rehabil Med. 2018 Feb 13;50(2):193-199. doi: 10.2340/16501977-2296. PY - 2018 SN - 1651-2081 (Electronic) 1650-1977 (Linking) SP - 193-199 ST - Predictors of return-to-work in patients with chronic musculoskeletal pain: A randomized clinical trial T2 - J Rehabil Med TI - Predictors of return-to-work in patients with chronic musculoskeletal pain: A randomized clinical trial UR - https://www.ncbi.nlm.nih.gov/pubmed/29206274 VL - 50 ID - 1371 ER - TY - JOUR AB - BACKGROUND: Sickness absence often occurs in patients with emotional distress or minor mental disorders. In several European countries, these patients are over-represented among those receiving illness benefits, and interventions are needed. The aim of this study was to evaluate the cost-effectiveness of an intervention conducted by social workers, designed to reduce sick leave duration in patients absent from work owing to emotional distress or minor mental disorders. METHODS: In this Randomized Controlled Trial, patients were recruited by GPs. The intervention group (N = 98) received an activating, structured treatment by social workers, the control group (N = 96) received routine GP care. Sick leave duration, clinical symptoms, and medical consumption (consumption of medical staffs' time as well as consumption of drugs) were measured at baseline and 3, 6, and 18 months later. RESULTS: Neither for sick leave duration nor for clinical improvement over time were significant differences found between the groups. Also the associated costs were not significantly lower in the intervention group. CONCLUSIONS: Compared with usual GP care, the activating social work intervention was not superior in reducing sick leave duration, improving clinical symptoms, and decreasing medical consumption. It was also not cost-effective compared with GP routine care in the treatment of minor mental disorders. Therefore, further implementation of the intervention is not justified. Potentially, programmes aimed at reducing sick leave duration in patients with minor mental disorders carried out closer to the workplace (e.g. by occupational physicians) are more successful than programmes in primary care. AD - Netherlands Institute for Health Services Research (NIVEL) Utrecht, the Netherlands. AN - 16837516 AU - Brouwers, E. P. AU - de Bruijne, M. C. AU - Terluin, B. AU - Tiemens, B. G. AU - Verhaak, P. F. CN - Medline 211026 DA - Apr DB - Medline DO - 10.1093/eurpub/ckl099 DP - NLM ET - 20060712 IS - 2 J2 - Eur J Public Health KW - Adaptation, Psychological Adolescent Adult Affective Symptoms/*economics/epidemiology/rehabilitation Cost-Benefit Analysis Family Practice/economics/methods Female Humans Male Mental Disorders/*economics/epidemiology/rehabilitation Middle Aged Netherlands/epidemiology Patient Education as Topic/*methods Problem Solving Program Evaluation Rehabilitation, Vocational/economics/methods Sick Leave/*statistics & numerical data Social Work, Psychiatric/economics/*methods Time Factors L1 - internal-pdf://1773705116/1379-Brouwers-2007.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Brouwers, Evelien P M de Bruijne, Martine C Terluin, Berend Tiemens, Bea G Verhaak, Peter F M eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2006/07/14 Eur J Public Health. 2007 Apr;17(2):214-20. doi: 10.1093/eurpub/ckl099. Epub 2006 Jul 12. PY - 2007 SN - 1101-1262 (Print) 1101-1262 (Linking) SP - 214-20 ST - Cost-effectiveness of an activating intervention by social workers for patients with minor mental disorders on sick leave: a randomized controlled trial T2 - Eur J Public Health TI - Cost-effectiveness of an activating intervention by social workers for patients with minor mental disorders on sick leave: a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/16837516 VL - 17 ID - 1379 ER - TY - JOUR AB - OBJECTIVE: The purpose of this study was to evaluate the effectiveness of an activating intervention designed to reduce sick leave duration in patients with emotional distress or minor mental disorders. METHOD: In a 1.5-year randomized controlled trial, 194 patients with minor mental disorders received either an experimental intervention by social workers or general practitioners' usual care. The intervention focused on understanding causes, developing and implementing problem-solving strategies and promoting early work resumption. Outcome measures were sick leave duration, mental health and physical health (questionnaires included the Hospital Anxiety and Depression Scale, the Four-Dimensional Symptom Questionnaire and SF-36), all measured at baseline at and 3, 6 and 18 months later. Multilevel analyses were used to evaluate differences between groups. RESULTS: The groups did not differ significantly on any of the outcome measures, except that the experimental group reported higher satisfaction with treatment. CONCLUSION: Although the intervention has benefits, it was not successful at its primary goal (i.e., to reduce sick leave duration in patients with emotional distress or minor mental disorders). Programs aimed at the reduction of sick leave duration may yield better results if targeted at patients with more severe emotional problems than at those with exclusively emotional distress or minor mental disorders, or if delivered by caregivers who are closer to the work environment than are social workers, such as occupational physicians. AD - Netherlands Institute for Health Services Research (NIVEL), PO Box 1568, 3500 BN Utrecht, The Netherlands. AN - 16675365 AU - Brouwers, E. P. AU - Tiemens, B. G. AU - Terluin, B. AU - Verhaak, P. F. CN - Medline 211026 DA - May-Jun DB - Medline DO - 10.1016/j.genhosppsych.2006.02.005 DP - NLM IS - 3 J2 - Gen Hosp Psychiatry KW - Adult Affective Symptoms/*therapy Female Humans Male Mental Disorders/*therapy Middle Aged Netherlands Physicians, Family Sick Leave/*trends Social Work Surveys and Questionnaires Treatment Outcome L1 - internal-pdf://2910511853/1380-Brouwers-2006.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Brouwers, Evelien P M Tiemens, Bea G Terluin, Berend Verhaak, Peter F M eng Randomized Controlled Trial Research Support, Non-U.S. Gov't 2006/05/06 Gen Hosp Psychiatry. 2006 May-Jun;28(3):223-9. doi: 10.1016/j.genhosppsych.2006.02.005. PY - 2006 SN - 0163-8343 (Print) 0163-8343 (Linking) SP - 223-9 ST - Effectiveness of an intervention to reduce sickness absence in patients with emotional distress or minor mental disorders: a randomized controlled effectiveness trial T2 - Gen Hosp Psychiatry TI - Effectiveness of an intervention to reduce sickness absence in patients with emotional distress or minor mental disorders: a randomized controlled effectiveness trial UR - https://www.ncbi.nlm.nih.gov/pubmed/16675365 VL - 28 ID - 1380 ER - TY - JOUR AB - INTRODUCTION: In Denmark, the magnitude and impact of work disability on the individual worker and society has prompted the development of a new "coordinated and tailored work rehabilitation" (CTWR) approach. The aim of this study was to compare the effects of CTWR with conventional case management (CCM) on return-to-work of workers on sick leave due to musculoskeletal disorders (MSDs). METHODS: The study was a randomized controlled trial with economic evaluation undertaken with workers on sick leave for 4-12 weeks due to MSDs. CTWR consists of a work disability screening by an interdisciplinary team followed by the collaborative development of a RTW plan. The primary outcome variable was registered cumulative sickness absence hours during 12 months follow-up. Secondary outcomes were work status as well as pain intensity and functional disability, measured at baseline, 3 and 12 months follow-up. The economic evaluation (intervention costs, productivity loss, and health care utilization costs) was based on administrative data derived from national registries. RESULTS: For the time intervals 0-6 months, 6-12 months, and the entire follow-up period, the number of sickness absence hours was significantly lower in the CTWR group as compared to the control group. The total costs saved in CTWR participants compared to controls were estimated at US $ 1,366 per person at 6 months follow-up and US $ 10,666 per person at 12 months follow-up. CONCLUSIONS: Workers on sick leave for 4-12 weeks due to MSD who underwent "CTWR" by an interdisciplinary team had fewer sickness absence hours than controls. The economic evaluation showed that-in terms of productivity loss-CTWR seems to be cost saving for the society. AD - Department of Health Sciences, Section of Social Medicine, Work & Health, University Medical Center Groningen, A. Deusinglaan 1, Building 3217, Room 605, 9713 AV, Groningen, The Netherlands. u.bultmann@med.umcg.nl AN - 19169654 AU - Bultmann, U. AU - Sherson, D. AU - Olsen, J. AU - Hansen, C. L. AU - Lund, T. AU - Kilsgaard, J. CN - Medline 211026 DA - Mar DB - Medline DO - 10.1007/s10926-009-9162-7 DP - NLM ET - 20090124 IS - 1 J2 - J Occup Rehabil KW - Case Management Cost Savings Denmark Disability Evaluation Employment/psychology Humans Musculoskeletal Diseases/economics/psychology/*rehabilitation Recovery of Function *Sick Leave/economics *Work Capacity Evaluation L1 - internal-pdf://3525740787/1400-Bultmann-2009.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Bultmann, Ute Sherson, David Olsen, Jens Hansen, Carl Lysbeck Lund, Thomas Kilsgaard, Jorgen eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2009/01/27 J Occup Rehabil. 2009 Mar;19(1):81-93. doi: 10.1007/s10926-009-9162-7. Epub 2009 Jan 24. PY - 2009 SN - 1573-3688 (Electronic) 1053-0487 (Linking) SP - 81-93 ST - Coordinated and tailored work rehabilitation: a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders T2 - J Occup Rehabil TI - Coordinated and tailored work rehabilitation: a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders UR - https://www.ncbi.nlm.nih.gov/pubmed/19169654 VL - 19 ID - 1400 ER - TY - JOUR AB - Multidisciplinary programmes using a vocational approach can enhance work return in chronic pain patients, but little is known about the long-term effects of rehabilitation. The current study examined the patterns of sickness absence 10 years after participation in 3 treatment groups (physiotherapy, cognitive behavioural therapy, and vocational multidisciplinary rehabilitation) in comparison to a control group receiving treatment-as-usual. Cost-effectiveness was also assessed. Two hundred fourteen patients participated in a randomized controlled trial and were followed-up via register data 10 years after the interventions. On average, persons in multidisciplinary rehabilitation had 42.98 fewer days on sickness absence per year compared to those treated-as-usual (95% confidence interval -82.45 to -3.52, P=0.03). The corresponding reduction of sickness absence after physiotherapy and cognitive behavioural therapy was not significantly different from the control group. The effect of rehabilitation seems to be more pronounced for disability pension than for sick leave. The economic analyses showed substantial cost savings for individuals in the multidisciplinary group compared to the control group. AD - Division of Intervention and Implementation Research, Department of Public Health, Karolinska Institutet, Sweden. AN - 21507573 AU - Busch, H. AU - Bodin, L. AU - Bergstrom, G. AU - Jensen, I. B. CN - Medline 211026 DA - Aug DB - Medline DO - 10.1016/j.pain.2011.02.004 DP - NLM ET - 20110420 IS - 8 J2 - Pain KW - Adolescent Adult Cognitive Behavioral Therapy/economics/methods Cost-Benefit Analysis Disabled Children/psychology Female Humans Longitudinal Studies Male Middle Aged Pain/economics/*rehabilitation Patient Compliance/statistics & numerical data *Physical Therapy Modalities/economics Retrospective Studies *Sick Leave/economics Sweden/epidemiology *Treatment Outcome Young Adult L1 - internal-pdf://0196237541/1413-Busch-2011.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Busch, Hillevi Bodin, Lennart Bergstrom, Gunnar Jensen, Irene B eng Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2011/04/22 Pain. 2011 Aug;152(8):1727-1733. doi: 10.1016/j.pain.2011.02.004. Epub 2011 Apr 20. PY - 2011 SN - 1872-6623 (Electronic) 0304-3959 (Linking) SP - 1727-1733 ST - Patterns of sickness absence a decade after pain-related multidisciplinary rehabilitation T2 - Pain TI - Patterns of sickness absence a decade after pain-related multidisciplinary rehabilitation UR - https://www.ncbi.nlm.nih.gov/pubmed/21507573 VL - 152 ID - 1413 ER - TY - JOUR AB - OBJECTIVE: To study the effects on sick leave from an early multidisciplinary assessment at a primary health care centre. DESIGN: Randomized controlled trial. SETTING: Patients who saw GPs at a primary health care centre in mid-Sweden and asked for a sickness certificate for psychiatric or musculoskeletal diagnoses were invited to participate. Patients included were sick-listed for less than four weeks; 33 patients were randomized either to an assessment within a week by a physiotherapist, a psychotherapist, and an occupational therapist or to "standard care". The therapists used methods and tools they normally use in their clinical work. MAIN OUTCOME MEASURE: Proportion of patients still sick-listed three months after randomization, total and net days on sick leave, and proportion who were on part-time sick leave. Results. At follow-up after three months, in contrast to the pre-trial hypothesis, there was a trend toward a higher proportion of patients still sick-listed in the intervention group (7/18) as compared with the control group (3/15). The intervention group also had significantly longer sick-listing periods (mean 58 days) than the control group (mean 36 days) (p = 0.038). The proportion of patients who were part time sick-listed was significantly higher in the intervention group (10/18) than in the control group (2/15) (p = 0.027). CONCLUSIONS: In this study an early multidisciplinary assessment was associated with longer periods on sick leave and more individuals on part-time sick leave. AD - Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Uppsala, Sweden. lars.carlsson@ltdalarna.se AN - 23909930 AU - Carlsson, L. AU - Englund, L. AU - Hallqvist, J. AU - Wallman, T. C2 - PMC3750435 CN - Medline 211026 DA - Sep DB - Medline DO - 10.3109/02813432.2013.811943 DP - NLM ET - 20130805 IS - 3 J2 - Scand J Prim Health Care KW - Adult *Disability Evaluation Female General Practice Humans Male Mental Disorders Middle Aged Musculoskeletal Diseases Occupational Therapy Physical Therapists Primary Health Care Rehabilitation/*methods Sick Leave/*trends Sweden/epidemiology Time Factors Treatment Outcome Workload L1 - internal-pdf://0279932740/1438-Carlsson-2013.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Carlsson, Lars Englund, Lars Hallqvist, Johan Wallman, Thorne eng Randomized Controlled Trial Research Support, Non-U.S. Gov't 2013/08/06 Scand J Prim Health Care. 2013 Sep;31(3):141-6. doi: 10.3109/02813432.2013.811943. Epub 2013 Aug 5. PY - 2013 SN - 1502-7724 (Electronic) 0281-3432 (Print) 0281-3432 (Linking) SP - 141-6 ST - Early multidisciplinary assessment was associated with longer periods of sick leave: a randomized controlled trial in a primary health care centre T2 - Scand J Prim Health Care TI - Early multidisciplinary assessment was associated with longer periods of sick leave: a randomized controlled trial in a primary health care centre UR - https://www.ncbi.nlm.nih.gov/pubmed/23909930 VL - 31 ID - 1438 ER - TY - JOUR AB - BACKGROUND: Sick leave due to common mental disorders (CMDs) is a public health problem in several countries, including Sweden. Given that symptom relief does not necessarily correspond to return to work, health care interventions focusing on factors that have proven important to influence the return to work process, such as self-efficacy, are warranted. Self-efficacy is also a central concept in person-centered care. OBJECTIVE: The aim of this study is to evaluate the effects of a person-centered eHealth intervention for patients on sick leave due to CMDs. METHODS: A randomized controlled trial of 209 patients allocated to either a control group (107/209, 51.2%) or an intervention group (102/209, 48.8%) was conducted. The control group received usual care, whereas the intervention group received usual care with the addition of a person-centered eHealth intervention. The intervention was built on person-centered care principles and consisted of telephone support and a web-based platform. The primary outcome was a composite score of changes in general self-efficacy (GSE) and level of sick leave at the 6-month follow-up. An intention-to-treat analysis included all participants, and a per-protocol analysis consisted of those using both the telephone support and the web-based platform. RESULTS: At the 3-month follow-up, in the intention-to-treat analysis, more patients in the intervention group improved on the composite score than those in the control group (20/102, 19.6%, vs 10/107, 9.3%; odds ratio [OR] 2.37, 95% CI 1.05-5.34; P=.04). At the 6-month follow-up, the difference was no longer significant between the groups (31/100, 31%, vs 25/107, 23.4%; OR 1.47, 95% CI 0.80-2.73; P=.22). In the per-protocol analysis, a significant difference was observed between the intervention and control groups at the 3-month follow-up (18/85, 21.2%, vs 10/107, 9.3%; OR 2.6, 95% CI 1.13-6.00; P=.02) but not at 6 months (30/84, 35.7%, vs 25/107, 23.4%; OR 1.8, 95% CI 0.97-3.43; P=.06). Changes in GSE drove the effects in the composite score, but the intervention did not affect the level of sick leave. CONCLUSIONS: A person-centered eHealth intervention for patients on sick leave due to CMDs improved GSE but did not affect the level of sick leave. TRIAL REGISTRATION: ClinicalTrials.gov NCT03404583; https://clinicaltrials.gov/ct2/show/NCT03404583. AD - Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden. Department of Internal Medicine and Geriatrics, Sahlgrenska University Hospital Ostra, Gothenburg, Sweden. The Institute of Stress Medicine, Region Vastra Gotaland, Gothenburg, Sweden. School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Research and Development, Primary Health Care, Region Vastra Gotaland, Gothenburg, Sweden. AN - 35289756 AU - Cederberg, M. AU - Alsen, S. AU - Ali, L. AU - Ekman, I. AU - Glise, K. AU - Jonsdottir, I. H. AU - Gyllensten, H. AU - Swedberg, K. AU - Fors, A. C1 - Conflicts of Interest: None declared. C2 - PMC8965681 CN - Embase rct uppdateringssökning 220511 DA - Mar 15 DB - PubMed-not-MEDLINE DO - 10.2196/30966 DP - NLM ET - 20220315 IS - 3 KW - anxiety depression intervention mHealth mobile phone patient-centered care person-centered care randomized controlled trial sickness absence stress telehealth L1 - internal-pdf://1861358982/10116-Cederberg-2022.pdf LA - English M3 - Article N1 - Cederberg, Matilda Alsen, Sara Ali, Lilas Ekman, Inger Glise, Kristina Jonsdottir, Ingibjorg H Gyllensten, Hanna Swedberg, Karl Fors, Andreas eng Canada 2022/03/16 JMIR Ment Health. 2022 Mar 15;9(3):e30966. doi: 10.2196/30966. PY - 2022 SN - 2368-7959 (Print) 2368-7959 (Electronic) 2368-7959 (Linking) SP - e30966 ST - Effects of a Person-Centered eHealth Intervention for Patients on Sick Leave Due to Common Mental Disorders (PROMISE Study): Open Randomized Controlled Trial T2 - JMIR Ment Health TI - Effects of a Person-Centered eHealth Intervention for Patients on Sick Leave Due to Common Mental Disorders (PROMISE Study): Open Randomized Controlled Trial UR - https://www.ncbi.nlm.nih.gov/pubmed/35289756 VL - 9 ID - 10116 ER - TY - JOUR AB - Objectives This study aimed to evaluate the effect of a stress management intervention (SMI) on lasting return to work (RTW) among patients with work-related stress complaints. Methods Sickness benefit departments from three local municipalities referred patients on sick leave with work-related adjustment disorders or mild depression to the Department of Occupational Medicine, Regional Hospital West Jutland. A 2x randomization procedure allocated patients into one of three groups: intervention (N=58), control A (which received a clinical assessment; N=56), or control B (no assessment; N=49). Treatment comprised individual work-focused cognitive behavioral therapy (CBT) with an optional workplace intervention. The outcome was time until lasting RTW (16 and 44 weeks follow-up) using register data. Results Median number of weeks until lasting RTW was 15, 19, and 32 for the intervention group, control A, and control B respectively. However, for group B, clinical assessment was not part of the inclusion process, which may have introduced selection bias. In the fully-adjusted Cox regression model, the intervention group exhibited significantly faster lasting RTW at 44 weeks; hazard ratio (HR) 1.57 [95% confidence interval (95% CI) 1.01-2.44] relative to control group A, with a non-significant trend evident at 16 weeks; HR 1.70 (95% CI 0.94-3.10), when controlling for age, gender, occupation, sick leave during previous year, full or partial sick leave, and diagnosis. Unadjusted analyses remained directionally consistent but were reduced to marginal significance. Conclusions There was a tendency towards faster lasting RTW in the intervention group compared to control A, which received clinical assessment, in all analyses. The intervention group returned to work about 4 weeks earlier than control A, which could translate into substantial financial gains. AD - Danish Ramazzini Centre, Dept. of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark. Vita.Ligaya.Dalgaard@vest.rm.dk. AN - 28650513 AU - Dalgaard, V. L. AU - Aschbacher, K. AU - Andersen, J. H. AU - Glasscock, D. J. AU - Willert, M. V. AU - Carstensen, O. AU - Biering, K. CN - Medline 211026 DA - Sep 1 DB - Medline DO - 10.5271/sjweh.3655 DP - NLM ET - 20170626 IS - 5 J2 - Scand J Work Environ Health KW - Adjustment Disorders/psychology Adult Cognitive Behavioral Therapy/*methods Denmark Female Humans Male Middle Aged Occupational Stress/psychology/*rehabilitation *Return to Work Sick Leave/statistics & numerical data Time Factors Workplace/psychology L1 - internal-pdf://0099966277/1576-Dalgaard-2017.pdf LA - English M3 - Randomized Controlled Trial N1 - Dalgaard, Vita Ligaya Aschbacher, Kirstin Andersen, Johan Hviid Glasscock, David John Willert, Morten Vejs Carstensen, Ole Biering, Karin eng K23 HL112955/HL/NHLBI NIH HHS/ Randomized Controlled Trial Finland 2017/06/27 Scand J Work Environ Health. 2017 Sep 1;43(5):436-446. doi: 10.5271/sjweh.3655. Epub 2017 Jun 26. PY - 2017 SN - 1795-990X (Electronic) 0355-3140 (Linking) SP - 436-446 ST - Return to work after work-related stress: a randomized controlled trial of a work-focused cognitive behavioral intervention T2 - Scand J Work Environ Health TI - Return to work after work-related stress: a randomized controlled trial of a work-focused cognitive behavioral intervention UR - https://www.ncbi.nlm.nih.gov/pubmed/28650513 VL - 43 ID - 1576 ER - TY - JOUR AB - Work-related stress is widespread and can lead to long-term absenteeism and work disability. Cognitive-behavioral treatment (CBT) has demonstrated effectiveness in treating psychopathology but has only rarely been tested in clinical samples with work-related stress. A randomized controlled trial was conducted to investigate the efficacy of CBT-based stress management training (SMT). Eighty-two patients on sickness leave with work-related stress were randomly assigned to (a) individual SMT, (b) group SMT, or (c) care as usual (CAU). The SMT comprised 12 sessions conducted by a psychologist. Complaints of burnout and distress were measured at baseline, and at 4, 7, and 10 months. Absenteeism was measured during the whole research period. Across treatment conditions, complaints and sickness absence reduced considerably between baseline and 4 months. Thereafter, complaints remained approximately stable, whereas sickness absence further reduced. Hardly any significant group difference emerged, and no consistent pattern could be discerned in favor of any treatment condition. In subgroups with low depressive complaints, though, individual SMT resulted in larger reductions of some complaints than CAU. In conclusion, this study adds to the evidence that CBT-based interventions as currently practiced are not successful in treating patients with clinical levels of work-related stress. AD - Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands. w.devente@uva.nl AN - 18572993 AU - de Vente, W. AU - Kamphuis, J. H. AU - Emmelkamp, P. M. AU - Blonk, R. W. CN - Medline 211026 DA - Jul DB - Medline DO - 10.1037/1076-8998.13.3.214 DP - NLM IS - 3 J2 - J Occup Health Psychol KW - *Absenteeism Adult Burnout, Professional/diagnosis/psychology/therapy *Cognitive Behavioral Therapy Depression/diagnosis/psychology/therapy Female Follow-Up Studies Humans Male Middle Aged Netherlands Occupational Diseases/diagnosis/psychology/*therapy *Psychotherapy, Group *Sick Leave Somatoform Disorders/diagnosis/psychology/*therapy Stress, Psychological/*complications Treatment Outcome L1 - internal-pdf://3552938015/1611-de Vente-2008.pdf LA - English M3 - Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - de Vente, Wieke Kamphuis, Jan H Emmelkamp, Paul M G Blonk, Roland W B eng Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2008/06/25 J Occup Health Psychol. 2008 Jul;13(3):214-31. doi: 10.1037/1076-8998.13.3.214. PY - 2008 SN - 1076-8998 (Print) 1076-8998 (Linking) SP - 214-31 ST - Individual and group cognitive-behavioral treatment for work-related stress complaints and sickness absence: a randomized controlled trial T2 - J Occup Health Psychol TI - Individual and group cognitive-behavioral treatment for work-related stress complaints and sickness absence: a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/18572993 VL - 13 ID - 1611 ER - TY - JOUR AB - BACKGROUND: Dialogue between supervisor and employee is of great importance for occupational rehabilitation. OBJECTIVE: To evaluate the effectiveness of a convergence dialogue meeting (CDM) of employee, therapist and supervisor aimed at facilitating return to work (RTW) as part of cognitive-behavioural treatment. METHODS: Randomized controlled trial including 60 employees sick-listed with common mental disorders and referred for specialized mental healthcare. Employees were randomly allocated either to an intervention group (n = 31) receiving work-focused cognitive-behavioural therapy plus CDM or a control group (n = 29) receiving work-focused cognitive-behavioural therapy without CDM. RESULTS: The time to first RTW was 12 days shorter (p = 0.334) in the intervention group, although full (i.e., at equal earnings as before reporting sick) RTW took 41 days longer (p = 0.122) than the control group. The odds of full RTW at the end of treatment were only 7% higher (p = 0.910) in the intervention group as compared to the control group. CONCLUSIONS: CDM did not significantly reduce the time to RTW. We recommend that therapists who are trained on CDM focus on barriers and solutions for RTW. AD - Pro Persona, Nijmegen, The Netherlands. Dimence Mental Health Care Centre, Deventer, The Netherlands. GGz Breburg, Breda, The Netherlands. ArboNed Occupational Health Service, Utrecht, The Netherlands. Radboud Centre Social Sciences, Radboud University and Pro Persona, Nijmegen, The Netherlands. AN - 27286071 AU - de Weerd, B. J. AU - van Dijk, M. K. AU - van der Linden, J. N. AU - Roelen, C. A. AU - Verbraak, M. J. CN - Medline 211026 DA - Jun 4 DB - Medline DO - 10.3233/WOR-162307 DP - NLM IS - 3 J2 - Work KW - Adult Cognitive Behavioral Therapy/*methods Communication Female *Group Processes Humans Male Mental Disorders/*rehabilitation Middle Aged *Return to Work Time Factors Absenteeism cognitive therapy mental health return to work sick leave L1 - internal-pdf://1554863304/1612-de Weerd-2016.pdf LA - English M3 - Randomized Controlled Trial N1 - de Weerd, Bas J van Dijk, Maarten K van der Linden, Jolijn N Roelen, Corne A M Verbraak, Marc J P M eng Randomized Controlled Trial Netherlands 2016/06/11 Work. 2016 Jun 4;54(3):647-55. doi: 10.3233/WOR-162307. PY - 2016 SN - 1875-9270 (Electronic) 1051-9815 (Linking) SP - 647-55 ST - The effectiveness of a convergence dialogue meeting with the employer in promoting return to work as part of the cognitive-behavioural treatment of common mental disorders: A randomized controlled trial T2 - Work TI - The effectiveness of a convergence dialogue meeting with the employer in promoting return to work as part of the cognitive-behavioural treatment of common mental disorders: A randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/27286071 VL - 54 ID - 1612 ER - TY - JOUR AB - STUDY DESIGN: A single-blinded, randomized controlled trial. OBJECTIVE: To determine the impact of information and advice during a disability evaluation by medical advisers on the return to work (RTW) rate and recurrence of sick leave of claimants with low back pain (LBP). SUMMARY OF BACKGROUND DATA: There is evidence on the importance of advice during the course of subacute LBP. The effect of informative interventions on RTW rates in workers receiving sickness benefit is not clear. METHODS: A total of 506 claimants with LBP were randomly assigned to the control group (disability evaluation) or the intervention group (combined counseling and disability evaluation). RTW, sick leave recurrence, subsequent surgery, and sick leave duration were measured during a 12-month follow-up. RESULTS: Patients who were provided information and advice showed a higher RTW rate, which was statistically significant at 1 year. That result is mainly attributable to the lower relapse rate in the intervention group (38%) than in the control group (60%). There were no differences between the 2 groups regarding subsequent surgery for LBP and duration of sick leave. CONCLUSION: Claimants should be routinely reassured and advised about LBP to allow early and safe RTW during a disability evaluation before any side effects of being sick-listed have settled. AD - From the Occupational, Environmental and Insurance Medicine, Department of Public Health, Kapucijnenvoer 35, Leuven, Belgium. AN - 22343272 AU - Du Bois, M. AU - Donceel, P. CN - Medline 211026 DA - Aug 1 DB - Medline DO - 10.1097/BRS.0b013e31824e4ada DP - NLM IS - 17 J2 - Spine KW - Adult Counseling/*methods *Disability Evaluation Female Humans Low Back Pain/diagnosis/*psychology Male Middle Aged Return to Work/*statistics & numerical data Sick Leave/*statistics & numerical data Single-Blind Method Treatment Outcome L1 - internal-pdf://1465653892/1668-Du Bois-2012.pdf LA - English M3 - Randomized Controlled Trial N1 - Du Bois, Marc Donceel, Peter eng Randomized Controlled Trial 2012/02/22 Spine (Phila Pa 1976). 2012 Aug 1;37(17):1425-31. doi: 10.1097/BRS.0b013e31824e4ada. PY - 2012 SN - 1528-1159 (Electronic) 0362-2436 (Linking) SP - 1425-31 ST - Guiding low back claimants to work: a randomized controlled trial T2 - Spine (Phila Pa 1976) TI - Guiding low back claimants to work: a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/22343272 VL - 37 ID - 1668 ER - TY - JOUR AB - Background: Most patients with long term sick leave due to musculoskeletal diseases are treated by general practitioners. The aim of this study was to test the hypothesis that early intervention by a specialist in physical medicine and rehabilitation will reduce the duration of long term sick leave due to musculoskeletal diseases. Material and methods: In collaboration with 14 National Insurance Offices in the Norwegian county of Vestfold, 829 patients aged 25-50 years with 8-12 weeks of sick leave for musculoskeletal diseases were included and randomized into an intervention group (n=409) and a control group (n=420). Exclusion criteria were no job, rheumatic diseases, fractures and joint diseases. The intervention group was examined by a specialist in Physical Medicine and Rehabilitation at the Hospital of Rehabilitation in Stavern, Norway, where they were examined and treated. The patients in the control group were treated by general practitioners as usual. Some of these patients were also referred to the same hospital or other specialists for examination as part of the general practitioner's own initiative. Data on sick leave, disability pension, and other social benefits were collected from the National Insurance Offices. Number of days of sick leave, rehabilitation benefits and vocational rehabilitation were used as end points. After two years of follow-up the end points were examined. The data were analyzed according to the "intention to treat" principle. Results: In the intervention group the average number of sick days was 138 as compared to 147 days in the control group. The difference of nine days of sick leave was not statistically significant (p=0,163). Regarding rehabilitation benefits and vocational rehabilitation, the two groups did not differ. Conclusion: Early intervention by a specialist in physical medicine and rehabilitation did not reduce the duration of long term sick leave for patients with musculoskeletal diseases in this study. After two years of observation no difference was found between the two groups in rehabilitation benefits and vocational rehabilitation. AD - H. Elvsåshagen, Gusland, 3294 Stavern, Norway AU - Elvsåshagen, H. AU - Tellnes, G. AU - Abdelnoor, M. H. CN - Embase 211110 DB - Embase IS - 2 KW - absenteeism adult arthropathy article clinical examination clinical trial controlled clinical trial controlled study disability disease duration fracture general practitioner hospital human insurance intervention study long term care major clinical study medical leave medical specialist multicenter study musculoskeletal disease Norway pension physical medicine physiotherapist randomized controlled trial rehabilitation care rheumatic disease social insurance treatment duration treatment outcome vocational rehabilitation work L1 - internal-pdf://1785664437/593-Article Text-2253-1-10-20100106.pdf LA - Norwegian M3 - Article N1 - L358349803 2010-03-03 2010-03-24 PY - 2009 SN - 0803-2491 SP - 219-222 ST - Does early intervention by a specialist in physical medicine and rehabilitation reduce the duration of long term sick leave among persons with musculoskeletal diseases? T2 - Norsk Epidemiologi TI - Does early intervention by a specialist in physical medicine and rehabilitation reduce the duration of long term sick leave among persons with musculoskeletal diseases? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L358349803&from=export VL - 19 ID - 5038 ER - TY - JOUR AB - Mental disorders contribute to high rates of sickness absence (SA) and impaired work functioning. The aim of the present study was to evaluate the efficacy of 3 interventions targeting SA of workers. Participants (n = 352; 78.4% females) of working age with current employment, and SA due to depression, anxiety disorders, or exhaustion disorder, were recruited to the study and randomized to (a) acceptance and commitment therapy (ACT), (b) a workplace dialogue intervention (WDI), (c) a combination of ACT and WDI, or (d) treatment as usual (TAU). For SA days, there was a significant interaction effect for the follow-up period, in which ACT + WDI generated more SA compared with TAU. When diagnostic group was included as a moderator, participants with exhaustion disorder had less SA days in the WDI group compared with TAU. For symptoms of depression, anxiety, and stress-related ill health, there were significant interaction effects for ACT and ACT + WDI, when compared with TAU, from pre- to postmeasurement (small to moderate between-groups effect sizes). Within-group effect sizes pre- to postmeasurement (Cohen's d) ranged from .55 to 1.17 (ACT), .40 to .94 (WDI), .26 to 1.13 (ACT + WI), and -.06 to .70 (TAU). There were no differences between groups during follow-up for symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved). AD - Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet. Department of Clinical Neuroscience, Karolinska Institutet. Department of Psychology, Uppsala University. Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institutet. AN - 28956942 AU - Finnes, A. AU - Ghaderi, A. AU - Dahl, J. AU - Nager, A. AU - Enebrink, P. CN - Medline 211026 DA - Feb DB - Medline DO - 10.1037/ocp0000097 DP - NLM ET - 20170928 IS - 1 J2 - J Occup Health Psychol KW - Acceptance and Commitment Therapy/*methods Adult Analysis of Variance Anxiety/*therapy Depression/*therapy Fatigue/psychology/*therapy Female Humans Interview, Psychological Male Mental Disorders/therapy Middle Aged Patient Satisfaction Sick Leave/*statistics & numerical data Stress, Psychological/*therapy Sweden Treatment Outcome Workplace/psychology Young Adult L1 - internal-pdf://2314917682/1775-Finnes-2019.pdf LA - English M3 - Randomized Controlled Trial N1 - Finnes, Anna Ghaderi, Ata Dahl, JoAnne Nager, Anna Enebrink, Pia eng REHSAM/ Randomized Controlled Trial 2017/09/29 J Occup Health Psychol. 2019 Feb;24(1):198-212. doi: 10.1037/ocp0000097. Epub 2017 Sep 28. PY - 2019 SN - 1939-1307 (Electronic) 1076-8998 (Linking) SP - 198-212 ST - Randomized controlled trial of acceptance and commitment therapy and a workplace intervention for sickness absence due to mental disorders T2 - J Occup Health Psychol TI - Randomized controlled trial of acceptance and commitment therapy and a workplace intervention for sickness absence due to mental disorders UR - https://www.ncbi.nlm.nih.gov/pubmed/28956942 VL - 24 ID - 1775 ER - TY - JOUR AB - BACKGROUND: The lack of efficient medical interventions for combating increasing sickness absence rates has lead to the introduction of alternative measures initiated by the Norwegian National Insurance Service or at workplaces. AIM: To determine whether minimal postal intervention had any effect on the length of sick leave. METHODS: Randomised, controlled trial with a one year follow up in Northern Norway in 1997 and 1998; 990 consecutive newly sick-listed persons with musculoskeletal or mental disorders were studied. Within the intervention group, 495 eligible sick-listed persons received a general information letter and a questionnaire as their sick leave passed 14 days. Possible intervention effects were analysed by survival analysis of the probability of returning to work within one year, and logistic regressions with benefits at one year as the dependent variable. RESULTS: The overall reduction of 8.3 (95% CI -22.5 to 6.0) calendar days in mean length of sick leaves in the intervention group compared to controls, was not statistically significant. However, intervention significantly reduced length of sick leaves in subgroups with mental disorders, and with rheumatic disorders and arthritis, and overall for sick leaves lasting 12 weeks or more. Young people with low back pain showed an adverse effect to intervention. The overall relative risk of receiving benefits due to sickness after one year in the intervention group was 0.69 (95% CI 0.51 to 0.93) compared to controls. CONCLUSION: The results should encourage employers, insurance institutions, and authorities to initiate challenges as questions on the length of sick leave and possible modified work measures, during the first few weeks of sick leave, for at least some groups of sick-listed persons. AD - Department of Community Medicine, University of Tromso, Norway. nils.fleten@ism.uit.no AN - 16644897 AU - Fleten, N. AU - Johnsen, R. C1 - Competing interests: none declared C2 - PMC2078047 CN - Medline 211026 DA - Oct DB - Medline DO - 10.1136/oem.2005.020438 DP - NLM ET - 20060427 IS - 10 J2 - Occup Environ Med KW - *Absenteeism Adolescent Adult Aged Chi-Square Distribution Female Humans Male Mental Disorders/epidemiology/*rehabilitation Middle Aged Musculoskeletal Diseases/epidemiology/*rehabilitation Norway Prospective Studies Rehabilitation, Vocational/*methods Self-Assessment *Sick Leave/statistics & numerical data Surveys and Questionnaires Time Factors Work Capacity Evaluation L1 - internal-pdf://0936791045/1783-Fleten-2006.pdf LA - English M3 - Randomized Controlled Trial N1 - Fleten, N Johnsen, R eng Randomized Controlled Trial England 2006/04/29 Occup Environ Med. 2006 Oct;63(10):676-82. doi: 10.1136/oem.2005.020438. Epub 2006 Apr 27. PY - 2006 SN - 1470-7926 (Electronic) 1351-0711 (Print) 1351-0711 (Linking) SP - 676-82 ST - Reducing sick leave by minimal postal intervention: a randomised, controlled intervention study T2 - Occup Environ Med TI - Reducing sick leave by minimal postal intervention: a randomised, controlled intervention study UR - https://www.ncbi.nlm.nih.gov/pubmed/16644897 VL - 63 ID - 1783 ER - TY - JOUR AB - Objectives This study aimed to investigate whether inpatient multimodal occupational rehabilitation (I-MORE) reduces sickness absence (SA) more than outpatient acceptance and commitment therapy (O-ACT) among individuals with musculoskeletal and mental health disorders. Methods Individuals on sick leave (2-12 months) due to musculoskeletal or common mental health disorders were randomized to I-MORE (N=86) or O-ACT (N=80). I-MORE lasted 3.5 weeks in which participants stayed at the rehabilitation center. I-MORE included ACT, physical exercise, work-related problem solving and creating a return to work plan. O-ACT consisted mainly of 6 weekly 2.5 hour group-ACT sessions. We assessed the primary outcome cumulative SA within 6 and 12 months with national registry-data. Secondary outcomes were time to sustainable return to work and self-reported health outcomes assessed by questionnaires. Results SA did not differ between the interventions at 6 months, but after one year individuals in I-MORE had 32 fewer SA days compared to O-ACT (median 85 [interquartile range 33-149] versus 117 [interquartile range 59-189)], P=0.034). The hazard ratio for sustainable return to work was 1.9 (95% confidence interval 1.2-3.0) in favor of I-MORE. There were no clinically meaningful between-group differences in self-reported health outcomes. Conclusions Among individuals on long-term SA due to musculoskeletal and common mental health disorders, a 3.5-week I-MORE program reduced SA compared with 6 weekly sessions of O-ACT in the year after inclusion. Studies with longer follow-up and economic evaluations should be performed. AD - Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), P.B. 8905 MTFS, 7491 Trondheim, Norway. sigmund.gismervik@ntnu.no. AN - 31901945 AU - Gismervik, S. O. AU - Aasdahl, L. AU - Vasseljen, O. AU - Fors, E. A. AU - Rise, M. B. AU - Johnsen, R. AU - Hara, K. AU - Jacobsen, H. B. AU - Pape, K. AU - Fleten, N. AU - Jensen, C. AU - Fimland, M. S. C1 - The authors declare no conflicts of interest. C2 - PMC8506316 CN - Medline 211026 DA - Jul 1 DB - Medline DO - 10.5271/sjweh.3882 DP - NLM ET - 20200105 IS - 4 J2 - Scand J Work Environ Health KW - Adolescent Adult Female Humans *Inpatients Male Mental Disorders/*rehabilitation Middle Aged Musculoskeletal Diseases/*rehabilitation *Occupational Health Services *Outpatients Return to Work/*statistics & numerical data Sick Leave/*statistics & numerical data Young Adult L1 - internal-pdf://2773882185/1868-Gismervik-2020.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Gismervik, Sigmund O Aasdahl, Lene Vasseljen, Ottar Fors, Egil A Rise, Marit B Johnsen, Roar Hara, Karen Jacobsen, Henrik B Pape, Kristine Fleten, Nils Jensen, Chris Fimland, Marius S eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Finland 2020/01/07 Scand J Work Environ Health. 2020 Jul 1;46(4):364-372. doi: 10.5271/sjweh.3882. Epub 2020 Jan 5. PY - 2020 SN - 1795-990X (Electronic) 0355-3140 (Print) 0355-3140 (Linking) SP - 364-372 ST - Inpatient multimodal occupational rehabilitation reduces sickness absence among individuals with musculoskeletal and common mental health disorders: a randomized clinical trial T2 - Scand J Work Environ Health TI - Inpatient multimodal occupational rehabilitation reduces sickness absence among individuals with musculoskeletal and common mental health disorders: a randomized clinical trial UR - https://www.ncbi.nlm.nih.gov/pubmed/31901945 VL - 46 ID - 1868 ER - TY - JOUR AB - PURPOSE: Randomized controlled trials (RCTs) of interventions aimed at reducing work-related stress indicate that cognitive behavioural therapy (CBT) is more effective than other interventions. However, definitions of study populations are often unclear and there is a lack of interventions targeting both the individual and the workplace. The aim of this study was to determine whether a stress management intervention combining individual CBT and a workplace focus is superior to no treatment in the reduction of perceived stress and stress symptoms and time to lasting return to work (RTW) in a clinical sample. METHODS: Patients with work-related stress reactions or adjustment disorders were randomly assigned to an intervention group (n = 57, 84.2% female) or a control group (n = 80, 83.8% female). Subjects were followed via questionnaires and register data. The intervention contained individual CBT and the offer of a workplace meeting. We examined intervention effects by analysing group differences in score changes on the Perceived Stress Scale (PSS-10) and the General Health Questionnaire (GHQ-30). We also tested if intervention led to faster lasting RTW. RESULTS: Mean baseline values of PSS were 24.79 in the intervention group and 23.26 in the control group while the corresponding values for GHQ were 21.3 and 20.27, respectively. There was a significant effect of time. 10 months after baseline, both groups reported less perceived stress and improved mental health. 4 months after baseline, we found significant treatment effects for both perceived stress and mental health. The difference in mean change in PSS after 4 months was - 3.09 (- 5.47, - 0.72), while for GHQ it was - 3.91 (- 7.15, - 0.68). There were no group differences in RTW. CONCLUSIONS: The intervention led to faster reductions in perceived stress and stress symptoms amongst patients with work-related stress reactions and adjustment disorders. 6 months after the intervention ended there were no longer differences between the groups. AD - Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark. davgla@rm.dk. Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark. AN - 29808433 AU - Glasscock, D. J. AU - Carstensen, O. AU - Dalgaard, V. L. CN - Medline 211026 DA - Aug DB - Medline DO - 10.1007/s00420-018-1314-7 DP - NLM ET - 20180528 IS - 6 J2 - Int Arch Occup Environ Health KW - Cognitive Behavioral Therapy/*methods Denmark Female Humans Male Occupational Diseases Occupational Stress/diagnosis/prevention & control/psychology/*therapy Regression Analysis Return to Work Stress, Psychological Surveys and Questionnaires Treatment Outcome Workplace/*psychology Adjustment disorders Cognitive behavioural therapy Occupational stress Rct Stress management intervention L1 - internal-pdf://0664056499/1873-Glasscock-2018.pdf LA - English M3 - Randomized Controlled Trial N1 - Glasscock, David J Carstensen, Ole Dalgaard, Vita Ligaya eng 34-2007-03/Danish Working Environment Research Fund/International Randomized Controlled Trial Germany 2018/05/29 Int Arch Occup Environ Health. 2018 Aug;91(6):675-687. doi: 10.1007/s00420-018-1314-7. Epub 2018 May 28. PY - 2018 SN - 1432-1246 (Electronic) 0340-0131 (Linking) SP - 675-687 ST - Recovery from work-related stress: a randomized controlled trial of a stress management intervention in a clinical sample T2 - Int Arch Occup Environ Health TI - Recovery from work-related stress: a randomized controlled trial of a stress management intervention in a clinical sample UR - https://www.ncbi.nlm.nih.gov/pubmed/29808433 VL - 91 ID - 1873 ER - TY - JOUR AB - PURPOSE: Major depression is associated with high levels of absence and reduced productivity. Therefore the costs to society are high. The aim of this study was to evaluate the cost-utility of collaborative care for major depressive disorder (MDD) compared to care as usual in an occupational healthcare setting. A societal perspective was taken. METHODS: In this randomised controlled trial, 126 sick-listed workers with MDD were included (65 collaborative care, 61 care as usual). Baseline measurements and follow up measures (3, 6, 9 and 12 months) were assessed by questionnaire. We applied the Trimbos/iMTA questionnaire for costs associated with psychiatric illness, the SF-HQL and the EQ-5D respectively measuring the health care utilization, production losses and general health related quality of life. RESULTS: The average annual healthcare costs in the collaborative care group were euro3,874 (95 % CI euro2,778-euro 5,718) compared to euro4,583 (95 % CI euro3,108-euro6,794) in the care as usual group. The average quality of life years (QALY's) gained were lower in the collaborative care group, 0.05 QALY. The majority of the ICERS (69 %) indicate that collaborative care is less costly but also less effective than care as usual. Including the productivity costs did not change this result. CONCLUSIONS: The cost-utility analysis showed that collaborative care generated reduced costs and a reduction in effects compared to care as usual and was therefore not a cost-effective intervention. AD - Institute for Medical Technology Assessment, Institute of Health Policy and Management, Burgermeester Oudlaan 50, PO Box 1738, 3000 DR, Rotterdam, The Netherlands, Goorden@bmg.eur.nl. AN - 24085535 AU - Goorden, M. AU - Vlasveld, M. C. AU - Anema, J. R. AU - van Mechelen, W. AU - Beekman, A. T. AU - Hoedeman, R. AU - van der Feltz-Cornelis, C. M. AU - Hakkaart-van Roijen, L. CN - Medline 211026 DA - Sep DB - Medline DO - 10.1007/s10926-013-9483-4 DP - NLM IS - 3 J2 - J Occup Rehabil KW - Adult *Cooperative Behavior *Cost-Benefit Analysis Depressive Disorder, Major/*economics/*therapy Efficiency, Organizational Female Health Care Costs Humans Male Mental Health Services/*economics Netherlands Occupational Health Services/*economics Quality of Life Sick Leave Surveys and Questionnaires L1 - internal-pdf://1102068595/1895-Goorden-2014.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Goorden, Maartje Vlasveld, Moniek C Anema, Johannes R van Mechelen, Willem Beekman, Aartjan T F Hoedeman, Rob van der Feltz-Cornelis, Christina M Hakkaart-van Roijen, Leona eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2013/10/03 J Occup Rehabil. 2014 Sep;24(3):555-62. doi: 10.1007/s10926-013-9483-4. PY - 2014 SN - 1573-3688 (Electronic) 1053-0487 (Linking) SP - 555-62 ST - Cost-utility analysis of a collaborative care intervention for major depressive disorder in an occupational healthcare setting T2 - J Occup Rehabil TI - Cost-utility analysis of a collaborative care intervention for major depressive disorder in an occupational healthcare setting UR - https://www.ncbi.nlm.nih.gov/pubmed/24085535 VL - 24 ID - 1895 ER - TY - JOUR AB - OBJECTIVE: To examine whether use of functional capacity evaluation (FCE) leads to better outcomes for injured workers. DESIGN: Cluster randomized controlled trial conducted with analysis at level of claimant. SETTING: Rehabilitation facility. PARTICIPANTS: Participants included claimants (N=203); of these, 103 were tested with FCE. Data were collected on all claimants undergoing RTW assessment at the facility for musculoskeletal conditions. Participants were predominantly employed (59%) men (73%) with chronic musculoskeletal conditions (median duration, 496d). INTERVENTIONS: FCEs are commonly used to identify work abilities and inform return-to-work (RTW) decisions. Therefore, FCE results have important consequences. Clinicians who were trained and experienced in performing FCEs were randomized into 2 groups. One group included 14 clinicians who were trained to conduct a semistructured functional interview; the other group (control group) continued to use standard FCE procedures. MAIN OUTCOME MEASURES: Outcomes included RTW recommendations after assessment, functional work level at time of assessment and 1, 3, and 6 months after assessment, and compensation outcomes. Analysis included Mann-Whitney U, chi-square, and t tests. RESULTS: All outcomes were similar between groups, and no statistically or clinically significant differences were observed. Mean differences between groups on functional work levels at assessment and follow-up ranged from 0.1 to 0.3 out of 4 (3%-8% difference, P>.05). CONCLUSIONS: Performance-based FCEs did not appear to enhance RTW outcomes beyond information gained from semistructured functional interviewing. Use of functional interviewing has the potential to improve efficiency of RTW assessment without compromising clinical, RTW, or compensation outcomes. AD - Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Workers' Compensation Board-Alberta/Millard Health, Edmonton, Alberta. Electronic address: dgross@ualberta.ca. Alberta Health Services, Calgary Zone, Calgary, Alberta. Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta. Department of Physical Therapy, University of Alberta, Edmonton, Alberta. School of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada. Workers' Compensation Board-Alberta/Millard Health, Edmonton, Alberta. AN - 24502839 AU - Gross, D. P. AU - Asante, A. K. AU - Miciak, M. AU - Battie, M. C. AU - Carroll, L. J. AU - Sun, A. AU - Mikalsky, M. AU - Huellstrung, R. AU - Niemelainen, R. CN - Medline 211026 DA - May DB - Medline DO - 10.1016/j.apmr.2014.01.017 DP - NLM ET - 20140203 IS - 5 J2 - Arch Phys Med Rehabil KW - Female Follow-Up Studies Humans Interview, Psychological/*methods Male Middle Aged Motor Activity/*physiology Musculoskeletal Diseases/physiopathology/*rehabilitation *Physical Therapy Modalities Prognosis Retrospective Studies Return to Work/*trends *Work Capacity Evaluation Insurance, disability Outcome and process assessment (health care) Rehabilitation Return to work Workers' compensation L1 - internal-pdf://1925009383/1920-Gross-2014.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Gross, Douglas P Asante, Alexander K Miciak, Maxi Battie, Michele C Carroll, Linda J Sun, Ambrose Mikalsky, Marti Huellstrung, Rene Niemelainen, Riikka eng Randomized Controlled Trial Research Support, Non-U.S. Gov't 2014/02/08 Arch Phys Med Rehabil. 2014 May;95(5):807-815.e1. doi: 10.1016/j.apmr.2014.01.017. Epub 2014 Feb 3. PY - 2014 SN - 1532-821X (Electronic) 0003-9993 (Linking) SP - 807-815 e1 ST - Are performance-based functional assessments superior to semistructured interviews for enhancing return-to-work outcomes? T2 - Arch Phys Med Rehabil TI - Are performance-based functional assessments superior to semistructured interviews for enhancing return-to-work outcomes? UR - https://www.ncbi.nlm.nih.gov/pubmed/24502839 VL - 95 ID - 1920 ER - TY - JOUR AB - PURPOSE: Functional capacity evaluations (FCE) are used to identify work abilities and are commonly integrated into rehabilitation programs. We studied whether integrating FCE into rehabilitation leads to better outcomes for injured workers. METHODS: A cluster randomised controlled trial was conducted at a workers' compensation rehabilitation facility (registration ISRCTN61284905). Clinicians were randomised into 2 groups: 1 group used FCE while another conducted semi-structured functional interviews. Outcomes included recommendations following assessment, rehabilitation program outcomes including functional work levels and pain intensity, as well as compensation outcomes at 1, 3, and 6 months after assessment. Analysis included Mann-Whitney U, Chi square and t tests. RESULTS: Subjects included 225 claimants of whom 105 were tested with FCE. Subjects were predominantly employed (84 %) males (63 %) with sub-acute musculoskeletal conditions (median duration 67 days). Claimants undergoing FCE had ~15 % higher average functional work levels recommended at time of assessment (Mann-Whitney U = 4,391.0, p < 0.001) but differences at other follow-up times were smaller (0-8 %), in favour of functional interviewing, and not statistically significant. Clinically important improvement during rehabilitation in functional work level (0.9/4, SRM = 0.94), pain intensity (2.0/10, SRM = 0.88) and self-reported disability (21.8/100, SRM = 1.45) were only observed in those undergoing the functional interview. CONCLUSIONS: Performance-based FCE integrated into occupational rehabilitation appears to lead to higher baseline functional work levels compared to a semi-structured functional interview, but not improved RTW rates or functional work levels at follow-up. Functional interviewing has potential for efficiency gains and higher likelihood of clinically important improvement following rehabilitation, however further research is needed. AD - Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G 2G4, Canada, dgross@ualberta.ca. AN - 24374369 AU - Gross, D. P. AU - Asante, A. K. AU - Miciak, M. AU - Battie, M. C. AU - Carroll, L. J. AU - Sun, A. AU - Mikalsky, M. AU - Huellstrung, R. AU - Niemelainen, R. CN - Medline 211026 DA - Dec DB - Medline DO - 10.1007/s10926-013-9491-4 DP - NLM IS - 4 J2 - J Occup Rehabil KW - Adult Alberta Female Follow-Up Studies Humans *Interviews as Topic Male Middle Aged Musculoskeletal Diseases/*rehabilitation Musculoskeletal Pain/rehabilitation Occupational Diseases/*rehabilitation Pain Measurement *Return to Work Self Report *Work Capacity Evaluation Workers' Compensation L1 - internal-pdf://2091189710/1921-Gross-2014.pdf LA - English M3 - Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Gross, Douglas P Asante, Alexander K Miciak, Maxi Battie, Michele C Carroll, Linda J Sun, Ambrose Mikalsky, Marti Huellstrung, Rene Niemelainen, Riikka eng Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2014/01/01 J Occup Rehabil. 2014 Dec;24(4):617-30. doi: 10.1007/s10926-013-9491-4. PY - 2014 SN - 1573-3688 (Electronic) 1053-0487 (Linking) SP - 617-30 ST - A cluster randomized clinical trial comparing functional capacity evaluation and functional interviewing as components of occupational rehabilitation programs T2 - J Occup Rehabil TI - A cluster randomized clinical trial comparing functional capacity evaluation and functional interviewing as components of occupational rehabilitation programs UR - https://www.ncbi.nlm.nih.gov/pubmed/24374369 VL - 24 ID - 1921 ER - TY - JOUR AB - STUDY DESIGN: A controlled randomized clinical trial was performed. OBJECTIVE: To investigate the effect of a light mobilization program on the duration of sick leave for patients with subacute low back pain. SUMMARY OF BACKGROUND DATA: Early intervention with information, diagnostics, and light mobilization may be a cost-effective method for returning patients quickly to normal activity. In this experiment, patients were referred to a low back pain clinic and given this simple and systematic program as an outpatient treatment. METHODS: In this study, 457 patients sick-listed 8 to 12 weeks for low back pain, as recorded by the National Insurance Offices, were randomized into two groups: an intervention group (n = 237) and a control group (n = 220). The intervention group was examined at a spine clinic and given information and advice to stay active. The control group was not examined at the clinic, but was treated with conventional primary health care. RESULTS: At 12-month follow-up assessment, 68.4% in the intervention group had returned to full-duty work, as compared with 56.4% in the control group. CONCLUSIONS: Early intervention with examination, information, and recommendations to stay active showed significant effects in reducing sick leave for patients with low back pain. AD - Spine Clinic, Central Hospital in Hedmark, Ottestad, Norway. emhagen@online.no AN - 10908942 AU - Hagen, E. M. AU - Eriksen, H. R. AU - Ursin, H. CN - Medline 211026 DA - Aug 1 DB - Medline DO - 10.1097/00007632-200008010-00017 DP - NLM IS - 15 J2 - Spine KW - Adolescent Adult Disability Evaluation *Exercise Therapy Female Follow-Up Studies Humans Low Back Pain/*rehabilitation Lumbosacral Region/physiology Male Middle Aged Outpatients Patient Education as Topic *Sick Leave Work Capacity Evaluation Workers' Compensation L1 - internal-pdf://0633383031/1952-Hagen-2000.pdf LA - English M3 - Clinical Trial Randomized Controlled Trial N1 - Hagen, E M Eriksen, H R Ursin, H eng Clinical Trial Randomized Controlled Trial 2000/07/26 Spine (Phila Pa 1976). 2000 Aug 1;25(15):1973-6. doi: 10.1097/00007632-200008010-00017. PY - 2000 SN - 0362-2436 (Print) 0362-2436 (Linking) SP - 1973-6 ST - Does early intervention with a light mobilization program reduce long-term sick leave for low back pain? T2 - Spine (Phila Pa 1976) TI - Does early intervention with a light mobilization program reduce long-term sick leave for low back pain? UR - https://www.ncbi.nlm.nih.gov/pubmed/10908942 VL - 25 ID - 1952 ER - TY - JOUR AB - AIMS: To investigate if a standardised physical exercise programme given in addition to a brief intervention at a spine clinic had an effect on return to work. METHODS: A total of 246 patients sick-listed 8-12 weeks for non-specific low back pain were offered a brief intervention programme at the spine clinic with examination, information, reassurance, and encouragement to engage in physical activity as normal as possible, before they were randomised into an intervention group (n = 124) and a control group (n = 122). Patients in the intervention group participated in a physical exercise programme at the spine clinic. RESULTS: During the 2-year follow-up, there were no significant differences between the groups on sick leave, pain, use of analgesics, psychological distress, coping strategies, fear-avoidance beliefs, self-reported disability, or walking distances. However, both groups increased return to work, reported less pain and better function, and reduced fear-avoidance beliefs for physical activity during the follow-up period. Fear-avoidance beliefs for work were not changed. CONCLUSIONS: A physical exercise programme for low back pain patients given after a brief intervention at a spine clinic did not have any additional effect on sick leave or fear-avoidance beliefs. Both groups reported less pain, better physical function, and increased return to work during follow-up. The treatment at the spine clinic did not contain a vocational rehabilitation programme directed towards individual work-related problems, which might explain no change in fear-avoidance beliefs for work. AD - Spine Clinic, Sykehuset Innlandet HF, Ottestad, Norway. emhagen@online.no AN - 20817653 AU - Hagen, E. M. AU - Odelien, K. H. AU - Lie, S. A. AU - Eriksen, H. R. CN - Medline 211026 DA - Nov DB - Medline DO - 10.1177/1403494810382472 DP - NLM ET - 20100903 IS - 7 J2 - Scand J Public Health KW - Absenteeism Adaptation, Psychological Adolescent Adult *Exercise *Exercise Therapy Fear Female Follow-Up Studies Humans Low Back Pain/psychology/*rehabilitation Male Middle Aged Outcome Assessment, Health Care *Rehabilitation, Vocational Sick Leave Socioeconomic Factors Surveys and Questionnaires Time Factors Young Adult L1 - internal-pdf://0411157700/1953-Hagen-2010.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Hagen, Eli Molde Odelien, Kirsti Hokkanen Lie, Stein Atle Eriksen, Hege R eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Sweden 2010/09/08 Scand J Public Health. 2010 Nov;38(7):731-8. doi: 10.1177/1403494810382472. Epub 2010 Sep 3. PY - 2010 SN - 1651-1905 (Electronic) 1403-4948 (Linking) SP - 731-8 ST - Adding a physical exercise programme to brief intervention for low back pain patients did not increase return to work T2 - Scand J Public Health TI - Adding a physical exercise programme to brief intervention for low back pain patients did not increase return to work UR - https://www.ncbi.nlm.nih.gov/pubmed/20817653 VL - 38 ID - 1953 ER - TY - JOUR AB - In general, randomized controlled studies concerning return to work have failed to demonstrate significant treatment effects for long-lasting musculoskeletal pain, and most treatments examined have not been economically beneficial. Individuals (n=654) sick-listed for at least 8 weeks with musculoskeletal pain, selected from the Norwegian mandatory sickness insurance system and volunteering to participate, were categorized into three groups differing in a prognosis score (good, medium, poor) for return to work, based on a brief, standardized screening of psychological and physiotherapy findings. They were then randomly assigned to three outpatient treatments with three different levels of intensity (ordinary treatment, light multidisciplinary, and extensive multidisciplinary treatment). The evaluation was based on 14 months follow-up data on return to work collected from social security records. The patients with good prognosis for return to work do equally well with ordinary treatment as with the two more intensive treatments. The patients with medium prognosis benefit equally from the two multidisciplinary treatments. The patients with poor prognosis receiving extensive multidisciplinary treatment returned to work at a higher rate than patients with poor prognosis receiving ordinary treatment, 55 vs. 37% (P<0.05) at 14 months. Multidisciplinary treatment is effective concerning return to work, when given to patients who are most likely to benefit from that treatment. Measures of pain or quality of life are not included in this study. The cost-benefit analysis of the economic returns of the light multidisciplinary and the extensive multidisciplinary treatment programs yields a positive net present social value of the treatment. A simple, standardized, screening instrument including only psychological and physiotherapeutic observations may be a useful clinical tool for allocating patients with musculoskeletal pain to the right level of treatment. AD - The Outpatient Spine Clinic, Haukeland University Hospital, Box 1, 5021 Bergen, Norway. ellen.haldorsen@haukeland.no AN - 11790467 AU - Haldorsen, E. M. AU - Grasdal, A. L. AU - Skouen, J. S. AU - Risa, A. E. AU - Kronholm, K. AU - Ursin, H. CN - Medline 211026 DA - Jan DB - Medline DO - 10.1016/s0304-3959(01)00374-8 DP - NLM IS - 1-2 J2 - Pain KW - Adult Aged Analysis of Variance Chi-Square Distribution Cost-Benefit Analysis/methods/statistics & numerical data Female Humans Male Middle Aged Musculoskeletal Diseases/diagnosis/*therapy Pain/diagnosis *Pain Management Prognosis Sick Leave/*statistics & numerical data Treatment Outcome L1 - internal-pdf://0846994961/1958-Haldorsen-2002.pdf LA - English M3 - Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Haldorsen, Ellen M Haland Grasdal, Astrid L Skouen, Jan Sture Risa, Alf Erling Kronholm, Karsten Ursin, Holger eng Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2002/01/16 Pain. 2002 Jan;95(1-2):49-63. doi: 10.1016/s0304-3959(01)00374-8. PY - 2002 SN - 0304-3959 (Print) 0304-3959 (Linking) SP - 49-63 ST - Is there a right treatment for a particular patient group? Comparison of ordinary treatment, light multidisciplinary treatment, and extensive multidisciplinary treatment for long-term sick-listed employees with musculoskeletal pain T2 - Pain TI - Is there a right treatment for a particular patient group? Comparison of ordinary treatment, light multidisciplinary treatment, and extensive multidisciplinary treatment for long-term sick-listed employees with musculoskeletal pain UR - https://www.ncbi.nlm.nih.gov/pubmed/11790467 VL - 95 ID - 1958 ER - TY - JOUR AB - Purpose Transfer from on-site rehabilitation to the participant's daily environment is considered a weak link in the rehabilitation chain. The main objective of this study is to see if adding boosted telephone follow-up directly after completing an occupational rehabilitation program effects work participation. Methods A randomized controlled study included participants with chronic pain, chronic fatigue or common mental disorders on long-term sick leave. After completing 3(1/2) weeks of acceptance and commitment therapy based occupational rehabilitation, participants were randomized to boosted follow-up or a control group before returning to their daily environment. The intervention was delivered over 6 months by on-site RTW coordinators mainly via telephone. Primary outcome was RTW categorized as participation in competitive work >/=1 day per week on average over 8 weeks. Results There were 213 participants of mean age 42 years old. Main diagnoses of sick leave certification were mental disorders (38%) and musculoskeletal disorders (30%). One year after discharge the intervention group had 87% increased odds (OR 1.87, 95% confidence interval 1.06-3.31, p = 0.031), of (re)entry to competitive work >/=1 day per week compared with the controls, with similar positive results for sensitivity analysis of participation half time (>/=2.5 days per week). The cost of boosted follow-up was 390.5 EUR per participant. Conclusion Participants receiving boosted RTW follow-up had higher (re)entry to competitive work >/=1 day per week at 1 year when compared to the control group. Adding low-cost boosted follow-up by telephone after completing an occupational rehabilitation program augmented the effect on return-to-work. AD - Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway. karen.w.hara@ntnu.no. Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. karen.w.hara@ntnu.no. Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. karen.w.hara@ntnu.no. The Norwegian Labour and Welfare Service of Sor-Trondelag, Trondheim, Norway. karen.w.hara@ntnu.no. Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway. Forensic Department and Research Centre Broset, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. The Norwegian Directorate for Labour and Welfare, Oslo, Norway. Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. Hysnes Rehabilitation Center, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Centre for Health Care Improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. AN - 28597308 AU - Hara, K. W. AU - Bjorngaard, J. H. AU - Brage, S. AU - Borchgrevink, P. C. AU - Halsteinli, V. AU - Stiles, T. C. AU - Johnsen, R. AU - Woodhouse, A. C1 - CONFLICT OF INTEREST: The authors declare that they have no conflict of interest. ETHICAL APPROVAL: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. The study has been approved by the Regional Committee for Medical and Health Research Ethics in Central Norway (No.: 2010/2404). C2 - PMC5978834 CN - Medline 211026 DA - Jun DB - Medline DO - 10.1007/s10926-017-9711-4 DP - NLM IS - 2 J2 - J Occup Rehabil KW - Acceptance and Commitment Therapy/*methods Adult Chronic Pain/psychology/rehabilitation Fatigue/psychology/rehabilitation Female Humans Male Mental Disorders/psychology/*rehabilitation Musculoskeletal Diseases/psychology/*rehabilitation Rehabilitation, Vocational/methods Reminder Systems/*instrumentation Return to Work/psychology/*statistics & numerical data Telephone Time Factors Work Capacity Evaluation Acceptance and commitment therapy Mental disorders Musculoskeletal pain Telerehabilitation Vocational rehabilitation L1 - internal-pdf://2796862884/1980-Hara-2018.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Hara, Karen Walseth Bjorngaard, Johan Hakon Brage, Soren Borchgrevink, Petter Christian Halsteinli, Vidar Stiles, Tore Charles Johnsen, Roar Woodhouse, Astrid eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2017/06/10 J Occup Rehabil. 2018 Jun;28(2):265-278. doi: 10.1007/s10926-017-9711-4. PY - 2018 SN - 1573-3688 (Electronic) 1053-0487 (Print) 1053-0487 (Linking) SP - 265-278 ST - Randomized Controlled Trial of Adding Telephone Follow-Up to an Occupational Rehabilitation Program to Increase Work Participation T2 - J Occup Rehabil TI - Randomized Controlled Trial of Adding Telephone Follow-Up to an Occupational Rehabilitation Program to Increase Work Participation UR - https://www.ncbi.nlm.nih.gov/pubmed/28597308 VL - 28 ID - 1980 ER - TY - JOUR AB - BACKGROUND AND OBJECTIVE: Cognitive-behavioural treatments (CBT) and physical group exercise (PE) have both shown promising effects in reducing disability and increasing work participation among chronic low back pain (CLBP) patients. A brief cognitive intervention (BI) has previously been demonstrated to reduce work disability in CLBP. The aim of this study was to test if the effect of BI could be further increased by adding either group CBT or group PE. METHODS: A total of 214 patients, all sick listed 2-10 months due to CLBP, were randomized to BI (n = 99), BI + group CBT (n = 55) or BI + group PE (n = 60). Primary outcome was increased work participation at 12 months, whereas secondary outcomes included pain-related disability, subjective health complaints, anxiety, depression, coping and fear avoidance. RESULTS: There were no significant differences between the groups in work participation at 12 months follow-up (chi(2) = 1.15, p = 0.56). No significant differences were found on the secondary outcomes either, except for a statistically significant reduction (time by group) in pseudoneurology one domain of subjective health complaints (sleep problems, tiredness, dizziness, anxiety, depression, palpitation, heat flushes) (F(2,136) = 3.109, p = 0.048) and anxiety (F(2,143) = 4.899, p = 0.009) for the groups BI + group CBT and BI + group PE, compared to BI alone. However, these differences were not significant in post hoc analyses (Scheffe adjusted). CONCLUSION: There was no support for an effect of the added group CBT or group PE treatments to a brief cognitive intervention in this study of patients on sick leave due to low back pain. SIGNIFICANCE: Our study demonstrates that treatments that previously were found to be effective and are included in most treatment guidelines, such as group cognitive-behavior therapy and exercise, were not effective in this given context compared to a brief, cognitive intervention. This implies that an optimized brief intervention is difficult to outperform in patients on sick leave due to low back pain. AD - Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway. Oslo University Hospital, Norway. Uni Research Health, Bergen, Norway. Department of Sport and Physical Activity, Bergen University College, Norway. Department of Clinical Medicine, Section of Psychiatry, Haukeland University Hospital, Bergen, Norway. Department of Clinical Dentistry, University of Bergen, Norway. Department of Health Promotion, University College of Southeast Norway, Horten, Norway. Department of Pain Management and Research, Oslo University Hospital, Norway. Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway. AN - 28449303 AU - Harris, A. AU - Moe, T. F. AU - Eriksen, H. R. AU - Tangen, T. AU - Lie, S. A. AU - Tveito, T. H. AU - Reme, S. E. CN - Medline 211026 DA - Sep DB - Medline DO - 10.1002/ejp.1041 DP - NLM ET - 20170427 IS - 8 J2 - Eur J Pain KW - Adaptation, Psychological Adult Chronic Pain/*therapy *Cognitive Behavioral Therapy Disability Evaluation *Exercise Therapy Female Humans Low Back Pain/*therapy Male Middle Aged *Psychotherapy, Brief *Psychotherapy, Group Sick Leave Treatment Outcome L1 - internal-pdf://3008194762/1987-Harris-2017.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial N1 - Harris, A Moe, T F Eriksen, H R Tangen, T Lie, S A Tveito, T H Reme, S E eng Multicenter Study Randomized Controlled Trial England 2017/04/28 Eur J Pain. 2017 Sep;21(8):1397-1407. doi: 10.1002/ejp.1041. Epub 2017 Apr 27. PY - 2017 SN - 1532-2149 (Electronic) 1090-3801 (Linking) SP - 1397-1407 ST - Brief intervention, physical exercise and cognitive behavioural group therapy for patients with chronic low back pain (The CINS trial) T2 - Eur J Pain TI - Brief intervention, physical exercise and cognitive behavioural group therapy for patients with chronic low back pain (The CINS trial) UR - https://www.ncbi.nlm.nih.gov/pubmed/28449303 VL - 21 ID - 1987 ER - TY - JOUR AB - OBJECTIVES: To evaluate whether adjuvant occupational therapy (OT) can improve the effectiveness of treatment-as-usual (TAU) in sick-listed employees with major depression. METHODS: In total, 117 employees sick-listed for a median duration of 4.8 months (IQR=2.6 to 10.1 months) because of major depression were randomised to TAU (n=39) or adjuvant OT (TAU+OT; n=78). OT (18 sessions) focussed on a fast return to work (RTW) and improving work-related coping and self-efficacy. The primary outcome was work participation (hours of absenteeism+duration until partial/full RTW). Secondary outcomes were depression, at-work functioning, and health-related functioning. Intermediate outcomes were work-related, coping and self-efficacy. Blinded assessments occurred at baseline and 6, 12 and 18 months follow-up. RESULTS: The groups did not significantly differ in their overall work participation (adjusted group difference=-1.9, 95% CI -19.9 to +16.2). However, those in TAU+OT did show greater improvement in depression symptoms (-2.8, -5.5 to -0.2), an increased probability of long-term symptom remission (+18%, +7% to +30%), and increased probability of long-term RTW in good health (GH) (+24%, 12% to 36%). There were no significant group differences in the remaining secondary/intermediate outcomes. CONCLUSIONS: In a highly impaired population, we could not demonstrate significant benefit of adjuvant OT for improving overall work participation. However, adjuvant OT did increase long-term depression recovery and long-term RTW in GH (ie, full RTW while being remitted, and with better work and role functioning). TRIAL REGISTRATION DUTCH TRIAL REGISTER: NTR2057. AD - Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands. H.L.Hees@amc.uva.nl AN - 23117218 AU - Hees, H. L. AU - de Vries, G. AU - Koeter, M. W. AU - Schene, A. H. CN - Medline 211026 DA - Apr DB - Medline DO - 10.1136/oemed-2012-100789 DP - NLM ET - 20121101 IS - 4 J2 - Occup Environ Med KW - *Absenteeism Adaptation, Psychological Adult Depression/*therapy Depressive Disorder, Major/*therapy Female Follow-Up Studies *Health Humans Male Middle Aged *Occupational Therapy Program Evaluation Remission Induction *Return to Work Self Efficacy Sick Leave Treatment Outcome L1 - internal-pdf://2436728665/2009-Hees-2013.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Hees, Hiske L de Vries, Gabe Koeter, Maarten W J Schene, Aart H eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2012/11/03 Occup Environ Med. 2013 Apr;70(4):252-60. doi: 10.1136/oemed-2012-100789. Epub 2012 Nov 1. PY - 2013 SN - 1470-7926 (Electronic) 1351-0711 (Linking) SP - 252-60 ST - Adjuvant occupational therapy improves long-term depression recovery and return-to-work in good health in sick-listed employees with major depression: results of a randomised controlled trial T2 - Occup Environ Med TI - Adjuvant occupational therapy improves long-term depression recovery and return-to-work in good health in sick-listed employees with major depression: results of a randomised controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/23117218 VL - 70 ID - 2009 ER - TY - JOUR AB - STUDY DESIGN: Randomized controlled trial. OBJECTIVES: To compare high- and low-intensity back schools with usual care in occupational health care. SUMMARY OF BACKGROUND DATA: The content and intensity of back schools vary widely and the methodologic quality of randomized controlled trials is generally weak. Until now, no back school has proven to be superior for workers sick-listed because of subacute nonspecific low back pain. METHODS: Workers (n = 299) sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain were recruited by the occupational physician and randomly assigned to a high-intensity back school, a low-intensity back school, or care as usual. Outcome measures were days until return to work, total days of sick-leave, pain, functional status, kinesiophobia, and perceived recovery and were assessed at baseline and at 3 and 6 months of follow-up. Principal analyses were performed according to the intention-to-treat principle. RESULTS: We randomly allocated 299 workers. Workers in the low-intensity back school returned to work faster compared with usual care and the high-intensity back school, with hazard ratios of 1.4 (P = 0.06) and 1.3 (P = 0.09), respectively. The comparison between high-intensity back school and usual care resulted in a hazard ratio of 1.0 (P = 0.83). The median number of sick-leave days was 68, 75, and 85 in the low-intensity back school, usual care, and high-intensity back school, respectively. Beneficial effects on functional status and kinesiophobia were found at 3 months in favor of the low-intensity back school. No substantial differences on pain and perceived recovery were found between groups. CONCLUSIONS: The low-intensity back school was most effective in reducing work absence, functional disability, and kinesiophobia, and more workers in this group scored a higher perceived recovery during the 6-month follow-up. AD - Body@Work, Research Center Physical Activity, Work and Health, TNO-VUmc, Amsterdam, The Netherlands. AN - 16648740 AU - Heymans, M. W. AU - de Vet, H. C. AU - Bongers, P. M. AU - Knol, D. L. AU - Koes, B. W. AU - van Mechelen, W. CN - Medline 211026 DA - May 1 DB - Medline DO - 10.1097/01.brs.0000216443.46783.4d DP - NLM IS - 10 J2 - Spine KW - Adult Disability Evaluation Female Humans Low Back Pain/physiopathology/*therapy Male *Occupational Health Services Pain Measurement Patient Education as Topic/*methods *Physical Therapy Modalities Sick Leave/statistics & numerical data Treatment Outcome Work Capacity Evaluation L1 - internal-pdf://1306511062/2035-Heymans-2006.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Heymans, Martijn W de Vet, Henrica C W Bongers, Paulien M Knol, Dirk L Koes, Bart W van Mechelen, Willem eng Randomized Controlled Trial Research Support, Non-U.S. Gov't 2006/05/02 Spine (Phila Pa 1976). 2006 May 1;31(10):1075-82. doi: 10.1097/01.brs.0000216443.46783.4d. PY - 2006 SN - 1528-1159 (Electronic) 0362-2436 (Linking) SP - 1075-82 ST - The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial T2 - Spine (Phila Pa 1976) TI - The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/16648740 VL - 31 ID - 2035 ER - TY - JOUR AB - INTRODUCTION: Behaviorally oriented graded activity interventions have been suggested for sick-listed workers with low back pain on return to work, but have not been extensively evaluated. METHODS: One hundred and thirty-four workers were randomly assigned to either a graded activity intervention (n = 67) or usual care (n = 67) and followed-up for 12 months. RESULTS: The graded activity group returned back to work faster with a median of 54 days compared to 67 days in the usual care group. The graded activity intervention was more effective after approximately 50 days post-randomization (HRR = 1.9, CI = 1.2-3.1, p = 0.01). Differences between the groups in number of recurrent episodes, total number of days of sick leave due to low back pain, and total number of days of sick leave due to all diagnoses, were in favor of the graded activity group, although not statistically significant. No effects of the graded activity intervention were found for functional status or pain. CONCLUSION: Graded activity intervention is a valuable strategy to enhance short-term return to work outcomes. AD - Department of Public and Occupational Health, VU University Medical Centre, Amsterdam, The Netherlands. AN - 16254756 AU - Hlobil, H. AU - Staal, J. B. AU - Twisk, J. AU - Koke, A. AU - Ariens, G. AU - Smid, T. AU - van Mechelen, W. CN - Medline 211026 DA - Dec DB - Medline DO - 10.1007/s10926-005-8035-y DP - NLM ET - 2005/10/29 IS - 4 J2 - J Occup Rehabil KW - Activities of Daily Living *Exercise Humans Low Back Pain/*rehabilitation Multivariate Analysis Netherlands Occupational Diseases/*rehabilitation Proportional Hazards Models Recurrence Sick Leave/statistics & numerical data Single-Blind Method Survival Analysis L1 - internal-pdf://3565563224/2048-Hlobil-2005.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Hlobil, Hynek Staal, J Bart Twisk, Jos Koke, Albere Ariens, Geertje Smid, Tjabe van Mechelen, Willem eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2005/10/29 J Occup Rehabil. 2005 Dec;15(4):569-80. doi: 10.1007/s10926-005-8035-y. PY - 2005 SN - 1053-0487 (Print) 1053-0487 (Linking) SP - 569-80 ST - The effects of a graded activity intervention for low back pain in occupational health on sick leave, functional status and pain: 12-month results of a randomized controlled trial T2 - J Occup Rehabil TI - The effects of a graded activity intervention for low back pain in occupational health on sick leave, functional status and pain: 12-month results of a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/16254756 VL - 15 ID - 2048 ER - TY - JOUR AB - OBJECTIVE: Stress-related disorders are common, associated with substantial individual suffering, and place a large economic burden on society. While treatment appears to be able to reduce symptoms, evidence of interventions to improve vocational outcomes is flimsy. Lack of integration of vocational rehabilitation and healthcare services has been suspected to be a major potential barrier in return-to-work (RTW) processes; therefore, we aimed to test the effectiveness of such integration. METHODS: We randomized participants who were on sick leave for >/= 4 weeks with a stress-related disorder. They were allocated to (i) service as usual (SAU), (ii) improved mental healthcare (MHC), or (iii) integrated interventions (INT). The primary outcome was RTW rates measured at 12 months. Secondary outcome were RTW rates measured at 6 months, proportion in work at 12 months, and levels of stress, anxiety, depression, and functioning at 6 months. RESULTS: We included 666 participants. On the primary outcome and almost all other vocational outcomes, SAU was superior to both INT and MHC. MHC and INT did not differ on any vocational outcome. On several symptom scales, MHC showed lower values than SAU, whilst INT did not differ from the two other groups. CONCLUSION: Both the INT and the MHC intervention lowered RTW rates compared with SAU, and thereby yielded a worse outcome. However, the MHC group showed a tendency towards having lower symptom levels compared with those in the SAU group; accordingly, the SAU group is not unequivocally superior. MHC and INT showed no general differences. AD - Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, Copenhagen. andreas.hoff@regionh.dk. AN - 35373306 AU - Hoff, A. AU - Fisker, J. AU - Poulsen, R. M. AU - Hjorthoj, C. AU - Rosenberg, N. K. AU - Nordentoft, M. AU - Bojesen, A. B. AU - Eplov, L. F. C1 - The authors declare no conflict of interests C2 - PMC9527782 CN - Cochrane Trials uppdateringssökning 220512 DA - Jul 1 DB - Medline DO - 10.5271/sjweh.4021 DP - NLM ET - 20220401 IS - 5 KW - Delivery of Health Care Humans *Mental Disorders/therapy *Mental Health Services Rehabilitation, Vocational Return to Work Sick Leave L1 - internal-pdf://3368894096/10219-Hoff-2022.pdf M3 - Journal: Article in Press N1 - Hoff, Andreas Fisker, Jonas Poulsen, Rie Mandrup Hjorthoj, Carsten Rosenberg, Nicole Kristjansen Nordentoft, Merete Bojesen, Anders Bo Eplov, Lene Falgaard eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Finland 2022/04/05 Scand J Work Environ Health. 2022 Jul 1;48(5):361-371. doi: 10.5271/sjweh.4021. Epub 2022 Apr 1. PY - 2022 SN - 1795-990X (Electronic) 0355-3140 (Print) 0355-3140 (Linking) SP - 361-371 ST - Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with stress-related disorders: results from a randomized trial T2 - Scand J Work Environ Health TI - Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with stress-related disorders: results from a randomized trial UR - https://www.ncbi.nlm.nih.gov/pubmed/35373306 VL - 48 ID - 10219 ER - TY - JOUR AB - OBJECTIVE: The aim of this study was to investigate an integrated mental healthcare and vocational rehabilitation intervention to improve and hasten the process of return-to-work of people on sick leave with anxiety and depression. METHODS: In this three-arm, randomised trial, participants were assigned to (1) integrated intervention (INT), (2) improved mental healthcare (MHC) or (3) service as usual (SAU). The primary outcome was time to return-to-work measured at 12-month follow-up. The secondary outcomes were time to return-to-work measured at 6-month follow-up; levels of anxiety, depression, stress symptoms, and social and occupational functioning at 6 months; and return-to-work measured as proportion in work at 12 months. RESULTS: 631 individuals were randomised. INT yielded a higher proportion in work compared with both MHC (56.2% vs 43.7%, p=0.012) and SAU (56.2% vs 45%, p=0.029) at 12-month follow-up. We found no differences in return-to-work in terms of sick leave duration at either 6-month or 12-month follow-up, with the latter being the primary outcome. No differences in anxiety, depression or functioning between INT, MHC and SAU were identified, but INT and MHC showed lower scores on Cohen's Perceived Stress Scale compared with SAU at 12-month follow-up. CONCLUSIONS: Although INT did not hasten the process of return-to-work, it yielded better outcome with regard to proportion in work compared with MHC and SAU. The findings suggest that INT compared with SAU is associated with a few, minor health benefits. Overall, INT yielded slightly better vocational and health outcomes, but the clinical significance of the health advantage is questionable. TRIAL REGISTRATION NUMBER: NCT02872051. AD - Copenhagen Research Centre for Mental Health (CORE), Hellerup, Denmark andreas.hoff@regionh.dk. National Board of Social Services, Odense, Denmark. Hejmdal Private Hospital, Copenhagen, Denmark. Mental Health Centre Copenhagen, Copenhagen, Denmark. Copenhagen Research Centre for Mental Health (CORE), Hellerup, Denmark. AN - 34916330 AU - Hoff, A. AU - Poulsen, R. M. AU - Fisker, J. AU - Hjorthoj, C. AU - Rosenberg, N. AU - Nordentoft, M. AU - Bojesen, A. B. AU - Eplov, L. F. C1 - Competing interests: None declared. C2 - PMC8785062 CN - Medline rct uppdateringssökning 220506 DA - Feb DB - Medline DO - 10.1136/oemed-2021-107894 DP - NLM ET - 20211216 IS - 2 J2 - Occup Environ Med KW - Adult Anxiety Disorders/*rehabilitation Depression/*rehabilitation Female Humans Male Mental Health Services/organization & administration Middle Aged Rehabilitation, Vocational/*methods Return to Work/*statistics & numerical data Sick Leave/statistics & numerical data Stress, Psychological occupational health psychiatry L1 - internal-pdf://2939830688/10218-Hoff-2022.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Hoff, Andreas Poulsen, Rie Mandrup Fisker, Jonas Hjorthoj, Carsten Rosenberg, Nicole Nordentoft, Merete Bojesen, Anders Bo Eplov, Lene Falgaard eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2021/12/18 Occup Environ Med. 2022 Feb;79(2):134-142. doi: 10.1136/oemed-2021-107894. Epub 2021 Dec 16. PY - 2022 SN - 1470-7926 (Electronic) 1351-0711 (Print) 1351-0711 (Linking) SP - 134-142 ST - Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with depression or anxiety: results from a three-arm, parallel randomised trial T2 - Occup Environ Med TI - Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with depression or anxiety: results from a three-arm, parallel randomised trial UR - https://www.ncbi.nlm.nih.gov/pubmed/34916330 VL - 79 ID - 10218 ER - TY - JOUR AB - BACKGROUND: Fatigue is a common complaint that may lead to long-term sick leave and work disability. AIMS: To assess the efficacy of cognitive-behavioural therapy by general practitioners for unexplained, persistent fatigue among employees. METHOD: A randomised controlled trial, using a pre-randomisation design in primary care, investigated 151 employees on sick leave with fatigue. Participants in the experimental group were offered five to seven 30 min sessions of cognitive-behavioural therapy by a general practitioner; those in the control group were offered no treatment. Main outcome measures (fatigue severity, self-reported absenteeism, registered absenteeism and clinical recovery) were assessed at 4 months, 8 months and 12 months. RESULTS: At baseline, 44% of the patients already met research criteria for chronic fatigue syndrome. There was no significant difference between the experimental group and the control group on primary or secondary outcomes at any point. CONCLUSIONS: Cognitive-behavioural therapy by general practitioners for unexplained, persistent fatigue did not prove to be an effective intervention. Since these doctors were unable to deliver this therapy effectively under ideal circumstances, it is unlikely that doctors in routine practice would be more successful in doing so. AD - Department of Epidemiology, Maastricht University, The Netherlands. m.huibers@dmkep.unimaas.nl AN - 14990522 AU - Huibers, M. J. AU - Beurskens, A. J. AU - Van Schayck, C. P. AU - Bazelmans, E. AU - Metsemakers, J. F. AU - Knottnerus, J. A. AU - Bleijenberg, G. CN - Medline 211026 DA - Mar DB - Medline DO - 10.1192/bjp.184.3.240 DP - NLM J2 - Br J Psychiatry KW - Adult Chronic Disease Cognitive Behavioral Therapy/*methods Family Practice/*methods Fatigue/*therapy Female Humans Male Middle Aged Primary Health Care/methods Sick Leave Treatment Outcome L1 - internal-pdf://0611363793/2089-Huibers-2004.pdf LA - English M3 - Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Huibers, Marcus J H Beurskens, Anna J H M Van Schayck, Constant P Bazelmans, Ellen Metsemakers, Job F M Knottnerus, J Andre Bleijenberg, Gijs eng Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2004/03/03 Br J Psychiatry. 2004 Mar;184:240-6. doi: 10.1192/bjp.184.3.240. PY - 2004 SN - 0007-1250 (Print) 0007-1250 (Linking) SP - 240-6 ST - Efficacy of cognitive-behavioural therapy by general practitioners for unexplained fatigue among employees: Randomised controlled trial T2 - Br J Psychiatry TI - Efficacy of cognitive-behavioural therapy by general practitioners for unexplained fatigue among employees: Randomised controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/14990522 VL - 184 ID - 2089 ER - TY - JOUR AB - STUDY DESIGN: Randomized clinical trial comparing two interventions in employees sick-listed 3 to 16 weeks because of low back pain (LBP). OBJECTIVE: To compare 1-year return to work (RTW), pain, disability and physical and mental health dimensions in subjects offered a hospital-based multidisciplinary intervention or a brief intervention. SUMMARY OF BACKGROUND DATA: Previous studies in sick-listed employees with LBP have indicated efficacy of both brief and more comprehensive multidisciplinary interventions. However, it remains unknown, which is the more effective, and which elements are instrumental in furthering RTW, and improving health. METHODS: The brief intervention comprised clinical examination and advice offered by a rehabilitation physician and a physiotherapist. In the multidisciplinary intervention, this intervention was supplemented with the expertise of a team and the assignment of a case manager who drew up a rehabilitation plan in collaboration with the patient and the multidisciplinary team. One-year RTW was estimated by data from a comprehensive national database of social transfer payments. Questionnaires were used to obtain baseline and 1-year data on Roland Morris disability score, LBP Rating Scale, SF36, and fear-avoidance. RESULTS: A total of 351 patients were included and randomized and 344 (98%) patients participated in all the consultations according to the study protocol. RTW was achieved by 125 (71.0%) participants in the multidisciplinary and 133 (76.0%) participants in the brief intervention group. The hazard ratio was 0.84 after adjustment for sex, age, smoking, compensation claims, disability score, and diagnosis (95% confidence interval [CI]: 0.65-1.08,P = 0.18). Multiple linear regression analysis displayed no differences in secondary outcomes, except for the mental health score (SF36), which was a little higher in the multidisciplinary intervention group than in the brief intervention group. CONCLUSION: Hospital-based multidisciplinary intervention may be no better than brief intervention to increase RTW and improve health in sick-listed employees with low back pain. AD - Department of Clinical Social Medicine, Centre of Public Health, Central Denmark Region and Department of Clinical Social Medicine and Rehabilitation, Institute of Public Health, University of Aarhus, Denmark. chris.jensen@stab.rm.dk AN - 21217456 AU - Jensen, C. AU - Jensen, O. K. AU - Christiansen, D. H. AU - Nielsen, C. V. CN - Medline 211026 DA - Jul 1 DB - Medline DO - 10.1097/BRS.0b013e3181eba711 DP - NLM IS - 15 J2 - Spine KW - Adult Disability Evaluation Female Follow-Up Studies Humans Linear Models Low Back Pain/diagnosis/*rehabilitation Male Middle Aged Multivariate Analysis *Pain Clinics Pain Measurement *Physical Therapy Modalities Sick Leave/*statistics & numerical data Surveys and Questionnaires Time Factors Treatment Outcome L1 - internal-pdf://3508283695/2153-Jensen-2011.pdf LA - English M3 - Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Jensen, Chris Jensen, Ole Kudsk Christiansen, David Hoyrup Nielsen, Claus Vinther eng Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2011/01/11 Spine (Phila Pa 1976). 2011 Jul 1;36(15):1180-9. doi: 10.1097/BRS.0b013e3181eba711. PY - 2011 SN - 1528-1159 (Electronic) 0362-2436 (Linking) SP - 1180-9 ST - One-year follow-up in employees sick-listed because of low back pain: randomized clinical trial comparing multidisciplinary and brief intervention T2 - Spine (Phila Pa 1976) TI - One-year follow-up in employees sick-listed because of low back pain: randomized clinical trial comparing multidisciplinary and brief intervention UR - https://www.ncbi.nlm.nih.gov/pubmed/21217456 VL - 36 ID - 2153 ER - TY - JOUR AB - BACKGROUND: Sick-listed employees with low back pain had similar return to work (RTW) rates at one-year follow-up in a randomized trial comparing two interventions, but the effects were modified by specific workplace related factors. The present study addressed the sustainability of the intervention effects by performing a two-year follow-up and by using different outcome measures. METHODS: A total of 351 employees sick-listed for 3-16 weeks due to LBP were recruited from their general practitioners and were randomly allocated to a hospital-based brief or multidisciplinary intervention. Outcome measures were based on sick leave registered in a national database of social and health-related benefits. RTW rates, RTW status, sick leave weeks and sick leave relapse were studied. RESULTS: During the two-year follow-up 80.0% and 77.3% had RTW for at least four weeks continuously, and the percentages with RTW at the 104th week were 61.1% and 58.0% in the brief and multidisciplinary intervention groups, respectively. At the 104th week 16.6% and 18.8% were on sick leave in the two groups, respectively, and about 12% were employed in modified jobs or participated in job training. The number of weeks on sick leave in the first year was significantly lower in the brief intervention group (median 14 weeks) than in the multidisciplinary intervention group (median 20 weeks), but during the second year the number of weeks on sick leave were not significantly different between intervention groups. Subgroups characterised by specific work related factors modified the effect of the intervention groups on RTW rates (p = 0.017). No difference in sick leave relapse was found between the intervention groups. CONCLUSION: The effects of the brief and multidisciplinary interventions at the two-year follow-up were in general similar to the effects at one-year follow-up. TRIAL REGISTRATION: Current Controlled Trials ISRCTN18609003. AD - Department of Clinical Social Medicine, Public Health and Quality Management, Central Denmark Region and Section of Clinical Social Med, and Rehabilitation, School of Public Health, University of Aarhus, Aarhus, Denmark. chris.jensen@stab.rm.dk AN - 22920158 AU - Jensen, C. AU - Jensen, O. K. AU - Nielsen, C. V. C2 - PMC3488486 CN - Medline 211026 DA - Aug 25 DB - Medline DO - 10.1186/1471-2474-13-156 DP - NLM ET - 20120825 J2 - BMC Musculoskelet Disord KW - Adult Denmark Female *General Practice Humans Inservice Training Interdisciplinary Communication Job Description Logistic Models Low Back Pain/diagnosis/physiopathology/*therapy Magnetic Resonance Imaging Male Middle Aged Pain Measurement *Patient Care Team Proportional Hazards Models Recurrence Registries *Return to Work *Sick Leave Time Factors Treatment Outcome Unemployment Workplace L1 - internal-pdf://3944448474/2154-Jensen-2012.pdf LA - English M3 - Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Jensen, Chris Jensen, Ole Kudsk Nielsen, Claus Vinther eng Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2012/08/28 BMC Musculoskelet Disord. 2012 Aug 25;13:156. doi: 10.1186/1471-2474-13-156. PY - 2012 SN - 1471-2474 (Electronic) 1471-2474 (Linking) SP - 156 ST - Sustainability of return to work in sick-listed employees with low-back pain. Two-year follow-up in a randomized clinical trial comparing multidisciplinary and brief intervention T2 - BMC Musculoskelet Disord TI - Sustainability of return to work in sick-listed employees with low-back pain. Two-year follow-up in a randomized clinical trial comparing multidisciplinary and brief intervention UR - https://www.ncbi.nlm.nih.gov/pubmed/22920158 VL - 13 ID - 2154 ER - TY - JOUR AB - The aim of the present study was to evaluate the long-term outcome of a behavioural medicine rehabilitation programme and the outcome of its two main components, compared to a 'treatment-as-usual' control group. The study employed a 4 x 5 repeated-measures design with four groups and five assessment periods during a 3-year follow-up. The group studied consisted of blue-collar and service/care workers on sick leave, identified in a nationwide health insurance scheme in Sweden. After inclusion, the subjects were randomised to one of the four conditions: behaviour-oriented physiotherapy (PT), cognitive behavioural therapy (CBT), behavioural medicine rehabilitation consisting of PT+CBT (BM) and a 'treatment-as-usual' control group (CG). Outcome variables were sick leave, early retirement and health-related quality of life. A cost-effectiveness analysis, comparing the programmes, was made. The results showed, consistently, the full-time behavioural medicine programme being superior to the three other conditions. The strongest effect was found on females. Regarding sick leave, the mean difference in the per-protocol analysis between the BM programme and the control group was 201 days, thus reducing sick leave by about two-thirds of a working year. Rehabilitating women has a substantial impact on costs for production losses, whereas rehabilitating men seem to be effortless with no significant effect on either health or costs. In conclusion, a full-time behavioural medicine programme is a cost-effective method for improving health and increasing return to work in women working in blue-collar or service/care occupations and suffering from back/neck pain. AD - Section for Personal Injury Prevention, Karolinska Institutet, Box 127 18, 112 94 Stockholm, Sweden Unit of Statistics and epidemiology, Clinical Research Center, Orebro University Hospital, 701 82 Orebro, Sweden. AN - 15911154 AU - Jensen, I. B. AU - Bergstrom, G. AU - Ljungquist, T. AU - Bodin, L. CN - Medline 211026 DA - Jun DB - Medline DO - 10.1016/j.pain.2005.03.005 DP - NLM ET - 20050419 IS - 3 J2 - Pain KW - Adult Back Pain/economics/*rehabilitation *Cognitive Behavioral Therapy Cost-Benefit Analysis Delivery of Health Care/statistics & numerical data Employment Female Follow-Up Studies Health Care Costs Humans Male Middle Aged Neck Pain/economics/*rehabilitation Pensions Physical Therapy Specialty/economics/*organization & administration Program Evaluation Quality of Life Rehabilitation/economics/*organization & administration Sick Leave L1 - internal-pdf://1076115755/2157-Jensen-2005.pdf LA - English M3 - Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Jensen, Irene B Bergstrom, Gunnar Ljungquist, Therese Bodin, Lennart eng Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2005/05/25 Pain. 2005 Jun;115(3):273-283. doi: 10.1016/j.pain.2005.03.005. Epub 2005 Apr 19. PY - 2005 SN - 0304-3959 (Print) 0304-3959 (Linking) SP - 273-283 ST - A 3-year follow-up of a multidisciplinary rehabilitation programme for back and neck pain T2 - Pain TI - A 3-year follow-up of a multidisciplinary rehabilitation programme for back and neck pain UR - https://www.ncbi.nlm.nih.gov/pubmed/15911154 VL - 115 ID - 2157 ER - TY - JOUR AB - The aim of the present study was to evaluate the outcome of a behavioral medicine (BM) rehabilitation program and the outcome of its two main components, compared to a 'treatment-as-usual' control group (CG). The study employed a 4x4 repeated-measures design with four groups and four assessment periods (pre-treatment, post-treatment, 6-month follow-up, and 18-month follow-up). The group studied consisted of subjects on sick leave identified in a nationwide health insurance scheme in Sweden. After inclusion, the subjects were randomized to one of four conditions, which were: (1) behavior-oriented physical therapy (PT); (2) cognitive behavioral therapy (CBT); (3) BM rehabilitation consisting of PT+CBT (BM); (4) a 'treatment-as-usual' CG. The treatments were given over a period of 4 weeks, PT and CBT on a part-time basis and BM on a full-time basis. Outcome variables were sick leave, early retirement, and health-related quality of life (measured using the Short Form Health Survey, SF-36). The results showed that the risk of being granted full-time early retirement was significantly lower for females in PT and CBT compared to the CG during the 18-month follow-up period. However, the total absence from work (sick listing plus early retirement) in days over the 18-month follow-up period was not significantly different in the CG compared to the treatments. On the SF-36, women in CBT and BM reported a significantly better health-related quality of life than women in the CG at the 18-month follow-up. No significant differences for men were found on the SF-36 scales. In conclusion, the results revealed gender differences in the outcome of the treatments and that the components of this BM program yielded as good results as the whole program. AD - Karolinska Institute, Section for Personal Injury Prevention, Box 127 18, 112 94, Stockholm, Sweden. AN - 11240079 AU - Jensen, I. B. AU - Bergstrom, G. AU - Ljungquist, T. AU - Bodin, L. AU - Nygren, A. L. CN - Medline 211026 DA - Mar DB - Medline DO - 10.1016/s0304-3959(00)00420-6 DP - NLM ET - 2001/03/10 IS - 1-2 J2 - Pain KW - Absenteeism Adult Behavioral Medicine/*methods Chronic Disease Cognitive Behavioral Therapy Female Humans Male Middle Aged Pain/rehabilitation *Palliative Care Patient Compliance Physical Therapy Modalities Quality of Life Reference Values *Sex Characteristics Spinal Diseases/physiopathology/*rehabilitation L1 - internal-pdf://0166210467/2158-Jensen-2001.pdf LA - English M3 - Clinical Trial Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Jensen, I B Bergstrom, G Ljungquist, T Bodin, L Nygren, A L eng Clinical Trial Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2001/03/10 Pain. 2001 Mar;91(1-2):65-78. doi: 10.1016/s0304-3959(00)00420-6. PY - 2001 SN - 0304-3959 (Print) 0304-3959 (Linking) SP - 65-78 ST - A randomized controlled component analysis of a behavioral medicine rehabilitation program for chronic spinal pain: are the effects dependent on gender? T2 - Pain TI - A randomized controlled component analysis of a behavioral medicine rehabilitation program for chronic spinal pain: are the effects dependent on gender? UR - https://www.ncbi.nlm.nih.gov/pubmed/11240079 VL - 91 ID - 2158 ER - TY - JOUR AB - OBJECTIVES: Common mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms. METHODS: Randomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee's manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health. RESULTS: A statistical interaction for group x time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences. CONCLUSION: PSI was effective in reducing sickness absence which was the primary outcome in this study. AD - Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden marijke.keus.van.de.poll@ki.se. Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gavle, Gavle, Sweden. Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Stockholm, Sweden. Department of Medical Sciences, Uppsala University, Uppsala, Sweden. AN - 32291291 AU - Keus van de Poll, M. AU - Nybergh, L. AU - Lornudd, C. AU - Hagberg, J. AU - Bodin, L. AU - Kwak, L. AU - Jensen, I. AU - Lohela-Karlsson, M. AU - Torgen, M. AU - Bergstrom, G. C1 - Competing interests: None declared. C2 - PMC7306872 CN - Medline 211026 DA - Jul DB - Medline DO - 10.1136/oemed-2019-106353 DP - NLM ET - 20200414 IS - 7 J2 - Occup Environ Med KW - Adult Female Humans Male Mental Disorders/*therapy Middle Aged Occupational Health Services/methods Occupational Stress/*therapy *Problem Solving Return to Work/statistics & numerical data Sick Leave/*statistics & numerical data Sweden OH services intervention studies mental health public health sickness absence L1 - internal-pdf://3246147774/2253-Keus van de Poll-2020.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Keus van de Poll, Marijke Nybergh, Lotta Lornudd, Caroline Hagberg, Jan Bodin, Lennart Kwak, Lydia Jensen, Irene Lohela-Karlsson, Malin Torgen, Margareta Bergstrom, Gunnar eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2020/04/16 Occup Environ Med. 2020 Jul;77(7):454-461. doi: 10.1136/oemed-2019-106353. Epub 2020 Apr 14. PY - 2020 SN - 1470-7926 (Electronic) 1351-0711 (Print) 1351-0711 (Linking) SP - 454-461 ST - Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services T2 - Occup Environ Med TI - Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services UR - https://www.ncbi.nlm.nih.gov/pubmed/32291291 VL - 77 ID - 2253 ER - TY - JOUR AB - OBJECTIVE: To compare the effect of function-centered treatment (FCT) and pain-centered treatment (PCT) on the number of work days, permanent disability, and the unemployment rate. DESIGN: Randomized controlled trial. SETTING: Inpatient rehabilitation center. PARTICIPANTS: Patients (N=174; 79% male; mean age, 42 y) with previous sick leave of 6 weeks or more. INTERVENTIONS: FCT (4 h/d for 3 wk) emphasized activity despite pain by using work simulation, strength, endurance, and cardiovascular training. PCT (2.5h/d for 3 wk) emphasized pain reduction and included passive and active mobilization, stretching, strength training, and a 4-hour mini back school with education and exercise. Analysis was by intention to treat. MAIN OUTCOME MEASURES: Work days, return to work, rate of patients receiving financial compensation for permanent disability, and unemployment rate. Effect sizes (Cohen d) were defined as small (0.2-0.5), moderate (0.5-0.8), and large (>0.8). RESULTS: After 1 year, the FCT group had significantly more work days (mean, 118; median, 39.5; interquartile range [IQR], 0-198) than the PCT group (mean, 74; median, 0; IQR, 0-160; Mann-Whitney U test, P=.011). The odds ratio of returning to work in the FCT group relative to the PCT group was 2.1 (95% confidence interval, 1.1-3.9). The differences in unemployment rates and in the numbers of patients receiving compensation for permanent disability were not significant. CONCLUSIONS: FCT is more effective than PCT for increasing work days. AD - Department of Rheumatology, Rehabilitation Centre Valens, Valens, Switzerland. jan.kool@zhwin.ch AN - 17826451 AU - Kool, J. AU - Bachmann, S. AU - Oesch, P. AU - Knuesel, O. AU - Ambergen, T. AU - de Bie, R. AU - van den Brandt, P. CN - Medline 211026 DA - Sep DB - Medline DO - 10.1016/j.apmr.2007.05.022 DP - NLM IS - 9 J2 - Arch Phys Med Rehabil KW - Adult Exercise Therapy/*methods Female Follow-Up Studies Humans Inpatients Low Back Pain/physiopathology/*rehabilitation Male Occupational Diseases/physiopathology/*rehabilitation Patient Compliance *Rehabilitation Centers Sick Leave/trends Time Factors Treatment Outcome Work Schedule Tolerance/*physiology *Workload L1 - internal-pdf://3535793930/2303-Kool-2007.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Kool, Jan Bachmann, Stefan Oesch, Peter Knuesel, Otto Ambergen, Ton de Bie, Rob van den Brandt, Piet eng Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2007/09/11 Arch Phys Med Rehabil. 2007 Sep;88(9):1089-94. doi: 10.1016/j.apmr.2007.05.022. PY - 2007 SN - 0003-9993 (Print) 0003-9993 (Linking) SP - 1089-94 ST - Function-centered rehabilitation increases work days in patients with nonacute nonspecific low back pain: 1-year results from a randomized controlled trial T2 - Arch Phys Med Rehabil TI - Function-centered rehabilitation increases work days in patients with nonacute nonspecific low back pain: 1-year results from a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/17826451 VL - 88 ID - 2303 ER - TY - JOUR AB - OBJECTIVE: To evaluate the cost effectiveness, cost utility, and cost-benefit of an integrated care programme compared with usual care for sick listed patients with chronic low back pain. DESIGN: Economic evaluation alongside a randomised controlled trial with 12 months' follow-up. SETTING: Primary care (10 physiotherapy practices, one occupational health service, one occupational therapy practice) and secondary care (five hospitals) in the Netherlands, 2005-9. PARTICIPANTS: 134 adults aged 18-65 sick listed because of chronic low back pain: 66 were randomised to integrated care and 68 to usual care. INTERVENTIONS: Integrated care consisted of a workplace intervention based on participatory ergonomics, with involvement of a supervisor, and a graded activity programme based on cognitive behavioural principles. Usual care was provided by general practitioners and occupational physicians according to Dutch guidelines. MAIN OUTCOME MEASURES: The primary outcome was duration until sustainable return to work. The secondary outcome was quality adjusted life years (QALYs), measured using EuroQol. RESULTS: Total costs in the integrated care group ( pound13 165, SD pound13 600) were significantly lower than in the usual care group ( pound18 475, SD pound13 616). Cost effectiveness planes and acceptability curves showed that integrated care was cost effective compared with usual care for return to work and QALYs gained. The cost-benefit analyses showed that every pound1 invested in integrated care would return an estimated pound26. The net societal benefit of integrated care compared with usual care was pound5744. CONCLUSIONS: Implementation of an integrated care programme for patients sick listed with chronic low back pain has a large potential to significantly reduce societal costs, increase effectiveness of care, improve quality of life, and improve function on a broad scale. Integrated care therefore has large gains for patients and society as well as for employers. AD - Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands. AN - 21118874 AU - Lambeek, L. C. AU - Bosmans, J. E. AU - Van Royen, B. J. AU - Van Tulder, M. W. AU - Van Mechelen, W. AU - Anema, J. R. C1 - Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any company for the submitted work; no financial relationships with any companies that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work. C2 - PMC2995018 CN - Medline 211026 DA - Nov 30 DB - Medline DO - 10.1136/bmj.c6414 DP - NLM ET - 20101130 J2 - Bmj KW - Absenteeism Adolescent Adult Aged Chronic Disease Cost-Benefit Analysis Delivery of Health Care, Integrated Health Resources/statistics & numerical data Humans Low Back Pain/economics/*rehabilitation Middle Aged Netherlands Occupational Therapy Physical Therapy Modalities Quality-Adjusted Life Years Rehabilitation, Vocational/economics Sick Leave Young Adult L1 - internal-pdf://4094758728/2362-Lambeek-2010.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Lambeek, Ludeke C Bosmans, Judith E Van Royen, Barend J Van Tulder, Maurits W Van Mechelen, Willem Anema, Johannes R eng Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2010/12/02 BMJ. 2010 Nov 30;341:c6414. doi: 10.1136/bmj.c6414. PY - 2010 SN - 1756-1833 (Electronic) 0959-8138 (Print) 0959-8138 (Linking) SP - c6414 ST - Effect of integrated care for sick listed patients with chronic low back pain: economic evaluation alongside a randomised controlled trial T2 - BMJ TI - Effect of integrated care for sick listed patients with chronic low back pain: economic evaluation alongside a randomised controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/21118874 VL - 341 ID - 2362 ER - TY - JOUR AB - OBJECTIVE: To evaluate the effectiveness of an integrated care programme, combining a patient directed and a workplace directed intervention, for patients with chronic low back pain. DESIGN: Population based randomised controlled trial. SETTING: Primary care (10 physiotherapy practices, one occupational health service, one occupational therapy practice) and secondary care (five hospitals). PARTICIPANTS: 134 adults aged 18-65 sick listed for at least 12 weeks owing to low back pain. INTERVENTION: Patients were randomly assigned to usual care (n=68) or integrated care (n=66). Integrated care consisted of a workplace intervention based on participatory ergonomics, involving a supervisor, and a graded activity programme based on cognitive behavioural principles. MAIN OUTCOME MEASURES: The primary outcome was the duration of time off work (work disability) due to low back pain until full sustainable return to work. Secondary outcome measures were intensity of pain and functional status. RESULTS: The median duration until sustainable return to work was 88 days in the integrated care group compared with 208 days in the usual care group (P=0.003). Integrated care was effective on return to work (hazard ratio 1.9, 95% confidence interval 1.2 to 2.8, P=0.004). After 12 months, patients in the integrated care group improved significantly more on functional status compared with patients in the usual care group (P=0.01). Improvement of pain between the groups did not differ significantly. CONCLUSION: The integrated care programme substantially reduced disability due to chronic low back pain in private and working life. Trial registration Current Controlled Trials ISRCTN28478651. AD - Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands. AN - 20234040 AU - Lambeek, L. C. AU - van Mechelen, W. AU - Knol, D. L. AU - Loisel, P. AU - Anema, J. R. C1 - Competing interests: None declared. C2 - PMC2840223 CN - Medline 211026 DA - Mar 16 DB - Medline DO - 10.1136/bmj.c1035 DP - NLM ET - 20100316 J2 - Bmj KW - Adolescent Adult Aged Chronic Disease Delivery of Health Care, Integrated/*statistics & numerical data Disabled Persons Female Hospitalization/statistics & numerical data Humans Low Back Pain/*rehabilitation Male Middle Aged Occupational Health Services/statistics & numerical data Occupational Therapy/statistics & numerical data Patient Compliance Physical Therapy Modalities/statistics & numerical data Program Evaluation Rehabilitation, Vocational Surveys and Questionnaires Treatment Outcome Young Adult L1 - internal-pdf://1752752918/2364-Lambeek-2010.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Lambeek, Ludeke C van Mechelen, Willem Knol, Dirk L Loisel, Patrick Anema, Johannes R eng FRN: 53909/Canadian Institutes of Health Research/Canada Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2010/03/18 BMJ. 2010 Mar 16;340:c1035. doi: 10.1136/bmj.c1035. PY - 2010 SN - 1756-1833 (Electronic) 0959-8138 (Print) 0959-8138 (Linking) SP - c1035 ST - Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life T2 - BMJ TI - Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life UR - https://www.ncbi.nlm.nih.gov/pubmed/20234040 VL - 340 ID - 2364 ER - TY - JOUR AB - OBJECTIVE: To compare return to work (RTW) rates among patients with low back pain (LBP) and different job relations randomized to brief or multidisciplinary intervention. DESIGN: A randomized controlled trial with 1-year follow-up. SETTING: Silkeborg Regional Hospital, Denmark. SUBJECTS: Four hundred seventy-six participants were divided into two groups concerning job relations: strong (influence on job and no fear of losing it) or weak (no influence on job and/or fear of losing it), and afterwards randomized to brief or multidisciplinary intervention. INTERVENTIONS: Brief intervention included examination and advice by a rheumatologist and a physiotherapist. Multidisciplinary intervention included brief intervention plus coaching by a case manager making a plan for RTW with the patient. MAIN MEASURES: Primary outcome was 1-year RTW rate. Secondary outcomes included pain intensity (LBP rating scale), disability (Roland Morris disability scale), and psychological measures (Common Mental Disorder Questionnaire, Major Depression Inventory, and EQ-5D-3L). RESULTS: Mean (SD) age was 43.1 (9.8) years. Among 272 participants with strong job relations, RTW was achieved for 104/137 (76%) receiving brief intervention compared to 89/135 (66%) receiving multidisciplinary intervention, hazard ratio 0.73 (CI: 0.55-0.96). Corresponding results for 204 participants with weak job relations were 69/102 (68%) in both interventions, hazard ratio 1.07 (CI: 0.77-1.49). For patients with strong job relations, depressive symptoms and quality of life were more improved after brief intervention. CONCLUSION: Brief intervention resulted in higher RTW rates than multidisciplinary intervention for employees with strong job relations. There were no differences in RTW rates between interventions for employees with weak job relations. AD - Diagnostic Center, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark. Department of Clinical Social Medicine and Rehabilitation, Godstrup Hospital, Herning, Denmark. Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus, Denmark. DEFACTUM, Central Denmark Region, Aarhus, Denmark. Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway. National Advisory Unit on Occupational Rehabilitation, Rauland, Norway. Norwegian Research Center A/S, Bergen, Norway. AN - 33843296 AU - Langagergaard, V. AU - Jensen, O. K. AU - Nielsen, C. V. AU - Jensen, C. AU - Labriola, M. AU - Sorensen, V. N. AU - Pedersen, P. CN - Medline 211026 DA - Sep DB - Medline DO - 10.1177/02692155211005387 DP - NLM ET - 20210411 IS - 9 J2 - Clin Rehabil KW - Humans *Low Back Pain/therapy Quality of Life Return to Work *Sick Leave Treatment Outcome Low back pain brief intervention multidisciplinary intervention radiculopathy sick leave L1 - internal-pdf://1820091284/2378-Langagergaard-2021.pdf LA - English M3 - Randomized Controlled Trial N1 - Langagergaard, Vivian Jensen, Ole Kudsk Nielsen, Claus Vinther Jensen, Chris Labriola, Merete Sorensen, Vibeke Neergaard Pedersen, Pernille eng Randomized Controlled Trial England 2021/04/13 Clin Rehabil. 2021 Sep;35(9):1290-1304. doi: 10.1177/02692155211005387. Epub 2021 Apr 11. PY - 2021 SN - 1477-0873 (Electronic) 0269-2155 (Linking) SP - 1290-1304 ST - The comparative effects of brief or multidisciplinary intervention on return to work at 1 year in employees on sick leave due to low back pain: A randomized controlled trial T2 - Clin Rehabil TI - The comparative effects of brief or multidisciplinary intervention on return to work at 1 year in employees on sick leave due to low back pain: A randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/33843296 VL - 35 ID - 2378 ER - TY - JOUR AB - OBJECTIVE: In an earlier study, we found that cognitive-behavioral therapy (CBT) delivered by general practitioners (GPs) for fatigue among employees on sick leave was not effective after 12 months. In this study we aim to assess the long-term efficacy of CBT by GPs for fatigue. It was hypothesized that the intervention could prevent deterioration as well as relapse of fatigue complaints and relapse into absenteeism in the long term. METHODS: Patients who participated in the original randomized controlled trial were followed up 4 years later. Fatigue and absenteeism were the main outcomes. RESULTS: Fatigue and absenteeism were high in the intervention and control groups at the 4-year follow-up. There was no significant difference between the intervention group and the control group on fatigue and absenteeism. The intervention group however tended toward less-favorable outcomes as compared with the control group. CONCLUSIONS: Like that of chronic fatigue syndrome, the prognosis of less-advanced fatigue is rather poor. CBT delivered by GPs is not effective in the long term. AD - Department of Epidemiology, Maastricht University, Maastricht, The Netherlands. stephanie.leone@epid.unimaas.nl AN - 17084137 AU - Leone, S. S. AU - Huibers, M. J. AU - Kant, I. AU - van Amelsvoort, L. G. AU - van Schayck, C. P. AU - Bleijenberg, G. AU - Knottnerus, J. A. CN - Medline 211026 DA - Nov DB - Medline DO - 10.1016/j.jpsychores.2006.04.010 DP - NLM IS - 5 J2 - J Psychosom Res KW - Absenteeism Adult *Cognitive Behavioral Therapy Family Practice Fatigue/psychology/*therapy Female Follow-Up Studies Humans Internal-External Control Male Middle Aged Prognosis Rehabilitation, Vocational/psychology Secondary Prevention Sick Leave L1 - internal-pdf://0594943682/2417-Leone-2006.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Leone, Stephanie S Huibers, Marcus J H Kant, Ijmert van Amelsvoort, Ludovic G P M van Schayck, Constant P Bleijenberg, Gijs Knottnerus, J Andre eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2006/11/07 J Psychosom Res. 2006 Nov;61(5):601-7. doi: 10.1016/j.jpsychores.2006.04.010. PY - 2006 SN - 0022-3999 (Print) 0022-3999 (Linking) SP - 601-7 ST - Long-term efficacy of cognitive-behavioral therapy by general practitioners for fatigue: a 4-year follow-up study T2 - J Psychosom Res TI - Long-term efficacy of cognitive-behavioral therapy by general practitioners for fatigue: a 4-year follow-up study UR - https://www.ncbi.nlm.nih.gov/pubmed/17084137 VL - 61 ID - 2417 ER - TY - JOUR AB - AIMS: Analysing and presenting data on different outcomes after sick-leave is challenging. The use of extended statistical methods supplies additional information and allows further exploitation of data. METHODS: Four hundred and fifty-seven patients, sick-listed for 8-12 weeks for low back pain, were randomized to intervention (n=237) or control (n=220). Outcome was measured as: "sick-listed'', "returned to work'', or "disability pension''. The individuals shifted between the three states between one and 22 times (mean 6.4 times). In a multi-state model, shifting between the states was set up in a transition intensity matrix. The probability of being in any of the states was calculated as a transition probability matrix. The effects of the intervention were modelled using a non-parametric model. RESULTS: There was an effect of the intervention for leaving the state sick-listed and shifting to returned to work (relative risk (RR)=1.27, 95% confidence interval (CI) 1.09- 1.47). The nonparametric estimates showed an effect of the intervention for leaving sick-listed and shifting to returned to work in the first 6 months. We found a protective effect of the intervention for shifting back to sick-listed between 6 and 18 months. The analyses showed that the probability of staying in the state returned to work was not different between the intervention and control groups at the end of the follow-up (3 years). CONCLUSIONS: We demonstrate that these alternative analyses give additional results and increase the strength of the analyses. The simple intervention did not decrease the probability of being on sick-leave in the long term; however, it decreased the time that individuals were on sick-leave. AD - Norwegian Network for Back Pain, The Research Unit, Department of Health, University Research Bergen, Bergen, Norway. Stein.Lie@unifob.uib.no AN - 18519297 AU - Lie, S. A. AU - Eriksen, H. R. AU - Ursin, H. AU - Hagen, E. M. CN - Medline 211026 DA - May DB - Medline DO - 10.1177/1403494807086979 DP - NLM ET - 2008/06/04 IS - 3 J2 - Scand J Public Health KW - Chronic Disease Disability Evaluation Follow-Up Studies Humans Low Back Pain/diagnosis/*rehabilitation Models, Theoretical Outcome Assessment, Health Care/methods Pensions Probability Rehabilitation, Vocational *Sick Leave Time Factors L1 - internal-pdf://3046985930/2444-Lie-2008.pdf LA - English M3 - Randomized Controlled Trial N1 - Lie, Stein Atle Eriksen, Hege R Ursin, Holger Hagen, Eli Molde eng Randomized Controlled Trial Sweden 2008/06/04 Scand J Public Health. 2008 May;36(3):279-83. doi: 10.1177/1403494807086979. PY - 2008 SN - 1403-4948 (Print) 1403-4948 (Linking) SP - 279-83 ST - A multi-state model for sick-leave data applied to a randomized control trial study of low back pain T2 - Scand J Public Health TI - A multi-state model for sick-leave data applied to a randomized control trial study of low back pain UR - https://www.ncbi.nlm.nih.gov/pubmed/18519297 VL - 36 ID - 2444 ER - TY - JOUR AB - BACKGROUND: In the industrial world, non-specific back and neck pain (BNP) is the largest diagnostic group underlying sick-listing. For patients with subacute and chronic (= full-time sick-listed for 43 - 84 and 85 - 730 days, respectively) BNP, cognitive-behavioural rehabilitation was compared with primary care. The specific aim was to answer the question: within an 18-month follow-up, will the outcomes differ in respect of sick-listing and number of health-care visits? METHODS: After stratification by age (< or = 44/> or = 45 years) and subacute/chronic BNP, 125 Swedish primary-care patients were randomly allocated to cognitive-behavioural rehabilitation (rehabilitation group) or continued primary care (primary-care group). Outcome measures were Return-to-work share (percentage) and Return-to-work chance (hazard ratios) over 18 months, Net days (crude sick-listing days x degree), and the number of Visits (to physicians, physiotherapists etc.) over 18 months and the three component six-month periods. Descriptive statistics, Cox regression and mixed-linear models were used. RESULTS: All patients: Return-to-work share and Return-to-work chance were equivalent between the groups. Net days and Visits were equivalent over 18 months but decreased significantly more rapidly for the rehabilitation group over the six-month periods (p < .05). Subacute patients: Return-to-work share was equivalent. Return-to-work chance was significantly greater for the rehabilitation group (hazard ratio 3.5 [95%CI1.001 - 12.2]). Net days were equivalent over 18 months but decreased significantly more rapidly for the rehabilitation group over the six-month periods and there were 31 days fewer in the third period. Visits showed similar though non-significant differences and there were half as many in the third period. Chronic patients: Return-to-work share, Return-to-work chance and Net days were equivalent. Visits were equivalent over 18 months but tended to decrease more rapidly for the rehabilitation group and there were half as many in the third period (non-significant). CONCLUSION: The results were equivalent over 18 months. However, there were indications that cognitive-behavioural rehabilitation in the longer run might be superior to primary care. For subacute BNP, it might be superior in terms of sick-listing and health-care visits; for chronic BNP, in terms of health-care visits only. More conclusive results concerning this possible long-term effect might require a longer follow-up. AD - Center for Family and Community Medicine, Karolinska Institutet, Alfred Nobels alle 12, SE-141 83 Huddinge, Sweden. odd.lindell@ki.se AN - 19116007 AU - Lindell, O. AU - Johansson, S. E. AU - Strender, L. E. C2 - PMC2649916 CN - Medline 211026 DA - Dec 30 DB - Medline DO - 10.1186/1471-2474-9-172 DP - NLM ET - 20081230 J2 - BMC Musculoskelet Disord KW - Acute Disease Adult Back Pain/*psychology/rehabilitation/*therapy Chronic Disease Cognitive Behavioral Therapy/*methods Female Follow-Up Studies Humans Male Middle Aged Neck Pain/*psychology/rehabilitation/*therapy Pain Measurement/methods Primary Health Care/*methods Treatment Outcome L1 - internal-pdf://4042712626/2454-Lindell-2008.pdf LA - English M3 - Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Lindell, Odd Johansson, Sven-Erik Strender, Lars-Erik eng Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2009/01/01 BMC Musculoskelet Disord. 2008 Dec 30;9:172. doi: 10.1186/1471-2474-9-172. PY - 2008 SN - 1471-2474 (Electronic) 1471-2474 (Linking) SP - 172 ST - Subacute and chronic, non-specific back and neck pain: cognitive-behavioural rehabilitation versus primary care. A randomized controlled trial T2 - BMC Musculoskelet Disord TI - Subacute and chronic, non-specific back and neck pain: cognitive-behavioural rehabilitation versus primary care. A randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/19116007 VL - 9 ID - 2454 ER - TY - JOUR AB - Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity, and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed. AD - a Department of Psychology , Umea University , Umea , Sweden. b Department of Community Medicine and Rehabilitation, Physiotherapy , Umea University , Umea , Sweden. c Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark. d Centre for Demographic and Aging Research (CEDAR) , Umea University , Umea , Sweden. e Department of Social and Psychological Studies , Karlstad University , Karlstad , Sweden. f Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine , Umea University , Umea , Sweden. AN - 29693483 AU - Malmberg Gavelin, H. AU - Eskilsson, T. AU - Boraxbekk, C. J. AU - Josefsson, M. AU - Stigsdotter Neely, A. AU - Slunga Jarvholm, L. CN - PsycInfo 211028 DA - Jul DB - Medline DO - 10.1080/10253890.2018.1461833 DP - NLM ET - 20180425 IS - 4 KW - Adult Anxiety/psychology/therapy Cognition/*physiology Cognition Disorders/psychology/*rehabilitation Depression/psychology/therapy Executive Function Exercise Fatigue/psychology/*rehabilitation Female Humans Male Memory, Episodic *Mental Health Middle Aged Neuropsychological Tests Sick Leave Stress, Psychological/psychology/*rehabilitation Young Adult Burnout aerobic training cognitive training exhaustion disorder randomized controlled trial stress rehabilitation L1 - internal-pdf://0417843320/3900-Malmberg Gavelin-2018.pdf N1 - Malmberg Gavelin, Hanna Eskilsson, Therese Boraxbekk, Carl-Johan Josefsson, Maria Stigsdotter Neely, Anna Slunga Jarvholm, Lisbeth eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2018/04/26 Stress. 2018 Jul;21(4):279-291. doi: 10.1080/10253890.2018.1461833. Epub 2018 Apr 25. PY - 2018 SN - 1607-8888 (Electronic) 1025-3890 (Linking) SP - 279-291 ST - Rehabilitation for improved cognition in patients with stress-related exhaustion disorder: RECO - a randomized clinical trial T2 - Stress TI - Rehabilitation for improved cognition in patients with stress-related exhaustion disorder: RECO - a randomized clinical trial UR - https://www.ncbi.nlm.nih.gov/pubmed/29693483 VL - 21 ID - 3900 ER - TY - JOUR AB - BACKGROUND: Neck and back pain are among the most common causes of prolonged disability, and development of interventions with effect on pain, disability and return to work is important. Reduction of fear avoidance might be one mechanism behind improvement after interventions. The aim of the present study was to evaluate changes in pain and disability at the 12-month follow-up of patients with neck and back pain treated with a work-focused intervention compared to patients treated with standard interventions, and the influence of improvement fear avoidance beliefs during the interventions on pain, disability and return to work at 12-month follow-up. METHODS: 413 employed patients with back or neck pain referred to secondary care, and sick-listed between 4 weeks and 12 months, were randomized to a work-focused rehabilitation or control interventions. Follow-up was conducted 4 and 12 months after inclusion. The groups were compared (independent sample t-test) regarding differences in disability scores (Oswestry disability index/neck disability index) and pain (numeric rating scale) from baseline to 12-month follow-up. Changes in fear avoidance beliefs (FABQ) from baseline to 4 month follow-up were calculated, and the association between this change and return to work, pain and disability at 12 months were tested in stepwise multiple logistic regression models. RESULTS: Pain and, disability scores decreased to in both the work-focused and control intervention to 12-month follow-up, and there were no significant differences between the groups. FABQ decreased similarly in both groups to 4 month follow-up. The logistic regression model revealed an association between a reduced FABQ work score at 4 months and return to work within one year (adjusted OR 3.60, 95% CI 1.19 to 10.88). Reduced FABQ physical activity score at 4 months was associated with decreased disability after 12 months (adjusted OR (3.65. 95% CI 1.43 to 9.28). CONCLUSIONS: Short work-focused rehabilitation had the same effect on pain and disability as control interventions. Reduction in FABQ-W score after treatment seems to be an important predictor for return to work in both groups. TRIAL REGISTRATION: Clinicaltrials.gov NCT00840697. AD - Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. gunn.hege.marchand@ntnu.no. Department of Physical Medicine and Rehabilitation, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway. gunn.hege.marchand@ntnu.no. Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Oslo, Norway. kjersti.myhre@medisin.uio.no. Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. gunnar.leivseth@uit.no. Institute of Clinical Medicine, Neuromuscular Disorders Research Group, UiT The Arctic University of Norway, Tromso, Norway. gunnar.leivseth@uit.no. Department of Biostatistics and Epidemiology, Oslo University Hospital, Ulleval, Oslo, Norway. leiv.sandvik@ous-hf.no. Lovisenberg Diakonale Hospital, Oslo, Norway. bjornlau2002@yahoo.no. National Institute of Occupational Health, Oslo, Norway. bjornlau2002@yahoo.no. Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Oslo, Norway. erik.bautz-holter@medisin.uio.no. Faculty of Medicine, University of Oslo, Oslo, Norway. erik.bautz-holter@medisin.uio.no. Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Oslo, Norway. e.c.t.roe@medisin.uio.no. Faculty of Medicine, University of Oslo, Oslo, Norway. e.c.t.roe@medisin.uio.no. AN - 25896785 AU - Marchand, G. H. AU - Myhre, K. AU - Leivseth, G. AU - Sandvik, L. AU - Lau, B. AU - Bautz-Holter, E. AU - Roe, C. C2 - PMC4410457 CN - Medline 211026 DA - Apr 21 DB - Medline DO - 10.1186/s12891-015-0553-y DP - NLM ET - 20150421 J2 - BMC Musculoskelet Disord KW - Adult Avoidance Learning Back Pain/diagnosis/psychology/*rehabilitation *Disability Evaluation Disabled Persons/psychology/*rehabilitation *Fear/psychology Female Humans Male Middle Aged Neck Pain/diagnosis/psychology/*rehabilitation *Occupational Health L1 - internal-pdf://0271145157/2550-Marchand-2015.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Marchand, Gunn Hege Myhre, Kjersti Leivseth, Gunnar Sandvik, Leiv Lau, Bjorn Bautz-Holter, Erik Roe, Cecilie eng Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2015/04/22 BMC Musculoskelet Disord. 2015 Apr 21;16:94. doi: 10.1186/s12891-015-0553-y. PY - 2015 SN - 1471-2474 (Electronic) 1471-2474 (Linking) SP - 94 ST - Change in pain, disability and influence of fear-avoidance in a work-focused intervention on neck and back pain: a randomized controlled trial T2 - BMC Musculoskelet Disord TI - Change in pain, disability and influence of fear-avoidance in a work-focused intervention on neck and back pain: a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/25896785 VL - 16 ID - 2550 ER - TY - JOUR AB - A cognitive-behavioral return-to-work focused program was evaluated in a randomized controlled design, and the effects were compared between two groups of women with musculoskeletal pain. One group of patients (n=36) had a history of long-term sick leave (>12 months) at the start of the program and the other (n=36) had a history of short-term sick leave (2-6 months). The outpatient treatment program, conducted by a psychologist, included 12 sessions with the primary aim to help the patients return-to-work. The treatment first included teaching of coping strategies such as applied relaxation, stress management, graded activity training and pacing. Thereafter the patients were taught how to manage difficulties at their return-to-work and how to generalize coping strategies to different risk factors at their work places. The control condition received treatment-as-usual. The results showed that the cognitive-behavioral return-to-work program was more effective than the treatment-as-usual control condition in reducing the number of days on sick leave for patients on short-term sick leave, but not for patients on long-term sick leave. The treatment program also helped the patients on short-term sick leave to increase their ability to control and decrease pain and to increase their general activity level compared to the control condition. These results underscore the need for an early return-to-work focused rehabilitation to prevent long-term sick leave and disability. AD - Department of Psychology, Uppsala University, Box 1225, SE 751 42, Uppsala, Sweden. charlotta.marhold@psyk.uu.se AN - 11240088 AU - Marhold, C. AU - Linton, S. J. AU - Melin, L. CN - Medline 211026 DA - Mar DB - Medline DO - 10.1016/s0304-3959(00)00431-0 DP - NLM IS - 1-2 J2 - Pain KW - *Absenteeism Adaptation, Psychological Adult *Cognitive Behavioral Therapy Depression/psychology Disability Evaluation Female Humans Middle Aged Pain/physiopathology *Pain Management Pain Measurement Psychiatric Status Rating Scales Sick Leave Surveys and Questionnaires Time Factors Treatment Outcome L1 - internal-pdf://0635824588/2551-Marhold-2001.pdf LA - English M3 - Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Marhold, C Linton, S J Melin, L eng Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't 2001/03/10 Pain. 2001 Mar;91(1-2):155-63. doi: 10.1016/s0304-3959(00)00431-0. PY - 2001 SN - 0304-3959 (Print) 0304-3959 (Linking) SP - 155-63 ST - A cognitive-behavioral return-to-work program: effects on pain patients with a history of long-term versus short-term sick leave T2 - Pain TI - A cognitive-behavioral return-to-work program: effects on pain patients with a history of long-term versus short-term sick leave UR - https://www.ncbi.nlm.nih.gov/pubmed/11240088 VL - 91 ID - 2551 ER - TY - JOUR AB - Purpose The aim of this study was to evaluate the effect of a multidisciplinary intervention (MDI) compared to a brief intervention (BI) with respect to return to work (RTW), pain and disability in workers on sick leave because of neck or shoulder pain. Methods 168 study participants with sickness absence for 4-16 weeks due to neck or shoulder pain were enrolled in a hospital-based clinical study and randomized to either MDI or BI. The primary outcome was RTW obtained by a national registry on public transfer payments. Secondary outcomes were self-reported pain and disability levels. One-year follow-up RTW rates were estimated by Cox proportional hazard regression adjusted for gender, age, sick leave prior to inclusion, part-time sick leave and clinical diagnosis. Secondary outcomes were analysed using logistic and linear regression analysis for pain and disability, respectively. Results In the MDI group, 50 participants (59%) experienced four or more continuous weeks of RTW while 48 (58%) returned to work in the BI group during the 1 year of follow-up. Results showed a statistically non significant tendency towards a lower rate of RTW in the MDI group than in the BI group (adjusted HR = 0.84, 95% CI 0.54, 1.31). There were no statistically significant differences in secondary outcomes between the MDI and BI groups. Conclusion The brief and the multidisciplinary interventions performed equally with respect to both primary and secondary outcomes. The added focus on RTW in the multidisciplinary group did not improve RTW rates in this group. AD - DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark. linethor@rm.dk. Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark. linethor@rm.dk. Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark. linethor@rm.dk. Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark. Spine Centre of Southern Denmark, Hospital Lillebaelt Middelfart and Institute of Regional Health Research, University of Southern Denmark, Oestre Hougvej 55, 5500, Middelfart, Denmark. DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark. Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark. Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark. AN - 28836120 AU - Moll, L. T. AU - Jensen, O. K. AU - Schiottz-Christensen, B. AU - Stapelfeldt, C. M. AU - Christiansen, D. H. AU - Nielsen, C. V. AU - Labriola, M. C1 - CONFLICT OF INTEREST: Line Thorndal Moll, Christina Malmose Stapelfeldt, Berit Schiottz-Christensen, David Hoyrup-Christiansen, Ole Kudsk Jensen, Claus Vinther Nielsen, Merete Labriola declare that they have no conflict of interests. ETHICAL APPROVAL: All procedures followed were in accordance with the ethical standards of the regional ethical committee and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants included in the study. C2 - PMC5978826 CN - Medline 211026 DA - Jun DB - Medline DO - 10.1007/s10926-017-9727-9 DP - NLM IS - 2 J2 - J Occup Rehabil KW - Adult *Exercise Therapy Female Follow-Up Studies Humans Male Middle Aged Neck Pain/psychology/*rehabilitation Pain Measurement/methods Proportional Hazards Models Return to Work/*statistics & numerical data Shoulder Pain/psychology/*rehabilitation Sick Leave/statistics & numerical data Time Factors Treatment Outcome Neck pain Rehabilitation Return to work Shoulder pain Sick leave L1 - internal-pdf://0293496238/2642-Moll-2018.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Moll, Line Thorndal Jensen, Ole Kudsk Schiottz-Christensen, Berit Stapelfeldt, Christina Malmose Christiansen, David Hoyrup Nielsen, Claus Vinther Labriola, Merete eng 987537 Danish Kroner/TrygFonden (DK)/International 10000 Danish kroner/Helga og Peter Kornings Fond (DK)/International 20000 Danish Kroner/Gigtforeningen (DK)/International 433000 Danish kroner/Aarhus Universitet (DK)/International 100000/Aase og Ejnar Danielsens Fond (DK)/International Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2017/08/25 J Occup Rehabil. 2018 Jun;28(2):346-356. doi: 10.1007/s10926-017-9727-9. PY - 2018 SN - 1573-3688 (Electronic) 1053-0487 (Print) 1053-0487 (Linking) SP - 346-356 ST - 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 T2 - J Occup Rehabil TI - 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 UR - https://www.ncbi.nlm.nih.gov/pubmed/28836120 VL - 28 ID - 2642 ER - TY - JOUR AB - STUDY DESIGN: Multicenter randomized trial with patients listed as sick for 1 to 12 months due to neck or back pain and referred to secondary care. OBJECTIVE: To compare the return-to-work (RTW) rate among patients offered work-focused rehabilitation or multidisciplinary rehabilitation. SUMMARY OF BACKGROUND DATA: A growing number of studies have focused on the RTW processes associated with patients with back pain. Many studies have combined a workplace focus with multidisciplinary treatments; however, this focus has not been evaluated in Norway among patients with neck and back pain thus far. METHODS: A total of 405 patients who were referred to the spine clinics at 2 university hospitals in Norway were randomly assigned into work-focused and control intervention groups. The existing treatments at each hospital were used as the control interventions, which entailed either a comprehensive multidisciplinary intervention or a brief multidisciplinary intervention. The RTW rates and proportions were compared at 12 months. RESULTS: During the first 12 months after inclusion, 142 (70%) participants in the work-focused rehabilitation group and 152 (75%) participants in the control group returned to work. The median time to RTW was 161 days in the work-focused group and 158 days in the control group. A comparison of the work-focused and control interventions revealed a relative RTW probability (hazard ratio) of 0.94 (95% confidence interval = 0.75-1.17) after adjusting for age, sex, and education. CONCLUSION: The results suggest that a focus on the workplace in specialist care does not substantially alter the RTW rate compared with standard multidisciplinary treatments. AD - *Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Oslo, Norway daggerFaculty of Medicine, Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway double daggerDepartment of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway section signCopenhagen Centre for Back Research (COPEBACK), Centre for Rheumatology and Spine Diseases, Glostrup Hospital, University of Copenhagen, Denmark paragraph signFaculty of Medicine, University of Oslo, Oslo, Norway ||Department of Biostatistics and Epidemiology, Oslo University Hospital, Ulleval, Oslo, Norway **National Institute of Occupational Health, Oslo, Norway; and daggerdaggerLovisenberg Hospital, Oslo, Norway. AN - 25271499 AU - Myhre, K. AU - Marchand, G. H. AU - Leivseth, G. AU - Keller, A. AU - Bautz-Holter, E. AU - Sandvik, L. AU - Lau, B. AU - Roe, C. CN - Medline 211026 DA - Nov 15 DB - Medline DO - 10.1097/BRS.0000000000000610 DP - NLM IS - 24 J2 - Spine KW - Adult Back Pain/*rehabilitation Female Humans Male Middle Aged Neck Pain/*rehabilitation Prospective Studies Rehabilitation/methods *Return to Work Sick Leave Time Factors L1 - internal-pdf://0438927245/2683-Myhre-2014.pdf LA - English M3 - Comparative Study Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Myhre, Kjersti Marchand, Gunn Hege Leivseth, Gunnar Keller, Anne Bautz-Holter, Erik Sandvik, Leiv Lau, Bjorn Roe, Cecilie eng Comparative Study Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2014/10/02 Spine (Phila Pa 1976). 2014 Nov 15;39(24):1999-2006. doi: 10.1097/BRS.0000000000000610. PY - 2014 SN - 1528-1159 (Electronic) 0362-2436 (Linking) SP - 1999-2006 ST - The effect of work-focused rehabilitation among patients with neck and back pain: a randomized controlled trial T2 - Spine (Phila Pa 1976) TI - The effect of work-focused rehabilitation among patients with neck and back pain: a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/25271499 VL - 39 ID - 2683 ER - TY - JOUR AB - BACKGROUND: Chronic work-related stress is quite prevalent in the working population and is in some cases accompanied by long-term sick leave. These stress complaints highly impact employees and are costly due to lost productivity and medical expenses. A new treatment platform with light therapy plus Pulsed Electro Magnetic Fields (PEMF) in combination with coaching was used to assess whether more positive effects on return to work, stress, work-related fatigue, and quality of life could be induced compared to coaching alone. METHODS: A placebo-controlled trial was executed after inclusion of 96 workers, aged 18-65 with work-related chronic stress complaints and who were on sick leave (either part-time or full-time). Participants were divided into three arms at random. Group 1 (n = 28) received the treatment and coaching (Intervention group), group 2 (n = 28) received the treatment with the device turned off and coaching (Placebo group) and group 3 (n = 28) received coaching only (Control group). The data were collected at baseline, and after 6, 12 and 24 weeks. The primary outcome was % return to work, and secondary outcomes were work-related fatigue (emotional exhaustion and need for recovery after work), stress (distress and hair cortisol), and quality of life (SF-36 dimensions: vitality, emotional role limitation, and social functioning). RESULTS: Eighty-four workers completed all measurements, 28 in each group. All groups improved significantly over time in the level of return to work, as well as on all secondary outcomes. No statistical differences between the three groups were found either on the primary outcome or on any of the secondary outcomes. CONCLUSIONS: Light therapy with Pulsed Electro Magnetic Fields PEMF therapy has no additional effect on return to work, stress, fatigue, and quality of live compared to coaching alone. TRIAL REGISTRATION: NTR4794 , registration date: 18-sep-2014. AD - Department: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands. k.nieuwenhuijsen@amc.nl. FluxPlus BV, Saal van Zwanenbergweg 11, 5026 RM, Tilburg, the Netherlands. Department: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands. AN - 28969697 AU - Nieuwenhuijsen, K. AU - Schoutens, A. M. C. AU - Frings-Dresen, M. H. W. AU - Sluiter, J. K. C1 - ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study has been approved by the Medical Ethics Assessment Committee of the Academic Medical Center (University of Amsterdam; Ref. METC 2014_260 #B2014922). Written informed consent was provided by all participants prior to enrolment. There are no risks associated with participating in the study due to the light intensity being lower than daylight and not including Ultra Violet or Infra Red wavelengths and the use of weak electromagnetic fields. No restrictions to other care of usual were in place for any study participant. CONSENT FOR PUBLICATION: Not applicable COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. C2 - PMC5625706 CN - Medline 211026 DA - Oct 2 DB - Medline DO - 10.1186/s12889-017-4720-y DP - NLM ET - 20171002 IS - 1 J2 - BMC Public Health KW - Adolescent Adult Aged Chronic Disease Combined Modality Therapy *Counseling Female Humans Magnetic Field Therapy/*methods Male Middle Aged Occupational Stress/*therapy *Phototherapy Return to Work/*statistics & numerical data Treatment Outcome Young Adult Burnout Fatigue Light therapy Pemf Quality of life Return to work Stress Work-related chronic stress L1 - internal-pdf://0103750700/2719-Nieuwenhuijsen-2017.pdf LA - English M3 - Randomized Controlled Trial N1 - Nieuwenhuijsen, Karen Schoutens, Antonius M C Frings-Dresen, Monique H W Sluiter, Judith K eng Randomized Controlled Trial England 2017/10/04 BMC Public Health. 2017 Oct 2;17(1):761. doi: 10.1186/s12889-017-4720-y. PY - 2017 SN - 1471-2458 (Electronic) 1471-2458 (Linking) SP - 761 ST - Evaluation of a randomized controlled trial on the effect on return to work with coaching combined with light therapy and pulsed electromagnetic field therapy for workers with work-related chronic stress T2 - BMC Public Health TI - Evaluation of a randomized controlled trial on the effect on return to work with coaching combined with light therapy and pulsed electromagnetic field therapy for workers with work-related chronic stress UR - https://www.ncbi.nlm.nih.gov/pubmed/28969697 VL - 17 ID - 2719 ER - TY - JOUR AB - OBJECTIVES: In case of long-term sick leave, gradually increasing workload appears to be an effective component of work-directed interventions to reduce sick leave due to common mental disorders (CMD). CMD are defined as stress-related, adjustment, anxiety, or depressive disorders. We developed an exposure-based return-to-work (RTW-E) intervention and evaluated the effect on time-to-full return to work (RTW) among workers who were on sick leave due to CMD in comparison to those treated with care-as-usual (CAU). CAU is guideline-directed and consists of problem-solving strategies and graded activities. METHODS: Using a two-armed cluster-randomized trial, we randomized 56 occupational physicians (OP). Of these, 35 OP treated 160 workers at the start of their sick leave; 75 workers received RTW-E and 85 workers received CAU. These workers were followed over a 12-month follow-up period. The time-to-full RTW lasting >/=28 days without recurrence was the primary outcome measure. To evaluate differences between groups, we used intention-to-treat and multilevel Cox's regression analysis. RESULTS: The median time-to-full RTW differed significantly between groups [hazard ratio (HR) 0.55; 95% confidence interval (95% CI) 0.33-0.89]. The workers receiving RTW-E (209 days; 95% CI 62-256) had a prolonged time-to-full RTW compared to workers receiving CAU (153 days; 95% CI 128-178). CONCLUSIONS: Workers on sick leave due to CMD treated with RTW-E showed a prolonged time-to-full RTW compared to those treated with CAU. We recommend that OP do not apply RTW-E but continue counseling workers on sick leave due to CMD according to CAU. AD - Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands. f.w.noordik@amc.nl AN - 22951572 AU - Noordik, E. AU - van der Klink, J. J. AU - Geskus, R. B. AU - de Boer, M. R. AU - van Dijk, F. J. AU - Nieuwenhuijsen, K. CN - Medline 211026 DA - Mar 1 DB - Medline DO - 10.5271/sjweh.3320 DP - NLM ET - 20120905 IS - 2 J2 - Scand J Work Environ Health KW - Adult Female Humans Male *Mental Disorders Middle Aged Return to Work/*psychology Sick Leave/*statistics & numerical data L1 - internal-pdf://0550426636/2737-Noordik-2013.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Noordik, Erik van der Klink, Jac J Geskus, Ronald B de Boer, Michiel R van Dijk, Frank J H Nieuwenhuijsen, Karen eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Finland 2012/09/07 Scand J Work Environ Health. 2013 Mar 1;39(2):144-54. doi: 10.5271/sjweh.3320. Epub 2012 Sep 5. PY - 2013 SN - 1795-990X (Electronic) 0355-3140 (Linking) SP - 144-54 ST - Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trial T2 - Scand J Work Environ Health TI - Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/22951572 VL - 39 ID - 2737 ER - TY - JOUR AB - BACKGROUND: Long-term sick leave has been of concern to politicians and decision-makers in Norway for several years. In the current study we assess the efficacy of a solution-focused follow-up for sick-listed employees. METHODS: Employees on long-term sick leave due to psychological problems or muscle skeletal pain (n = 703) were invited to participate in the project. Following self-recruitment, 103 were randomly allocated to receive solution-focused follow-up (n = 53) or "treatment as usual" (n = 50). The intervention was integrated within the regular follow up of six social security offices and organised as eight weekly solution focused work sessions. Effectiveness was measured by rate of return to work and health related quality of life (SF-36). RESULTS: Intention to treat analysis showed no significant differences between the two groups for any of the outcome measures. Secondary analysis, comparing those who attended at least 50% of the sessions with the control group revealed a significant difference in favour of the active intervention group in the SF-36 subscale of mental health (Effect Size 0.56, p = 0.05). When comparing the subgroup of participants with psychological problems there was a significant difference in mental health in favour of the intervention group (Effect Size 0.71, p = 0.041). CONCLUSION: A voluntary solution-focused intervention offered by social-security offices is no more effective than regular follow up for employees on long-term sick leave due to psychological problems or muscle skeletal pain. AD - Psykologbistand as, Kristian Augusts gate 13, 0164 Oslo, Norway. pal@psykologbistand.no AN - 16542443 AU - Nystuen, P. AU - Hagen, K. B. C2 - PMC1459128 CN - Medline 211026 DA - Mar 16 DB - Medline DO - 10.1186/1471-2458-6-69 DP - NLM ET - 20060316 J2 - BMC Public Health KW - Adult Burnout, Professional/*therapy Directive Counseling/*organization & administration/statistics & numerical data Female Follow-Up Studies Humans Male Mental Disorders/*therapy Middle Aged Musculoskeletal Diseases/complications/*therapy Norway Occupational Diseases/classification/psychology/*therapy Occupational Health Services/*organization & administration/statistics & numerical data Pain/etiology *Pain Management Problem Solving Program Evaluation Quality of Life Sick Leave/*statistics & numerical data Social Security/*organization & administration Treatment Outcome Voluntary Programs L1 - internal-pdf://1965962150/2762-Nystuen-2006.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Nystuen, Pal Hagen, Kare B eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2006/03/18 BMC Public Health. 2006 Mar 16;6:69. doi: 10.1186/1471-2458-6-69. PY - 2006 SN - 1471-2458 (Electronic) 1471-2458 (Linking) SP - 69 ST - Solution-focused intervention for sick listed employees with psychological problems or muscle skeletal pain: a randomised controlled trial [ISRCTN39140363] T2 - BMC Public Health TI - Solution-focused intervention for sick listed employees with psychological problems or muscle skeletal pain: a randomised controlled trial [ISRCTN39140363] UR - https://www.ncbi.nlm.nih.gov/pubmed/16542443 VL - 6 ID - 2762 ER - TY - JOUR AB - BACKGROUND: There is moderate quality evidence that integrating work-directed interventions and components from psychological therapies reduces sickness absence in the medium term. We aimed to extend this evidence by examining objectively ascertained income and work participation status up to 4 years after an intervention to improve outcomes among people who struggle with work from common mental disorder. METHODS: The intervention combined components from cognitive behavioural therapy with principles from supported employment, and compared its efficacy with usual care. Outcomes were derived from registry data with no attrition, in a pragmatic multisite randomised controlled trial (N=1193). RESULTS: The intervention group had higher income, higher work participation and more months without receiving benefits over the 10-month to 46-month long-term follow-up period after end of treatment, but differences were not statistically significant. For the group on long-term benefits at inclusion, effect sizes were larger and statistically significant. CONCLUSION: There were no statistically significant differences between the two groups in the primary outcome in the total population. In a secondary analysis for the subgroup most at risk of permanent work exclusion, long-term outcomes were favourable in the intervention group compared with usual care. The results support integrated work and health services for people on the severe end of work participation challenges. TRIAL REGISTRATION NUMBER: NCT01146730. AD - Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. Department of Psychosocial Science, University of Bergen, Bergen, Norway. Department of Economics, University of Bergen, Bergen, Norway. Uni Research Health, Uni Research, Bergen, Norway. Department of Psychology, University of Oslo, Oslo, Norway. AN - 30032103 AU - Overland, S. AU - Grasdal, A. L. AU - Reme, S. E. C1 - Competing interests: None declared. CN - Medline 211026 DA - Oct DB - Medline DO - 10.1136/oemed-2018-105137 DP - NLM ET - 20180721 IS - 10 J2 - Occup Environ Med KW - *Absenteeism Adult *Cognitive Behavioral Therapy Employment, Supported/*methods Female Humans *Income Insurance Benefits/*statistics & numerical data Insurance, Health/*statistics & numerical data Male Mental Disorders/*therapy Middle Aged Norway Young Adult mental health sickness absence supported employment work disability work-focused CBT L1 - internal-pdf://2793678282/2823-Overland-2018.pdf LA - English M3 - Multicenter Study N1 - Overland, Simon Grasdal, Astrid Louise Reme, Silje Endresen eng Multicenter Study England 2018/07/23 Occup Environ Med. 2018 Oct;75(10):703-708. doi: 10.1136/oemed-2018-105137. Epub 2018 Jul 21. PY - 2018 SN - 1470-7926 (Electronic) 1351-0711 (Linking) SP - 703-708 ST - Long-term effects on income and sickness benefits after work-focused cognitive-behavioural therapy and individual job support: a pragmatic, multicentre, randomised controlled trial T2 - Occup Environ Med TI - Long-term effects on income and sickness benefits after work-focused cognitive-behavioural therapy and individual job support: a pragmatic, multicentre, randomised controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/30032103 VL - 75 ID - 2823 ER - TY - JOUR AB - PURPOSE: To study return to work (RTW) at 2-year follow-up in a randomised controlled trial comparing brief intervention (BI) and multidisciplinary intervention (MDI) in employees on sick leave due to low back pain (LBP) stratified for job relations. METHODS: In total 476 employees on sick leave for 4-12 weeks due to LBP were divided into strata with weak or strong job relations, based on perceived risk of losing job and influence on job planning. In each stratum participants were allocated to BI or MDI. All participants received BI, i.e. a clinical examination by a rheumatologist and physiotherapist. In addition, MDI involved a case manager who made a rehabilitation plan in collaboration with the participant. The primary outcome was time to RTW. Secondary outcomes were median weeks in different employment status and selfreported pain, disability and psychological health. Sustained RTW was estimated by work status the last 4 weeks before the 2-year date. RESULTS: Participants with strong job relations who received BI had a higher RTW rate (hazard ratio = 0.74 (95% CI 0.57; 0.96)) and spent more weeks working than participants who received MDI. In the stratum of weak job relations, no difference was seen regarding RTW and weeks working. For health-related outcomes and sustained RTW no significant results were found in neither stratum. CONCLUSIONS: Employees with strong job relations achieved higher RTW rates when receiving BI compared to MDI, while no difference was found between intervention groups for employees with weak job relations. TRIAL REGISTRATION: Current Controlled Trials ISRCTN14136384. Registered 4 August. AD - DEFACTUM, Central Denmark Region, Aarhus, Denmark. Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark. Department of Clinical Social Medicine and Rehabilitation, Regional Hospital Godstrup, Herning, Denmark. Department of Public Health, Aarhus University, Aarhus, Denmark. DEFACTUM, Central Denmark Region, Aarhus, Denmark. pelped@rm.dk. Department of Public Health, Aarhus University, Aarhus, Denmark. pelped@rm.dk. AN - 35147899 AU - Pedersen, K. K. W. AU - Langagergaard, V. AU - Jensen, O. K. AU - Nielsen, C. V. AU - Sorensen, V. N. AU - Pedersen, P. CN - Cochrane Trials uppdateringssökning 220512 DA - Dec DB - Medline DO - 10.1007/s10926-022-10030-1 DP - NLM ET - 20220211 IS - 4 KW - Humans *Sick Leave *Low Back Pain/psychology Return to Work Follow-Up Studies Treatment Outcome Employment Low back pain Multidisciplinary intervention Rehabilitation Sick leave Vocational rehabilitation L1 - internal-pdf://2157979755/10412-Pedersen-2022.pdf M3 - Journal: Article in Press N1 - Pedersen, Kathrine K W Langagergaard, Vivian Jensen, Ole K Nielsen, Claus V Sorensen, Vibeke N Pedersen, Pernille eng Randomized Controlled Trial Netherlands 2022/02/12 J Occup Rehabil. 2022 Dec;32(4):697-704. doi: 10.1007/s10926-022-10030-1. Epub 2022 Feb 11. PY - 2022 SN - 1573-3688 (Electronic) 1053-0487 (Linking) SP - 697-704 ST - Two-Year Follow-Up on Return to Work in a Randomised Controlled Trial Comparing Brief and Multidisciplinary Intervention in Employees on Sick Leave Due to Low Back Pain T2 - J Occup Rehabil TI - Two-Year Follow-Up on Return to Work in a Randomised Controlled Trial Comparing Brief and Multidisciplinary Intervention in Employees on Sick Leave Due to Low Back Pain UR - https://www.ncbi.nlm.nih.gov/pubmed/35147899 VL - 32 ID - 10412 ER - TY - JOUR AB - AIMS: To evaluate differences in employment status, during a five-year follow-up period in patients on sick leave due to low back pain who had participated in a trial comparing a brief and a multidisciplinary intervention. METHODS: From 2004 to 2008, 535 patients were referred to the Spine Centre at the Regional Hospital in Silkeborg if they had been on sick leave for 3-16 weeks due to low back pain. All patients underwent a clinical examination by a rehabilitation physician and a physiotherapist, and were randomised to either the brief intervention or the multidisciplinary intervention. The outcome was employment status from randomisation to five years of follow-up and was measured by the mean number of weeks in four different groups of employment status (sequence analysis) and a fraction of the number of weeks working (work participation score) that were accumulated over the years. RESULTS: A total of 231 patients were randomised to the brief intervention and 233 patients to the multidisciplinary intervention. No statistically significant differences in the mean weeks spent within the different employment statuses were found between the two intervention groups. After five years of follow-up, participants in the multidisciplinary intervention had a 19% higher risk of not having a work participation score above 75% compared to participants in the brief intervention. CONCLUSIONS: After five years of follow-up no differences in employment status were found between participants in the brief and the multidisciplinary intervention. AD - 1 DEFACTUM, Central Denmark Region, Denmark. 2 Section of Clinical Social Medicine and Rehabilitation, University of Aarhus, Denmark. 3 Spine Centre, Regional Hospital Silkeborg, Denmark. 4 Department of Public Health and General Practice, Norwegian University of Science and Technology, Norway. 5 National Centre for Occupational Rehabilitation, Norway. AN - 28767002 AU - Pedersen, P. AU - Nielsen, C. V. AU - Jensen, O. K. AU - Jensen, C. AU - Labriola, M. CN - Medline 211026 DA - May DB - Medline DO - 10.1177/1403494817722290 DP - NLM ET - 20170802 IS - 3 J2 - Scand J Public Health KW - Adolescent Adult Denmark Employment/*statistics & numerical data Follow-Up Studies Humans Low Back Pain/*rehabilitation Middle Aged Rehabilitation/methods Return to Work/statistics & numerical data Sick Leave/*statistics & numerical data Time Factors Treatment Outcome Young Adult Return to work brief intervention low back pain multidisciplinary intervention relapse sequence analysis sick leave L1 - internal-pdf://0183138296/2845-Pedersen-2018.pdf LA - English M3 - Randomized Controlled Trial N1 - Pedersen, Pernille Nielsen, Claus Vinther Jensen, Ole Kudsk Jensen, Chris Labriola, Merete eng Randomized Controlled Trial Sweden 2017/08/03 Scand J Public Health. 2018 May;46(3):383-388. doi: 10.1177/1403494817722290. Epub 2017 Aug 2. PY - 2018 SN - 1651-1905 (Electronic) 1403-4948 (Linking) SP - 383-388 ST - Employment status five years after a randomised controlled trial comparing multidisciplinary and brief intervention in employees on sick leave due to low back pain T2 - Scand J Public Health TI - Employment status five years after a randomised controlled trial comparing multidisciplinary and brief intervention in employees on sick leave due to low back pain UR - https://www.ncbi.nlm.nih.gov/pubmed/28767002 VL - 46 ID - 2845 ER - TY - JOUR AB - BACKGROUND: The aim of this study was to evaluate the effect of psychoeducation on return to work as an adjunct to standard case management in individuals on sick leave at risk of having a mental disorder. The participants could have different diagnoses but were all at risk of having a mental disorder. METHODS: Between 2012 and 2014, 430 participants on sick leave were randomly allocated to either an intervention or control group. The psychoeducation consisted of 2-h sessions once a week for 6 weeks. The sessions focused on stress and work life and was based on problem-solving techniques and coping strategies. The main outcome, the relative risk (RR) of a full return to work based on register data from the job centres, was determined during the first 3 and 6 months after participation in the psychoeducation programme. At baseline and at 3 and 6 months after the intervention, the participants received a questionnaire on psychological symptoms, mental health-related quality of life, and locus of control. RESULTS: During the first 6 months after inclusion, the two groups had almost the same RR of a full return to work (RR:0.97, 95% CI: 0.78;1.21), but during the first 3 months, the individuals in the intervention group had a significantly higher risk of not having fully returned to work (RR:0.68, 95% CI:0.47;0.98). The individuals in the intervention group who had participated in at least four of the six psychoeducational sessions returned to work considerably slower at both time points than did the control group. The intervention did not decrease the level of psychological symptoms or improve mental health-related quality of life; however, individuals in the intervention group improved their scores on internal locus of control at both 3 and 6 months. CONCLUSION: Offering psychoeducation to individuals on sick leave at risk of having a mental disorder had no influence on the chance of a full return to work during the first 6 months; however, it did result in a higher relative risk of not returning to work after 3 months. Therefore, we do not recommend offering psychoeducation in this form to facilitate return to work. TRIAL REGISTRATION: Clinical Trial.gov NCT01637363. Registered 6 July 2012. AD - Psychiatric Research Unit West, Regional Psychiatric Services West, Central Denmark Region, Gl. Landevej 49, 7400, Herning, Denmark. Pernille.Pedersen@stab.rm.dk. Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark. Pernille.Pedersen@stab.rm.dk. Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark. Pernille.Pedersen@stab.rm.dk. Psychiatric Research Unit West, Regional Psychiatric Services West, Central Denmark Region, Gl. Landevej 49, 7400, Herning, Denmark. Hans.Soegaard@ps.rm.dk. Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark. Hans.Soegaard@ps.rm.dk. Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark. Merete.Labriola@stab.rm.dk. Section of Clinical Social Medicine and Rehabilitation, School of Public Health, University of Aarhus, Aarhus, Denmark. Merete.Labriola@stab.rm.dk. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. eanohr@health.sdu.dk. Department of Public Health and General Practice, Norwegian University of Science and Technology, NTNU, Trondheim, Norway. Chris.Jensen@air.no. National Centre for Occupational Rehabilitation, Rauland, Norway. Chris.Jensen@air.no. AN - 26253219 AU - Pedersen, P. AU - Sogaard, H. J. AU - Labriola, M. AU - Nohr, E. A. AU - Jensen, C. C2 - PMC4529726 CN - Medline 211026 DA - Aug 8 DB - Medline DO - 10.1186/s12889-015-2087-5 DP - NLM ET - 20150808 J2 - BMC Public Health KW - Adaptation, Psychological Adult Counseling/*methods Female Humans Male Mental Disorders/psychology/*therapy *Mental Health Middle Aged Quality of Life *Sick Leave Stress, Psychological/psychology/therapy Surveys and Questionnaires Work/*psychology Young Adult L1 - internal-pdf://3095975293/2846-Pedersen-2015.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Pedersen, Pernille Sogaard, Hans Jorgen Labriola, Merete Nohr, Ellen A Jensen, Chris eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2015/08/09 BMC Public Health. 2015 Aug 8;15:763. doi: 10.1186/s12889-015-2087-5. PY - 2015 SN - 1471-2458 (Electronic) 1471-2458 (Linking) SP - 763 ST - Effectiveness of psychoeducation in reducing sickness absence and improving mental health in individuals at risk of having a mental disorder: a randomised controlled trial T2 - BMC Public Health TI - Effectiveness of psychoeducation in reducing sickness absence and improving mental health in individuals at risk of having a mental disorder: a randomised controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/26253219 VL - 15 ID - 2846 ER - TY - JOUR AB - OBJECTIVE: To evaluate the effectiveness of guideline-based care (GBC) of workers with mental health problems, which promotes counseling by the occupational physician (OP) facilitating return to work (RTW). METHODS: In a randomized controlled trial with police workers on sick leave due to mental health problems (n = 240), trained OPs delivered GBC in the intervention group. Time to RTW and recurrences during 1-year follow-up, analyzed using Cox proportional hazards models, were compared with usual care (UC) with easy access to a psychologist. RESULTS: GBC by OPs did not result in earlier RTW than UC. Subgroup analysis showed a small effect in favor of GBC for workers with administrative functions and/or "minor" stress-related symptoms. CONCLUSIONS: GBC did not differ in RTW compared with UC, but may be beneficial for the majority of workers with minor stress-related disorders. AD - Departments of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands. AN - 19225417 AU - Rebergen, D. S. AU - Bruinvels, D. J. AU - Bezemer, P. D. AU - van der Beek, A. J. AU - van Mechelen, W. CN - Medline 211026 DA - Mar DB - Medline DO - 10.1097/JOM.0b013e3181990d32 DP - NLM ET - 2009/02/20 IS - 3 J2 - J Occup Environ Med KW - Adult Female Humans Male Mental Disorders/*therapy Middle Aged Netherlands *Occupational Health *Outcome Assessment, Health Care Police Practice Guidelines as Topic Proportional Hazards Models Psychology Sick Leave L1 - internal-pdf://0388009837/2961-Rebergen-2009.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Rebergen, D S Bruinvels, D J Bezemer, P D van der Beek, A J van Mechelen, W eng Randomized Controlled Trial Research Support, Non-U.S. Gov't 2009/02/20 J Occup Environ Med. 2009 Mar;51(3):305-12. doi: 10.1097/JOM.0b013e3181990d32. PY - 2009 SN - 1536-5948 (Electronic) 1076-2752 (Linking) SP - 305-12 ST - Guideline-based care of common mental disorders by occupational physicians (CO-OP study): a randomized controlled trial T2 - J Occup Environ Med TI - Guideline-based care of common mental disorders by occupational physicians (CO-OP study): a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/19225417 VL - 51 ID - 2961 ER - TY - JOUR AB - OBJECTIVE: To evaluate the cost-effectiveness of an activating guideline-based care (GBC) by occupational physicians (OPs). METHODS: An economic evaluation was conducted in a randomized controlled trial with police workers on sick leave due to mental health problems (n = 240). In the intervention group trained OPs provided GBC, compared with usual care with easy access to a psychologist. Sick leave data and health care costs were gathered after 1-year follow-up. Analyses comprised bootstrap techniques, cost-effectiveness planes, and acceptability curves. RESULTS: Health care utilization costs (euro574.532 in total) were significantly lower in the intervention group (mean difference -euro520; 95% CI -euro980 to euro59), whereas there were no significant differences in days of sick leave and productivity loss costs. CONCLUSIONS: GBC could be cost-effective, as lower direct costs lead to equal treatment outcomes of workers with common mental disorders. AD - Department of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands. AN - 19225416 AU - Rebergen, D. S. AU - Bruinvels, D. J. AU - van Tulder, M. W. AU - van der Beek, A. J. AU - van Mechelen, W. CN - Medline 211026 DA - Mar DB - Medline DO - 10.1097/JOM.0b013e3181990d8e DP - NLM ET - 2009/02/20 IS - 3 J2 - J Occup Environ Med KW - Adult Cost-Benefit Analysis Efficiency Female Guidelines as Topic Health Services/economics/statistics & numerical data Health Services Accessibility Humans Male Mental Disorders/*therapy Middle Aged *Occupational Health Practice Guidelines as Topic Randomized Controlled Trials as Topic Sick Leave L1 - internal-pdf://1184323522/2964-Rebergen-2009.pdf LA - English M3 - Research Support, Non-U.S. Gov't N1 - Rebergen, D S Bruinvels, D J van Tulder, M W van der Beek, A J van Mechelen, W eng Research Support, Non-U.S. Gov't 2009/02/20 J Occup Environ Med. 2009 Mar;51(3):313-22. doi: 10.1097/JOM.0b013e3181990d8e. PY - 2009 SN - 1536-5948 (Electronic) 1076-2752 (Linking) SP - 313-22 ST - Cost-effectiveness of guideline-based care for workers with mental health problems T2 - J Occup Environ Med TI - Cost-effectiveness of guideline-based care for workers with mental health problems UR - https://www.ncbi.nlm.nih.gov/pubmed/19225416 VL - 51 ID - 2964 ER - TY - JOUR AB - OBJECTIVES: Common mental disorders (CMDs) are a major cause of rising disability benefit expenditures. We urgently need evidence on programmes that can increase work participation in CMDs. The aim of this study was to evaluate the effectiveness of work-focused cognitive-behavioural therapy (CBT) and individual job support for people struggling with work participation due to CMDs. METHODS: A randomised controlled multicentre trial (RCT) including 1193 participants was conducted. Participants were on sick leave, at risk of going on sick leave or on long-term benefits. The intervention integrated work-focused CBT with individual job support. The control group received usual care. The main outcome was objectively ascertained work participation at 12 months follow-up, with changes in mental health and health-related quality of life as secondary outcomes. RESULTS: A larger proportion of participants in the intervention group had increased or maintained their work participation at follow-up compared to the control group (44.2% vs 37.2%, p=0.015). The difference remained significant after 18 months (difference 7.8%, p=0.018), and was even stronger for those on long-term benefits (difference 12.2%, p=0.007). The intervention also reduced depression (t=3.23, p</=0.001) and anxiety symptoms (t=2.52, p=0.012) and increased health-related quality of life (t=2.24, p=0.026) more than usual care. CONCLUSIONS: A work-focused CBT and individual job support was more effective than usual care in increasing or maintaining work participation for people with CMDs. The effects were profound for people on long-term benefits. This is the first large-scale RCT to demonstrate an effect of a behavioural intervention on work participation for the large group of workers with CMDs. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, registration number: NCT01146730. AD - Uni Research Health, Bergen, Norway. Department of Economics, University of Bergen, Bergen, Norway. Uni Research Health, Bergen, Norway Department of Psychosocial Science, University of Bergen, Bergen, Norway. Department of Public Mental Health, Norwegian Institute of Public Health, Bergen, Norway Department of Psychosocial Science, University of Bergen, Bergen, Norway. AN - 26251065 AU - Reme, S. E. AU - Grasdal, A. L. AU - Lovvik, C. AU - Lie, S. A. AU - Overland, S. C2 - PMC4602235 CN - Medline 211026 DA - Oct DB - Medline DO - 10.1136/oemed-2014-102700 DP - NLM ET - 20150806 IS - 10 J2 - Occup Environ Med KW - Adult Age Factors Cognitive Behavioral Therapy/*organization & administration Employment, Supported/*methods Female Humans Logistic Models Male Mental Disorders/diagnosis/epidemiology/*therapy Middle Aged Multivariate Analysis Norway Program Evaluation Risk Assessment Sex Factors Sick Leave/*statistics & numerical data Sickness Impact Profile Treatment Outcome Young Adult LA - English M3 - Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Reme, Silje Endresen Grasdal, Astrid Louise Lovvik, Camilla Lie, Stein Atle Overland, Simon eng Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2015/08/08 Occup Environ Med. 2015 Oct;72(10):745-52. doi: 10.1136/oemed-2014-102700. Epub 2015 Aug 6. PY - 2015 SN - 1470-7926 (Electronic) 1351-0711 (Print) 1351-0711 (Linking) SP - 745-52 ST - Work-focused cognitive-behavioural therapy and individual job support to increase work participation in common mental disorders: a randomised controlled multicentre trial T2 - Occup Environ Med TI - Work-focused cognitive-behavioural therapy and individual job support to increase work participation in common mental disorders: a randomised controlled multicentre trial UR - https://www.ncbi.nlm.nih.gov/pubmed/26251065 VL - 72 ID - 2979 ER - TY - JOUR AB - STUDY DESIGN: A randomized controlled trial. OBJECTIVE: The aim of this study was to evaluate whether a tailored and manualized cognitive behavior therapy (CBT) or nutritional supplements of seal oil and soy oil had any additional benefits over a brief cognitive intervention (BI) on return to work (RTW). SUMMARY OF BACKGROUND DATA: Brief intervention programs are clinically beneficial and cost-effective for patients with low back pain (LBP). CBT is recommended for LBP, but evidence on RTW is lacking. Seal oil has previously been shown to have a possible effect on muscle pain, but no randomized controlled trials have so far been carried out in LBP patients. METHODS: Four hundred thirteen adults aged 18 to 60 years were included. Participants were sick-listed 2 to 10 months due to LBP. Main outcome was objectively ascertained work participation at 12-month follow-up. Participants were randomly assigned to BI (n = 100), BI and CBT (n = 103), BI and seal oil (n = 105), or BI and soy oil (n = 105). BI is a two-session cognitive, clinical examination program followed by two booster sessions, while the CBT program is a tailored, individual, seven-session manual-based treatment. RESULTS: At 12-month follow-up, 60% of the participants in the BI group, 50% in the BI and CBT group, 51% in the BI and seal oil group, and 53% in the BI and soy oil group showed reduced sick leave from baseline, and had either partly or fully RTW. The differences between the groups were not statistically significant (chi = 2.54, P = 0.47). There were no significant differences between the treatment groups at any of the other follow-up assessments either, except for a significantly lower sick leave rate in the BI group than the other groups during the first 3 months of follow-up (chi = 9.50, P = 0.02). CONCLUSION: CBT and seal oil had no additional benefits over a brief cognitive intervention on sick leave. The brief cognitive intervention alone was superior in facilitating a fast RTW. LEVEL OF EVIDENCE: 2. AD - Uni Research Health, Bergen, Norway. Oslo University Hospital, Oslo, Norway. Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo. Department of Health Promotion, University College of Southeast Norway, Oslo, Norway. Department of Health Promotion and Development, University of Bergen, Bergen, Norway. Department of of Clinical Dentistry, University of Bergen, Bergen, Norway. Department of Economics, University of Bergen, Bergen, Norway. Department of Research and Development, Clinic Physical Medicine and Rehabilitation, Vestfold Hospital Trust, T solidus in circlensberg, Norway. Department of Psychiatry, Haukeland University Hospital, Bergen, Norway. Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Ottestad, Norway. Department of Physical Medicine and Rehabilitation, St Olav University Hospital, Trondheim, Norway. The Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. Unicare, Friskvernklinikken, Asker, Norway. National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway. National Competence Centre for Complex Disorders, St Olav's Hospital, Trondheim, Norway. Department of Psychological Medicine, King's College London, London, UK. Department of Sport and Physical Activity, Bergen University College, Bergen, Norway. AN - 27760062 AU - Reme, S. E. AU - Tveito, T. H. AU - Harris, A. AU - Lie, S. A. AU - Grasdal, A. AU - Indahl, A. AU - Brox, J. I. AU - Tangen, T. AU - Hagen, E. M. AU - Gismervik, S. AU - Odegard, A. AU - Fr Yland, L. AU - Fors, E. A. AU - Chalder, T. AU - Eriksen, H. R. CN - Medline 211026 DA - Oct 15 DB - Medline DO - 10.1097/BRS.0000000000001596 DP - NLM IS - 20 J2 - Spine KW - Adult *Cognitive Behavioral Therapy Combined Modality Therapy *Dietary Supplements Female Humans Low Back Pain/drug therapy/psychology/*therapy Male Middle Aged *Sick Leave Treatment Outcome Young Adult L1 - internal-pdf://0384965535/2983-Reme-2016.pdf LA - English M3 - Comparative Study Multicenter Study Randomized Controlled Trial N1 - Reme, Silje E Tveito, Torill H Harris, Anette Lie, Stein Atle Grasdal, Astrid Indahl, Aage Brox, Jens Ivar Tangen, Tone Hagen, Eli Molde Gismervik, Sigmund Odegard, Arit Fr Yland, Livar Fors, Egil A Chalder, Trudie Eriksen, Hege R eng Comparative Study Multicenter Study Randomized Controlled Trial 2016/10/21 Spine (Phila Pa 1976). 2016 Oct 15;41(20):1557-1564. doi: 10.1097/BRS.0000000000001596. PY - 2016 SN - 1528-1159 (Electronic) 0362-2436 (Linking) SP - 1557-1564 ST - Cognitive Interventions and Nutritional Supplements (The CINS Trial): A Randomized Controlled, Multicenter Trial Comparing a Brief Intervention With Additional Cognitive Behavioral Therapy, Seal Oil, and Soy Oil for Sick-Listed Low Back Pain Patients T2 - Spine (Phila Pa 1976) TI - Cognitive Interventions and Nutritional Supplements (The CINS Trial): A Randomized Controlled, Multicenter Trial Comparing a Brief Intervention With Additional Cognitive Behavioral Therapy, Seal Oil, and Soy Oil for Sick-Listed Low Back Pain Patients UR - https://www.ncbi.nlm.nih.gov/pubmed/27760062 VL - 41 ID - 2983 ER - TY - JOUR AB - Study Design: A randomized controlled trial comparing usual care with a program for the coordination of primary health care (CORE) for the treatment of subacute low-back pain patients.Objectives: To measure the effectiveness of the CORE program as a mean for implementing clinical practice guidelines for low-back pain in an urban community.Summary Of Background Data: Clinical practice guidelines have been developed for primary care physicians and patients on the clinical management of low-back pain. The implementation of the guidelines in a large community is difficult with the multiplicity of medical and nonmedical back care providers and products. The CORE program was designed to make the guidelines fit in this complex environment.Methods: One hundred ten workers compensated for low-back pain for 4 to 8 weeks in metropolitan Montreal were randomized in two groups: usual care (N = 56) and the CORE program (N = 54). Coordination of primary health care was performed by two primary care physicians and a nurse in liaison with the treating physicians, and included a complete examination, recommendations for the clinical management, and support to carry out the recommendations. All workers were followed for 6 months. Back pain and functional status were assessed at baseline, 3 months, and 6 months.Results: In the 6-month follow-up, the CORE group returned to work 6.6 days (standard error = 8.9) quicker than the control group, a difference that was not statistically significant. However, the CORE group showed a sustained improvement in pain and functional status with two-fold differences at the end of the 6 months of follow-up. This represented nine points on the Oswestry scale (P = 0.02) and 12 points on the Quebec Back Pain Disability Scale (P = 0.01). The CORE group also used three times less specialized imaging tests of the spine at 3 months (P < 0.01) and exercised twice as much at 6 months (P < 0.05) than the controls.Conclusions: The therapeutic results for workers with low-back pain could be improved by implementing the clinical practice guidelines with primary care physicians in a large community, without delaying the return to work. The CORE intervention for back pain patients is highly relevant to primary care practice. It is simple in its application, flexible to accommodate physicians' and- patients' preferences in health care, and it is effective on patients' clinical outcome. AD - Montreal Department of Public Health, Quebec, Canada Department of Public Health, 1301 Sherbrooke Street East, Montreal, Quebec, Canada H2L 1M3; e-mail: mrossign@santepub-mtl.qc.ca AN - 107102023. Language: English. Entry Date: 20000401. Revision Date: 20190818. Publication Type: journal article AU - Rossignol, M. AU - Abenhaim, L. AU - Séguin, P. AU - Neveu, A. AU - Collet, J. AU - Ducruet, T. AU - Shapiro, S. AU - Rossignol, M. AU - Abenhaim, L. AU - Séguin, P. AU - Neveu, A. AU - Collet, J. P. AU - Ducruet, T. AU - Shapiro, S. CN - Cinahl 211119 DB - c8h DO - 10.1097/00007632-200001150-00018 DP - EBSCOhost IS - 2 KW - Low Back Pain -- Epidemiology Low Back Pain -- Therapy Primary Health Care Clinical Trials Questionnaires Visual Analog Scaling Research Instruments Neuropsychological Tests Job Re-Entry Kaplan-Meier Estimator Cox Proportional Hazards Model Health Resource Utilization Descriptive Statistics Outcomes Research Adult Male Female Funding Source Human L1 - internal-pdf://0366752969/9407-Rossignol-2000.pdf N1 - commentary; research; tables/charts; randomized controlled trial. Commentary: Schonstein E. Co-ordinating health care for workers with compensable back pain improves long term functional status. (AUST J PHYSIOTHER) 2001; 47 (2): 151-151. Journal Subset: Allied Health; Biomedical; Peer Reviewed; USA. Instrumentation: Quebec Back Pain Disability Scale (QBPDS); Fear-Avoidance Beliefs Questionnaire; Dallas Pain Questionnaire; Oswestry Questionnaire; Visual Analog Scaling. Grant Information: Quebec Research Institute in Occupational Health and Safety. NLM UID: 7610646. PMID: NLM10685491. PY - 2000 SN - 0362-2436 SP - 251-259 ST - Coordination of primary health care for back pain. A randomized controlled trial T2 - Spine (03622436) TI - Coordination of primary health care for back pain. A randomized controlled trial UR - https://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=107102023&site=ehost-live VL - 25 ID - 9407 ER - TY - JOUR AB - The aim of this study was to evaluate specific effects for patients with adjustment or exhaustion disorder, the Stress subgroup (n = 152), regarding symptom severity and sick leave after CBT, a return-to-work intervention (RTW-I), and a combination of them (COMBO), using data from a randomized trial. In the original study, primary care patients on sick leave (N = 211) were randomized to CBT (n = 64), RTW-I (n = 67), or COMBO (n = 80). Blinded Clinician Severity Rating (CSR) of symptoms and sick leave registry data were primary outcomes. Subgroup analyses showed that for the Stress subgroup, CBT led to greater reduction of symptoms than RTW-I posttreatment, but COMBO did not differ from CBT or RTW-I. Regarding sick leave, there was no difference between treatments in the Stress subgroup. An exploratory analysis of the treatment effects in a subgroup of patients with depression, anxiety or insomnia indicates that RTW-I reduced sick leave faster than CBT. We conclude that CBT may be promising as an effective treatment of stress and exhaustion disorder. AD - Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden. Department of Neurobiology, Division of Family medicine, Care Sciences and Society (NVS), H1, Karolinska Institutet, Stockholm, Sweden. Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden. Department of Psychology, Stockholm University, Stockholm, Sweden. Stress Research Institute, Stockholm University, Stockholm, Sweden. AN - 31691305 AU - Salomonsson, S. AU - Santoft, F. AU - Lindsater, E. AU - Ejeby, K. AU - Ingvar, M. AU - Ljotsson, B. AU - Ost, L. G. AU - Lekander, M. AU - Hedman-Lagerlof, E. CN - Medline 211026 DA - Apr DB - Medline DO - 10.1111/sjop.12590 DP - NLM ET - 20191106 IS - 2 J2 - Scand J Psychol KW - Adult *Cognitive Behavioral Therapy Female Humans Male Mental Disorders/psychology/*therapy Middle Aged *Return to Work *Sick Leave Treatment Outcome Young Adult Cbt Stress adjustment disorder depression exhaustion disorder return-to-work L1 - internal-pdf://1136071366/3087-Salomonsson-2020.pdf LA - English M3 - Randomized Controlled Trial N1 - Salomonsson, Sigrid Santoft, Fredrik Lindsater, Elin Ejeby, Kersti Ingvar, Martin Ljotsson, Brjann Ost, Lars-Goran Lekander, Mats Hedman-Lagerlof, Erik eng This study was funded by Karolinska Institutet and by research grants from Stockholm County Council/ Randomized Controlled Trial England 2019/11/07 Scand J Psychol. 2020 Apr;61(2):281-289. doi: 10.1111/sjop.12590. Epub 2019 Nov 6. PY - 2020 SN - 1467-9450 (Electronic) 0036-5564 (Linking) SP - 281-289 ST - Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial T2 - Scand J Psychol TI - Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial UR - https://www.ncbi.nlm.nih.gov/pubmed/31691305 VL - 61 ID - 3087 ER - TY - JOUR AB - OBJECTIVES: Common mental disorders (CMDs) cause great individual suffering and long-term sick leave. Cognitive-behavioural therapy (CBT) effectively treats CMDs, but sick leave is not reduced to the same extent as psychiatric symptoms. Research results regarding return-to-work interventions (RTW-Is) and their effect on sick leave are inconclusive. The aim of this study was to evaluate CBT, a RTW-I and combined CBT and RTW-I (COMBO) for primary care patients on sick leave due to CMDs. METHODS: Patients with CMDs (n=211) were randomised to CBT (n=64), RTW-I (n=67) or COMBO (n=80). Sick-leave registry data after 1 year and blinded Clinician's Severity Rating (CSR) of symptoms post-treatment and at follow-ups after 6 and 12 months were primary outcomes. RESULTS: There was no significant difference between treatments in days on sick leave 1 year after treatment start (mean difference in sick-leave days range=9-27). CBT led to larger reduction of symptoms post-treatment (CSR; Cohen's d=0.4 (95% CI 0.1 to 0.8)) than RTW-I, whereas COMBO did not differ from CBT or RTW-I. At follow-up, after 1 year, there was no difference between groups. All treatments were associated with large pre-treatment to post-treatment improvements, and results were maintained at 1-year follow-up. CONCLUSION: No treatment was superior to the other regarding reducing sick leave. All treatments effectively reduced symptoms, CBT in a faster pace than RTW-I, but at 1-year follow-up, all groups had similar symptom levels. Further research is needed regarding how CBT and RTW-I can be combined more efficiently to produce a larger effect on sick leave while maintaining effective symptom reduction. AD - Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden. Department of Neurobiology, Care Sciences and Society (NVS), H1, Division of Family Medicine, Karolinska Institutet, Stockholm, Sweden. Department of Psychology, Stockholm University, Stockholm, Sweden. Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden. Department of Neuroradiology, Karolinska University Hospital Stockholm, Stockholm, Sweden. Stress Research Institute, Stockholm University, Stockholm, Sweden. AN - 28756415 AU - Salomonsson, S. AU - Santoft, F. AU - Lindsater, E. AU - Ejeby, K. AU - Ljotsson, B. AU - Ost, L. G. AU - Ingvar, M. AU - Lekander, M. AU - Hedman-Lagerlof, E. C1 - Competing interests: None declared. CN - Medline 211026 DA - Dec DB - Medline DO - 10.1136/oemed-2017-104342 DP - NLM ET - 20170729 IS - 12 J2 - Occup Environ Med KW - Adult Behavior Therapy/*methods Cognitive Behavioral Therapy Female Humans Male Mental Disorders/*therapy Middle Aged *Return to Work *Sick Leave Treatment Outcome Young Adult cognitive behavioural therapy common mental disorders return-to-work L1 - internal-pdf://3768761666/3088-Salomonsson-2017.pdf LA - English M3 - Randomized Controlled Trial N1 - Salomonsson, Sigrid Santoft, Fredrik Lindsater, Elin Ejeby, Kersti Ljotsson, Brjann Ost, Lars-Goran Ingvar, Martin Lekander, Mats Hedman-Lagerlof, Erik eng Randomized Controlled Trial England 2017/08/02 Occup Environ Med. 2017 Dec;74(12):905-912. doi: 10.1136/oemed-2017-104342. Epub 2017 Jul 29. PY - 2017 SN - 1470-7926 (Electronic) 1351-0711 (Linking) SP - 905-912 ST - Cognitive-behavioural therapy and return-to-work intervention for patients on sick leave due to common mental disorders: a randomised controlled trial T2 - Occup Environ Med TI - Cognitive-behavioural therapy and return-to-work intervention for patients on sick leave due to common mental disorders: a randomised controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/28756415 VL - 74 ID - 3088 ER - TY - JOUR AB - STUDY DESIGN: A cluster-randomized controlled trial. OBJECTIVE: To evaluate the effects of two strategies to increase the use of active sick leave (ASL) among patients with low back pain (LBP) on improved return to work and quality of life. SUMMARY OF BACKGROUND DATA: Active sick leave is an option provided by the Norwegian National Insurance Administration that enables employees to return to modified duties at the workplace with 100% of normal wages. A proactive implementation strategy increased the use of ASL for LBP patients from 11.5% to 17.7% compared with a passive intervention and a control group ( = 0.006). METHODS: Sixty-five municipalities were randomly assigned to a passive intervention, a proactive intervention, or a control group. The interventions, which were designed to improve the use of ASL, were targeted at patients on sick leave for LBP for more than 16 days (n = 6179), their general practitioners, employers, and local insurance officers. The main outcome measures were the average number of days off work, the proportion of patients returning to work within 1 year, and self-reported quality of life while on sick leave. RESULTS: The median number of days on sick leave was similar in the proactive intervention group (70 days), the passive intervention group (68 days), and the control group (71 days) ( = 0.8). The proportion of patients returning to work before 50 weeks was also similar in the proactive (89%), passive (89.5%), and control groups (89.1%). Response rates for the questionnaires that were sent to patients were low (38%), and no significant differences were observed across the three groups for quality of life or patient satisfaction. CONCLUSIONS: It is not likely that efforts to increase the use of ASL will result in measurable economic benefits or improved health outcomes at the population level. The benefits of ASL for individual patients with LBP are not known. AD - Department of Social Services Research, Norwegian Directorate for Health and Social Welfare, Oslo, Norway. inger.scheel@shdir.no AN - 12461401 AU - Scheel, I. B. AU - Hagen, K. B. AU - Herrin, J. AU - Carling, C. AU - Oxman, A. D. CN - Medline 211026 DA - Dec 1 DB - Medline DO - 10.1097/00007632-200212010-00014 DP - NLM IS - 23 J2 - Spine KW - Back Pain/*rehabilitation Cluster Analysis Humans Norway *Outcome and Process Assessment, Health Care Patient Satisfaction Program Evaluation/economics/*statistics & numerical data Quality of Life *Rehabilitation, Vocational Sick Leave/classification/economics/*statistics & numerical data Surveys and Questionnaires *Workload L1 - internal-pdf://3817656851/3130-Scheel-2002.pdf LA - English M3 - Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Scheel, Inger B Hagen, Kare Birger Herrin, Jeph Carling, Cheryl Oxman, Andrew D eng Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't 2002/12/04 Spine (Phila Pa 1976). 2002 Dec 1;27(23):2734-40. doi: 10.1097/00007632-200212010-00014. PY - 2002 SN - 1528-1159 (Electronic) 0362-2436 (Linking) SP - 2734-40 ST - Blind faith? The effects of promoting active sick leave for back pain patients: a cluster-randomized controlled trial T2 - Spine (Phila Pa 1976) TI - Blind faith? The effects of promoting active sick leave for back pain patients: a cluster-randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/12461401 VL - 27 ID - 3130 ER - TY - JOUR AB - OBJECTIVE: To investigate return to work and cost-effectiveness of the addition of cognitive-behavioral treatment to standard therapy compared to standard 3-week inpatient rehabilitation for patients with chronic low back pain. METHODS: A prospective economic evaluation alongside a randomized controlled trial was performed. Outcomes included days off work due to spinal complaints, health-related quality of life, and direct and indirect disease-related costs. RESULTS: A total of 409 patients with chronic low back pain, who were admitted to a 3-week inpatient rehabilitation, were randomly assigned to usual care or usual care plus cognitive behavioral treatment. Average incremental costs for psychological treatment during rehabilitation were Euros 127 (95% CI 125.6, 130.9; p < 0.001). Six months after rehabilitation, patients in the intervention group were absent from work an average of 5.4 (95% CI -1.4, 12.1; p = 0.12) days less than patients receiving usual treatment. Between groups, there were no significant differences in quality-adjusted life-years gained or in direct medical or nonmedical costs. The cognitive behavioral treatment showed lower indirect costs: Euros 751 (95% CI -145, 1641; p = 0.097). CONCLUSION: Adding a cognitive behavioral component to standard therapy may reduce work days lost and thus decrease indirect costs. From a societal perspective, the cost of the psychological treatment was compensated by lower indirect costs. AD - GSF - National Research Center for Environment and Health, Institute of Health Economics and Health Care Management, Neuherberg. Germany. bernd.schweikert@gsf.de AN - 17143986 AU - Schweikert, B. AU - Jacobi, E. AU - Seitz, R. AU - Cziske, R. AU - Ehlert, A. AU - Knab, J. AU - Leidl, R. CN - Medline 211026 DA - Dec DB - Medline DP - NLM IS - 12 J2 - J Rheumatol KW - Chronic Disease Cognitive Behavioral Therapy/*economics Combined Modality Therapy Cost-Benefit Analysis Employment Health Care Costs Humans Low Back Pain/physiopathology/*psychology/*rehabilitation Prospective Studies Quality of Life Sick Leave Treatment Outcome L1 - internal-pdf://2794649868/3168-Schweikert-2006.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Schweikert, Bernd Jacobi, Eckart Seitz, Robert Cziske, Reinhard Ehlert, Antje Knab, Julia Leidl, Reiner eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Canada 2006/12/05 J Rheumatol. 2006 Dec;33(12):2519-26. PY - 2006 SN - 0315-162X (Print) 0315-162X (Linking) SP - 2519-26 ST - Effectiveness and cost-effectiveness of adding a cognitive behavioral treatment to the rehabilitation of chronic low back pain T2 - J Rheumatol TI - Effectiveness and cost-effectiveness of adding a cognitive behavioral treatment to the rehabilitation of chronic low back pain UR - https://www.ncbi.nlm.nih.gov/pubmed/17143986 VL - 33 ID - 3168 ER - TY - JOUR AB - Objectives This study aimed to evaluate the effectiveness of a workplace intervention (WI) added to an inpatient multimodal occupational rehabilitation program (I-MORE) on sickness absence. Methods In this researcher-blinded randomized controlled trial with parallel groups, individuals on sick leave due to musculoskeletal, unspecified- or common mental health disorders were randomized to I-MORE (N=87) or I-MORE+WI (N=88). I-MORE lasted 2+1 weeks (with one week at home in between) and consisted of "acceptance and commitment therapy", physical exercise, and work-related problem solving. The additional WI consisted of a preparatory part, a workplace meeting involving the sick-listed worker, the employer, and the primary rehabilitation therapist at the rehabilitation center, and follow-up work related to the meeting. The primary outcomes were number of sickness absence days and time until sustainable return to work (RTW) during 12 months of follow-up, measured by registry data. Results The median number of sickness absence days during the 12-month follow-up for I-MORE was 115 days [interquartile range (IQR) 53-183] versus 130 days (IQR 81-212) for I-MORE+WI. The difference between groups was not statistically significant (P=0.084). The hazard ratio for sustainable RTW was 0.74 (95% confidence interval 0.48-1.16; P=0.192) in favor of I-MORE. Conclusions This study provided no evidence in favor of I-MORE+WI compared to only I-MORE for long-term sickness absent individuals with musculoskeletal-, common mental- or unspecified disorders. AD - Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Postboks 8905, 7491 Trondheim, Norway. mskagseth@gmail.com. AN - 31834410 AU - Skagseth, M. AU - Fimland, M. S. AU - Rise, M. B. AU - Johnsen, R. AU - Borchgrevink, P. C. AU - Aasdahl, L. C1 - The authors declare no conflicts of interest. C2 - PMC8506308 CN - Medline 211026 DA - Jul 1 DB - Medline DO - 10.5271/sjweh.3873 DP - NLM ET - 20191213 IS - 4 J2 - Scand J Work Environ Health KW - Adolescent Adult Female Humans Inpatients Male Mental Disorders/*rehabilitation Middle Aged Musculoskeletal Diseases/*rehabilitation *Occupational Health Services Return to Work/*statistics & numerical data Sick Leave/*statistics & numerical data Single-Blind Method *Workplace Young Adult L1 - internal-pdf://3155940772/3233-Skagseth-2020.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Skagseth, Martin Fimland, Marius S Rise, Marit B Johnsen, Roar Borchgrevink, Petter C Aasdahl, Lene eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Finland 2019/12/14 Scand J Work Environ Health. 2020 Jul 1;46(4):356-363. doi: 10.5271/sjweh.3873. Epub 2019 Dec 13. PY - 2020 SN - 1795-990X (Electronic) 0355-3140 (Print) 0355-3140 (Linking) SP - 356-363 ST - Effectiveness of adding a workplace intervention to an inpatient multimodal occupational rehabilitation program: A randomized clinical trial T2 - Scand J Work Environ Health TI - Effectiveness of adding a workplace intervention to an inpatient multimodal occupational rehabilitation program: A randomized clinical trial UR - https://www.ncbi.nlm.nih.gov/pubmed/31834410 VL - 46 ID - 3233 ER - TY - JOUR AB - Former studies have questioned the quality and effectiveness of multidisciplinary rehabilitation for working-age adults with fibromyalgia and chronic widespread pain (CWP). High-quality trials are needed, and return to work should also be included as an outcome variable. This randomized study evaluated the return-to-work outcome of an extensive and a light multidisciplinary treatment program combining cognitive strategies and exercise versus treatment-as-usual initiated by a general practitioner, for CWP patients. The patients (n=208), on sick leave for 3 months on average, were randomized to the extensive program including group sessions, a light and more individual program, and to treatment-as-usual. The number of days absent from work and full return to work were used as an outcome, and follow-up lasted 54 months after the programs ended. The regression analysis showed that the extensive program was associated with significantly fewer days absent from work among women. For women, the mean effect of extensive treatment versus treatment-as-usual on total number of days absent from work was estimated to -206.95 days. Among men, the light program was associated with significantly more days absent from work compared to treatment-as-usual. Both among men and women, independent of type of treatment, patients with poorer health (poor prognosis) were absent from work more days than patients with good prognosis. In our sample, higher age significantly increased the number of days absent from work, but only for women. The extensive outpatient multidisciplinary treatment program was effective in returning women to work. AD - Outpatient Spine Clinic, Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, N-5021 Bergen, Norway. jssk@helse-bergen.no AN - 16310718 AU - Skouen, J. S. AU - Grasdal, A. AU - Haldorsen, E. M. CN - Medline 211026 DA - Feb DB - Medline DO - 10.1016/j.ejpain.2005.02.005 DP - NLM IS - 2 J2 - Eur J Pain KW - Adult Age Distribution Ambulatory Care/methods/organization & administration Chronic Disease *Employment Family Practice/*methods Female Fibromyalgia/complications/*therapy Follow-Up Studies Humans Male Middle Aged Pain/etiology Pain Clinics/*organization & administration *Pain Management Primary Health Care/methods Program Evaluation Regression Analysis Sex Distribution Sick Leave L1 - internal-pdf://0649463020/3241-Skouen-2006.pdf LA - English M3 - Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Skouen, Jan Sture Grasdal, Astrid Haldorsen, Ellen M H eng Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2005/11/29 Eur J Pain. 2006 Feb;10(2):145-52. doi: 10.1016/j.ejpain.2005.02.005. PY - 2006 SN - 1090-3801 (Print) 1090-3801 (Linking) SP - 145-52 ST - Return to work after comparing outpatient multidisciplinary treatment programs versus treatment in general practice for patients with chronic widespread pain T2 - Eur J Pain TI - Return to work after comparing outpatient multidisciplinary treatment programs versus treatment in general practice for patients with chronic widespread pain UR - https://www.ncbi.nlm.nih.gov/pubmed/16310718 VL - 10 ID - 3241 ER - TY - JOUR AB - STUDY DESIGN: A subgroup of 195 patients with chronic low back pain, being part of a larger study of other musculoskeletal patients, were included in a randomized controlled prospective clinical study. OBJECTIVES: To evaluate the outcome in terms of return to work and cost-effectiveness of a light multidisciplinary treatment program with an extensive multidisciplinary program and treatment as usual initiated by their general practitioner. SUMMARY OF BACKGROUND DATA: Light multidisciplinary programs seem to reduce sick leave in patients with subacute low back pain. There are few, if any, previous studies of the effectiveness of light versus extensive multidisciplinary treatment on return to work in patients with chronic low back pain. METHODS: Patients with chronic low back pain (n = 195), on an average sick-listed for 3 months, were included. The patients were randomized to a light multidisciplinary treatment program, an extensive multidisciplinary program, or treatment as usual by their primary physician. Full return to work was used as outcome response, and follow-up was 26 months after the end of treatment. Cost-benefit was calculated for the treatment programs. RESULTS: In men significantly better results for full return to work were found for the light multidisciplinary treatment compared with treatment as usual, but no differences were found between extensive multidisciplinary treatment and treatment as usual. No significant differences between any of the two multidisciplinary treatment programs and the controls were found for women. Productivity gains for the society from light multidisciplinary treatment versus "treatment as usual" of 57 male patients with low back pain would during the first 2 years accumulate to U.S. $852.000. CONCLUSIONS: The light multidisciplinary treatment model is a cost-effective treatment for men with chronic low back pain. AD - Outpatient Spine Clinic, Haukeland University Hospital, Norway. jssk@haukeland.no AN - 11979157 AU - Skouen, J. S. AU - Grasdal, A. L. AU - Haldorsen, E. M. AU - Ursin, H. CN - Medline 211026 DA - May 1 DB - Medline DO - 10.1097/00007632-200205010-00002 DP - NLM IS - 9 J2 - Spine KW - Adult Aged Chronic Disease Cost-Benefit Analysis Female Follow-Up Studies Health Care Costs/*statistics & numerical data Humans Low Back Pain/*economics/*rehabilitation Male Middle Aged Norway Odds Ratio Outcome Assessment, Health Care/*economics/statistics & numerical data Pain Clinics/statistics & numerical data Risk Sex Factors *Sick Leave/statistics & numerical data Time L1 - internal-pdf://2451052835/3242-Skouen-2002.pdf LA - English M3 - Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Skouen, Jan S Grasdal, Astrid L Haldorsen, Ellen M H Ursin, Holger eng Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2002/04/30 Spine (Phila Pa 1976). 2002 May 1;27(9):901-9; discussion 909-10. doi: 10.1097/00007632-200205010-00002. PY - 2002 SN - 1528-1159 (Electronic) 0362-2436 (Linking) SP - 901-9; discussion 909-10 ST - Relative cost-effectiveness of extensive and light multidisciplinary treatment programs versus treatment as usual for patients with chronic low back pain on long-term sick leave: randomized controlled study T2 - Spine (Phila Pa 1976) TI - Relative cost-effectiveness of extensive and light multidisciplinary treatment programs versus treatment as usual for patients with chronic low back pain on long-term sick leave: randomized controlled study UR - https://www.ncbi.nlm.nih.gov/pubmed/11979157 VL - 27 ID - 3242 ER - TY - JOUR AB - BACKGROUND: Low back pain is a common medical and social problem frequently associated with disability and absence from work. However, data on effective return to work after interventions for low back pain are scarce. OBJECTIVE: To determine the effectiveness of a behavior-oriented graded activity program compared with usual care. DESIGN: Randomized, controlled trial. SETTING: Occupational health services department of an airline company in the Netherlands. PATIENTS: 134 workers who were absent from work because of low back pain were randomly assigned to either graded activity (n = 67) or usual care (n = 67). INTERVENTION: Graded activity, a physical exercise program based on operant-conditioning behavioral principles, to stimulate a rapid return to work. MEASUREMENTS: Outcomes were the number of days of absence from work because of low back pain, functional status (Roland Disability Questionnaire), and severity of pain (11-point numerical scale). RESULTS: The median number of days of absence from work over 6 months of follow-up was 58 days in the graded activity group and 87 days in the usual care group. From randomization onward, graded activity was effective after 50 days of absence from work (hazard ratio, 1.9 [95% CI, 1.2 to 3.2]; P = 0.009). The graded activity group was more effective in improving functional status and pain than the usual care group. The effects, however, were small and not statistically significant. CONCLUSIONS: Graded activity was more effective than usual care in reducing the number of days of absence from work because of low back pain. AD - Institute for Research in Extramural Medicine and the Department of Social Medicine, VU University Medical Center, Amsterdam, The Netherlands. AN - 14734329 AU - Staal, J. B. AU - Hlobil, H. AU - Twisk, J. W. AU - Smid, T. AU - Koke, A. J. AU - van Mechelen, W. CN - Medline 211026 DA - Jan 20 DB - Medline DO - 10.7326/0003-4819-140-2-200401200-00007 DP - NLM ET - 2004/01/22 IS - 2 J2 - Ann Intern Med KW - Absenteeism Behavior Therapy/*methods Conditioning, Operant Disability Evaluation *Exercise Therapy Humans Low Back Pain/physiopathology/*therapy Occupational Diseases/physiopathology/*therapy Occupational Health Services/*methods Single-Blind Method Treatment Outcome L1 - internal-pdf://2435619505/3289-Staal-2004.pdf LA - English M3 - Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Staal, J Bart Hlobil, Hynek Twisk, Jos W R Smid, Tjabe Koke, Albere J A van Mechelen, Willem eng Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't 2004/01/22 Ann Intern Med. 2004 Jan 20;140(2):77-84. doi: 10.7326/0003-4819-140-2-200401200-00007. PY - 2004 SN - 1539-3704 (Electronic) 0003-4819 (Linking) SP - 77-84 ST - Graded activity for low back pain in occupational health care: a randomized, controlled trial T2 - Ann Intern Med TI - Graded activity for low back pain in occupational health care: a randomized, controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/14734329 VL - 140 ID - 3289 ER - TY - JOUR AB - BACKGROUND: Low back pain is a common medical and social problem associated with disability and absence from work. Knowledge on effective return to work (RTW) interventions is scarce. OBJECTIVE: To determine the effectiveness of graded activity as part of a multistage RTW programme. DESIGN: Randomised controlled trial. SETTING: Occupational healthcare. SUBJECTS: 112 workers absent from work for more than eight weeks due to low back pain were randomised to either graded activity (n = 55) or usual care (n = 57). INTERVENTION: Graded activity, a physical exercise programme aimed at RTW based on operant-conditioning behavioural principles. MAIN OUTCOME MEASURES: The number of days off work until first RTW for more then 28 days, total number of days on sick leave during follow up, functional status, and severity of pain. Follow up was 26 weeks. RESULTS: Graded activity prolonged RTW. Median time until RTW was equal to the total number of days on sick leave and was 139 (IQR = 69) days in the graded activity group and 111 (IQR = 76) days in the usual care group (hazard ratio = 0.52, 95% CI 0.32 to 0.86). An interaction between a prior workplace intervention and graded activity, together with a delay in the start of the graded activity intervention, explained most of the delay in RTW (hazard ratio = 0.86, 95% CI 0.40 to 1.84 without prior intervention and 0.39, 95% CI 0.19 to 0.81 with prior intervention). Graded activity did not improve pain or functional status clinically significantly. CONCLUSIONS: Graded activity was not effective for any of the outcome measures. Different interventions combined can lead to a delay in RTW. Delay in referral to graded activity delays RTW. In implementing graded activity special attention should be paid to the structure and process of care. AD - Coronel Institute for Occupational and Environmental Health, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands. AN - 16847036 AU - Steenstra, I. A. AU - Anema, J. R. AU - Bongers, P. M. AU - de Vet, H. C. AU - Knol, D. L. AU - van Mechelen, W. C1 - Competing interests: none. C2 - PMC2077992 CN - Medline 211026 DA - Nov DB - Medline DO - 10.1136/oem.2005.021675 DP - NLM ET - 20060717 IS - 11 J2 - Occup Environ Med KW - Adolescent Adult Aged Behavior Therapy/methods Disability Evaluation *Exercise Therapy Female Humans Low Back Pain/diagnosis/*rehabilitation Male Middle Aged Occupational Health Services/*methods Pain Measurement Sick Leave L1 - internal-pdf://3923158907/3305-Steenstra-2006.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Steenstra, I A Anema, J R Bongers, P M de Vet, H C W Knol, D L van Mechelen, W eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2006/07/19 Occup Environ Med. 2006 Nov;63(11):718-25. doi: 10.1136/oem.2005.021675. Epub 2006 Jul 17. PY - 2006 SN - 1470-7926 (Electronic) 1351-0711 (Print) 1351-0711 (Linking) SP - 718-25 ST - The effectiveness of graded activity for low back pain in occupational healthcare T2 - Occup Environ Med TI - The effectiveness of graded activity for low back pain in occupational healthcare UR - https://www.ncbi.nlm.nih.gov/pubmed/16847036 VL - 63 ID - 3305 ER - TY - JOUR AB - OBJECTIVE: To evaluate the cost-effectiveness and cost-utility of a return to work (RTW) program for workers on sick-leave due to low back pain (LBP), comparing a workplace intervention implemented between 2 to 8 weeks of sick-leave with usual care, and a clinical intervention after 8 weeks of sick-leave with usual care. DESIGN: Economic evaluation alongside a randomised controlled trial (RCT). STUDY POPULATION: Workers sick-listed for a period of 2 to 6 weeks due to LBP. INTERVENTIONS: 1. workplace assessment, work modifications and case management). 2. physiotherapy based on operant behavioural principles. 3. usual care: provided by an occupational physician. OUTCOMES: The primary outcome was return to work (RTW). Other outcomes were pain intensity, functional status, quality of life and general health. The economic evaluation was conducted from a societal perspective. Outcomes were assessed at baseline (after 2-6 weeks on sick-leave), and 12 weeks, 26 weeks, and 52 weeks after the first day of sick-leave. RESULTS: The workplace intervention group returned to work 30.0 days (95% CI=[3.1, 51.3]) earlier on average than the usual care group at slightly higher direct costs (ratio of 1 day: 19 euro). Workers in the clinical intervention group that had received usual care in the first 8 weeks returned to work 21.3 days (95% CI= [-74.1, 29.2]) later on average. The group that had received the workplace intervention in the first 8 weeks and the clinical intervention after 8 weeks returned to work 50.9 days (95% CI=[-89.4, -2.7]) later on average. A workplace intervention was more effective than usual care in RTW at slightly higher costs and was equally effective as usual care at equal costs on other outcomes. A clinical intervention was less effective than usual care and associated with higher costs. CONCLUSION: The workplace intervention results in a safe and faster RTW than usual care at reasonable costs for workers on sick-leave for two to six weeks due to LBP. AD - Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands. AN - 17086503 AU - Steenstra, I. A. AU - Anema, J. R. AU - van Tulder, M. W. AU - Bongers, P. M. AU - de Vet, H. C. AU - van Mechelen, W. CN - Medline 211026 DA - Dec DB - Medline DO - 10.1007/s10926-006-9053-0 DP - NLM IS - 4 J2 - J Occup Rehabil KW - Adolescent Adult Aged Behavior Therapy/*economics/methods Cost of Illness Cost-Benefit Analysis Ergonomics Female *Health Care Costs Humans Low Back Pain/economics/*rehabilitation Male Middle Aged Netherlands Occupational Diseases/economics/*rehabilitation Occupational Health Nursing Occupational Therapy/*economics/methods Rehabilitation, Vocational/*economics/methods L1 - internal-pdf://1135759084/3307-Steenstra-2006.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Steenstra, Ivan A Anema, Johannes R van Tulder, Maurits W Bongers, Paulien M de Vet, Henrica C W van Mechelen, Willem eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2006/11/07 J Occup Rehabil. 2006 Dec;16(4):557-78. doi: 10.1007/s10926-006-9053-0. PY - 2006 SN - 1053-0487 (Print) 1053-0487 (Linking) SP - 557-78 ST - Economic evaluation of a multi-stage return to work program for workers on sick-leave due to low back pain T2 - J Occup Rehabil TI - Economic evaluation of a multi-stage return to work program for workers on sick-leave due to low back pain UR - https://www.ncbi.nlm.nih.gov/pubmed/17086503 VL - 16 ID - 3307 ER - TY - JOUR AB - STUDY DESIGN: A randomized, controlled trial. OBJECTIVE: To examine the impact of physical function and pain on work status in patients who are long-term sick-listed because of back pain. SUMMARY OF BACKGROUND DATA: Sickness benefit is granted to a person who is incapable of working because of reduced functioning. Improved physical function and decrease of pain may be important in considering return to work. METHODS: Physical performance (five activities), disability, and pain (self-reported questionnaires) were assessed at baseline and at the 1-year follow-up evaluation in 117 patients randomized to an intervention group (n = 81) and a control group (n = 36). RESULTS: At the 1-year follow-up evaluation, 50% had returned to work. Statistically significant improvements were demonstrated from baseline to follow-up evaluation in returners to work: in the intervention group on all tests and in the control group on all except two performance tests. Improvement measures discriminated between returners and nonreturners to work in the intervention group on all physical tests and a pain test and in the control group on three physical tests and a pain test. In the intervention group, odds ratios for not having returned to work were high when test measures at follow-up indicated markedly impaired physical function and high pain; in the control group, this appeared in high pain. CONCLUSIONS: Return to work was related to physical function and pain. More importance seemed to be attributed to physical performance in the intervention group than in the controls as a basis for returning patients to work. AD - Section of Physiotherapy Science, Faculty of Medicine, University of Bergen, Norway. liv.strand@isf.uib.no AN - 11295903 AU - Strand, L. I. AU - Ljunggren, A. E. AU - Haldorsen, E. M. AU - Espehaug, B. CN - Medline 211026 DA - Apr 1 DB - Medline DO - 10.1097/00007632-200104010-00022 DP - NLM IS - 7 J2 - Spine KW - Adult Back Pain/*physiopathology Disability Evaluation Female Follow-Up Studies Humans Male Middle Aged Pain/*physiopathology Physical Fitness/*physiology Work/*physiology/statistics & numerical data L1 - internal-pdf://2373301072/3328-Strand-2001.pdf LA - English M3 - Clinical Trial Randomized Controlled Trial N1 - Strand, L I Ljunggren, A E Haldorsen, E M Espehaug, B eng Clinical Trial Randomized Controlled Trial 2001/04/11 Spine (Phila Pa 1976). 2001 Apr 1;26(7):800-8. doi: 10.1097/00007632-200104010-00022. PY - 2001 SN - 0362-2436 (Print) 0362-2436 (Linking) SP - 800-8 ST - The impact of physical function and pain on work status at 1-year follow-up in patients with back pain T2 - Spine (Phila Pa 1976) TI - The impact of physical function and pain on work status at 1-year follow-up in patients with back pain UR - https://www.ncbi.nlm.nih.gov/pubmed/11295903 VL - 26 ID - 3328 ER - TY - JOUR AB - Purpose Purpose is to: (1) study effectiveness of the hospital-based work support intervention for cancer patients at two years of follow-up compared to usual care and (2) identify which early factors predict time to return-to-work (RTW). Methods In this multi-center randomised controlled trial (RCT), 106 (self-)employed cancer patients were randomized to an intervention group or control group and provided 2 years of follow-up data. The intervention group received patient education and work-related support at the hospital. Primary outcome was RTW (rate and time) and quality of life (SF-36), and secondary outcomes were, work ability (WAI), and work functioning (WLQ). Univariate Cox regression analyses were performed to study which early factors predict time to full RTW. Results Participants were diagnosed with breast (61%), gynaecological cancer (35%), or other type of cancer (4%). RTW rates were 84% and 90% for intervention versus control group. They were high compared to national register-based studies. No differences between groups were found on any of the outcomes. Receiving chemotherapy (HR = 2.43, 95% CI 1.59-3.73 p < 0.001), low level of education (HR = 1.65, 95% CI 1.076-2.52 p = 0.02) and low work ability (HR = 1.09 [95% CI 1.04-1.17] p = 0.02) were associated with longer time to full RTW. Conclusions We found high RTW rates compared to national register-based studies and we found no differences between groups. Future studies should therefore focus on reaching the group at risk, which consist of patients who receive chemotherapy, have a low level of education and have a low work ability at diagnosis. TRIAL REGISTRATION: Netherlands Trial Registry (NTR) (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1658): NTR1658. AD - Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. Finnish Institute of Occupational Health, Kuopio, Finland. Department of Internal Medicine, Reinier de Graaf Groep, Delft, The Netherlands. Department of Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands. Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands. Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. a.g.deboer@amc.nl. AN - 30778742 AU - Tamminga, S. J. AU - Verbeek, Jham AU - Bos, Mmem AU - Fons, G. AU - Kitzen, Jjem AU - Plaisier, P. W. AU - Frings-Dresen, M. H. W. AU - de Boer, Agem C1 - Authors Tamminga, Verbeek, Bos, Fons, Kitzen, Plaisier, Frings-Dresen and de Boer declare that they have no competing interest. C2 - PMC6838305 CN - Medline 211026 DA - Dec DB - Medline DO - 10.1007/s10926-019-09831-8 DP - NLM IS - 4 J2 - J Occup Rehabil KW - Adult Female Follow-Up Studies Humans Male Middle Aged Neoplasms/*rehabilitation Physical Functional Performance Program Evaluation Proportional Hazards Models Quality of Life Return to Work/psychology/*statistics & numerical data Time Factors Hospital Neoplasms Oncology service Program effectiveness Randomized controlled trial Return to work L1 - internal-pdf://2239119789/3381-Tamminga-2019.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Tamminga, S J Verbeek, J H A M Bos, M M E M Fons, G Kitzen, J J E M Plaisier, P W Frings-Dresen, M H W de Boer, A G E M eng ?Pathways to work? (www.verbeteronderzoek.nl)/Instituut Gak/International CANWON IS1211/European Cooperation in Science and Technology/International Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2019/02/20 J Occup Rehabil. 2019 Dec;29(4):701-710. doi: 10.1007/s10926-019-09831-8. PY - 2019 SN - 1573-3688 (Electronic) 1053-0487 (Print) 1053-0487 (Linking) SP - 701-710 ST - Two-Year Follow-Up of a Multi-centre Randomized Controlled Trial to Study Effectiveness of a Hospital-Based Work Support Intervention for Cancer Patients T2 - J Occup Rehabil TI - Two-Year Follow-Up of a Multi-centre Randomized Controlled Trial to Study Effectiveness of a Hospital-Based Work Support Intervention for Cancer Patients UR - https://www.ncbi.nlm.nih.gov/pubmed/30778742 VL - 29 ID - 3381 ER - TY - JOUR AB - OBJECTIVE: One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial. METHODS: Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65) or control group (n = 68). The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial), quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis. RESULTS: Return-to-work rates were 86% and 83% (p = 0.6) for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14-435) versus 192 days (range 82-465) (p = 0.90) with a hazard ratio of 1.03 (95% CI 0.64-1.6). Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups. CONCLUSION: The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which aspects of the intervention are useful and which elements need improvement. TRIAL REGISTRATION: Nederlands Trial Register (NTR) 1658. AD - Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. S.J.Tamminga@amc.uva.nl AN - 23717406 AU - Tamminga, S. J. AU - Verbeek, J. H. AU - Bos, M. M. AU - Fons, G. AU - Kitzen, J. J. AU - Plaisier, P. W. AU - Frings-Dresen, M. H. AU - de Boer, A. G. C1 - Competing Interests: Co-author Angela de Boer is a PLOS ONE Editorial Board member and Jos Verbeek has done so in the past. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials. C2 - PMC3661555 CN - Medline 211026 DB - Medline DO - 10.1371/journal.pone.0063271 DP - NLM ET - 20130522 IS - 5 J2 - PLoS ONE KW - Cost-Benefit Analysis/*economics Female Hospitals Humans Male Middle Aged Neoplasms/*economics/*rehabilitation Physician-Patient Relations Quality of Life Return to Work/*economics Sick Leave/economics Work/*economics L1 - internal-pdf://4058181506/3382-Tamminga-2013.pdf LA - English M3 - Clinical Trial Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Tamminga, Sietske J Verbeek, Jos H A M Bos, Monique M E M Fons, Guus Kitzen, Jos J E M Plaisier, Peter W Frings-Dresen, Monique H W de Boer, Angela G E M eng Clinical Trial Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2013/05/30 PLoS One. 2013 May 22;8(5):e63271. doi: 10.1371/journal.pone.0063271. Print 2013. PY - 2013 SN - 1932-6203 (Electronic) 1932-6203 (Linking) SP - e63271 ST - Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial T2 - PLoS One TI - Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/23717406 VL - 8 ID - 3382 ER - TY - JOUR AB - Purpose Evidence-based guidelines in occupational health care improve the quality of care and may reduce sickness absence duration. Notwithstanding that, guideline adherence of occupational physicians (OPs) is limited. Based on the literature on guideline implementation, an intervention was developed that was shown to effectively improve self-reported adherence in OPs. The aim of present study was to evaluate whether this intervention leads to earlier return to work (RTW) in workers with common mental disorders (CMD). Methods In a two-armed cluster randomized controlled trial, 66 OPs were randomized. The trial included 3379 workers, with 1493 in the intervention group and 1886 in the control group. The outcome measures were: time to full RTW, time to first RTW, and total hours of sickness absence. Cox regression analyses and generalized linear mixed model analyses were used for the evaluations. Results The median time to RTW was 154 days among the 3228 workers with CMD. No significant differences occurred in (time to) full RTW between intervention and control group HR 0.96 (95% CI 0.81-1.15) nor for first RTW HR 0.96 (95% CI 0.80-1.15). The mean total hours of sickness absence was 478 h in the intervention group and 483 h in the control group. Conclusions The intervention to enhance OPs' guideline adherence did not lead to earlier RTW in workers with CMD guided by the OPs. Possible explanations are the remaining external barriers for guideline use, and that perceived guideline adherence might not represent actual guideline adherence and improved care.Trail registration: ISRCTN86605310. AD - Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands. Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands. e.p.m.brouwers@tilburguniversity.edu. Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands. Phrenos Centre of Expertise, PO Box 1203, 3500 BE, Utrecht, The Netherlands. Parnassia Group, Dijk en Duin Mental Health Center, PO Box 305, 1900 AH, Castricum, The Netherlands. Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. Netherlands School of Public & Occupational Health, PO Box 20022, 3502 LA, Utrecht, The Netherlands. AN - 27904985 AU - van Beurden, K. M. AU - Brouwers, E. P. M. AU - Joosen, M. C. W. AU - de Boer, M. R. AU - van Weeghel, J. AU - Terluin, B. AU - van der Klink, J. J. L. C1 - JJLvdK was the manager and main author of the NVAB guideline. JJLvdK did not receive fees for the use of the guideline. KMvB, EPMB, MCWJ, MRdB, BT declare that they have no conflicts of interests. C2 - PMC5709451 CN - Medline 211026 DA - Dec DB - Medline DO - 10.1007/s10926-016-9682-x DP - NLM IS - 4 J2 - J Occup Rehabil KW - Adult Female *Guideline Adherence Humans Male Mental Disorders/*rehabilitation Middle Aged Occupational Health Services/*standards Proportional Hazards Models Return to Work/*statistics & numerical data Self Report Sick Leave/*statistics & numerical data Time Factors Mental health Occupational health service Occupational medicine Practice guideline Return to work L1 - internal-pdf://1634047382/3473-van Beurden-2017.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial N1 - van Beurden, Karlijn M Brouwers, Evelien P M Joosen, Margot C W de Boer, Michiel R van Weeghel, Jaap Terluin, Berend van der Klink, Jac J L eng 208030001/ZonMw/ Multicenter Study Randomized Controlled Trial Netherlands 2016/12/03 J Occup Rehabil. 2017 Dec;27(4):559-567. doi: 10.1007/s10926-016-9682-x. PY - 2017 SN - 1573-3688 (Electronic) 1053-0487 (Print) 1053-0487 (Linking) SP - 559-567 ST - Effectiveness of an Intervention to Enhance Occupational Physicians' Guideline Adherence on Sickness Absence Duration in Workers with Common Mental Disorders: A Cluster-Randomized Controlled Trial T2 - J Occup Rehabil TI - Effectiveness of an Intervention to Enhance Occupational Physicians' Guideline Adherence on Sickness Absence Duration in Workers with Common Mental Disorders: A Cluster-Randomized Controlled Trial UR - https://www.ncbi.nlm.nih.gov/pubmed/27904985 VL - 27 ID - 3473 ER - TY - JOUR AB - OBJECTIVES: Given the individual and economic burden of chronic work disability in low back pain patients, there is a need for effective preventive interventions. The aim of the present study was to investigate whether problem-solving therapy had a supplemental value when added to behavioral graded activity, regarding days of sick leave and work status. DESIGN: Randomized controlled trial. PATIENTS AND SETTING: Employees who were recently on sick leave as a result of nonspecific low back pain were referred to the rehabilitation center by general practitioner, occupational physician, or rehabilitation physician. Forty-five employees had been randomly assigned to the experimental treatment condition that included behavioral graded activity and problem-solving therapy (GAPS), and 39 employees had been randomly assigned to behavioral graded activity and group education (GAGE). OUTCOME MEASURES: Days of sick leave and work status. Data were retrieved from occupational health services. RESULTS: Data analyses showed that employees in the GAPS group had significantly fewer days of sick leave in the second half-year after the intervention. Moreover, work status was more favorable for employees in this condition, in that more employees had a 100% return-to-work and fewer patients ended up receiving disability pensions one year after the intervention. Sensitivity analyses confirmed these results. CONCLUSIONS: The addition of problem-solving therapy to behavioral graded activity had supplemental value in employees with nonspecific low back pain. AD - Department of Medical, Clinical and Experimental Psychology, Maastricht University, 6200 MD Maastricht, The Netherlands. a.vandenhout@zw.unimaas.nl AN - 12616178 AU - van den Hout, J. H. AU - Vlaeyen, J. W. AU - Heuts, P. H. AU - Zijlema, J. H. AU - Wijnen, J. A. CN - Medline 211026 DA - Mar-Apr DB - Medline DO - 10.1097/00002508-200303000-00003 DP - NLM IS - 2 J2 - Clin J Pain KW - Adult Behavior Therapy/*methods Cognitive Behavioral Therapy/*methods Combined Modality Therapy *Disability Evaluation Disease Management Employment/statistics & numerical data Female Humans Low Back Pain/classification/diagnosis/etiology/*prevention & control Male Occupational Diseases/complications/prevention & control *Patient Education as Topic/methods Problem Solving Reproducibility of Results Sensitivity and Specificity Sick Leave/statistics & numerical data Treatment Outcome L1 - internal-pdf://0109386166/3485-van den Hout-2003.pdf LA - English M3 - Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - van den Hout, Johanna H C Vlaeyen, Johan W S Heuts, Peter H T G Zijlema, Johan H L Wijnen, Joseph A G eng Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2003/03/05 Clin J Pain. 2003 Mar-Apr;19(2):87-96. doi: 10.1097/00002508-200303000-00003. PY - 2003 SN - 0749-8047 (Print) 0749-8047 (Linking) SP - 87-96 ST - Secondary prevention of work-related disability in nonspecific low back pain: does problem-solving therapy help? A randomized clinical trial T2 - Clin J Pain TI - Secondary prevention of work-related disability in nonspecific low back pain: does problem-solving therapy help? A randomized clinical trial UR - https://www.ncbi.nlm.nih.gov/pubmed/12616178 VL - 19 ID - 3485 ER - TY - JOUR AB - AIMS: To compare an innovative activating intervention with "care as usual" (control group) for the guidance of employees on sickness leave because of an adjustment disorder. It was hypothesised that the intervention would be more effective than care as usual in lowering the intensity of symptoms, increasing psychological resources, and decreasing sickness leave duration. METHODS: A prospective, cluster randomised controlled trial was carried out with 192 patients on first sickness leave for an adjustment disorder. Symptom intensity, sickness duration, and return to work rates were measured at 3 months and 12 months. Analyses were performed on an intention to treat basis. RESULTS: At 3 months, significantly more patients in the intervention group had returned to work compared with the control group. At 12 months all patients had returned to work, but sickness leave was shorter in the intervention group than in the control group. The recurrence rate was lower in the intervention group. There were no differences between the two study groups with regard to the decrease of symptoms. At baseline, symptom intensity was higher in the patients than in a normal reference population, but decreased over time in a similar manner in both groups to approximately normal levels. CONCLUSION: The experimental intervention for adjustment disorders was successful in shortening sick leave duration, mainly by decreasing long term absenteeism. AD - Coronel Institute for Occupational and Environmental Health, Academic Medical Center, Netherlands. j.j.vanderklink@amc.uva.nl AN - 12771395 AU - van der Klink, J. J. AU - Blonk, R. W. AU - Schene, A. H. AU - van Dijk, F. J. C2 - PMC1740545 CN - Medline 211026 DA - Jun DB - Medline DO - 10.1136/oem.60.6.429 DP - NLM IS - 6 J2 - Occup Environ Med KW - *Absenteeism Adjustment Disorders/*prevention & control/rehabilitation Adult Analysis of Variance Cluster Analysis Cognitive Behavioral Therapy/*methods Female Health Status Humans Male Problem Solving Prospective Studies Rehabilitation, Vocational Secondary Prevention *Sick Leave Treatment Outcome L1 - internal-pdf://3982109280/3495-van der Klink-2003.pdf LA - English M3 - Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - van der Klink, J J L Blonk, R W B Schene, A H van Dijk, F J H eng Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2003/05/29 Occup Environ Med. 2003 Jun;60(6):429-37. doi: 10.1136/oem.60.6.429. PY - 2003 SN - 1351-0711 (Print) 1470-7926 (Electronic) 1351-0711 (Linking) SP - 429-37 ST - Reducing long term sickness absence by an activating intervention in adjustment disorders: a cluster randomised controlled design T2 - Occup Environ Med TI - Reducing long term sickness absence by an activating intervention in adjustment disorders: a cluster randomised controlled design UR - https://www.ncbi.nlm.nih.gov/pubmed/12771395 VL - 60 ID - 3495 ER - TY - JOUR AB - OBJECTIVES: To evaluate the cost effectiveness, cost utility and cost benefit of a workplace intervention compared with usual care for sick-listed employees with distress. METHODS: An economic evaluation was conducted alongside a randomised controlled trial. Employees with distress and who were sick-listed for 2-8 weeks were randomised to a workplace intervention (n=73) or to usual care (n=72). The workplace intervention is a stepwise process involving the sick-listed employee and their supervisor, aimed at formulating a consensus-based plan for return to work (RTW). The effect outcomes were lasting RTW and quality-adjusted life years (QALYs). Healthcare utilisation was measured over 12 months. Cost effectiveness analyses (CEA) and cost utility analyses (CUA) were conducted from the societal perspective and cost benefit analyses (CBA) from the employer perspective. Bootstrapping techniques were used to estimate cost and effect differences, related CIs, and cost effectiveness and cost utility ratios. Cost effectiveness planes were presented and subgroup analyses were performed. RESULTS: CEA and CUA revealed no statistically significant differences in lasting RTW, QALYs or costs. The CBA indicated a statistically significant higher cost of occupational health services in the workplace intervention group. The workplace intervention was not cost effective according to the CEA, CUA and CBA. CONCLUSIONS: Widespread implementation of the workplace intervention for sick-listed employees with distress is not recommended because there was no economic benefit compared with usual care. Future trials should confirm if the workplace intervention is cost effective for the subgroup employees who intended to return to work despite symptoms. This trial has been registered at the Dutch National Trial Register ISRCTN92307123. AD - Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. AN - 20798027 AU - van Oostrom, S. H. AU - Heymans, M. W. AU - de Vet, H. C. AU - van Tulder, M. W. AU - van Mechelen, W. AU - Anema, J. R. CN - Medline 211026 DA - Sep DB - Medline DO - 10.1136/oem.2009.051979 DP - NLM IS - 9 J2 - Occup Environ Med KW - Adult Anxiety/economics/rehabilitation Cost-Benefit Analysis Depression/economics/rehabilitation Efficiency, Organizational Epidemiologic Methods Female Health Care Costs/*statistics & numerical data Humans Male Middle Aged Netherlands Occupational Health Services/*economics/methods Prognosis Quality-Adjusted Life Years Sick Leave/statistics & numerical data Stress, Psychological/economics/*rehabilitation Treatment Outcome Workplace/psychology L1 - internal-pdf://2480227534/3525-van Oostrom-2010.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - van Oostrom, Sandra H Heymans, Martijn W de Vet, Henrica C W van Tulder, Maurits W van Mechelen, Willem Anema, Johannes R eng Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2010/08/28 Occup Environ Med. 2010 Sep;67(9):603-10. doi: 10.1136/oem.2009.051979. PY - 2010 SN - 1470-7926 (Electronic) 1351-0711 (Linking) SP - 603-10 ST - Economic evaluation of a workplace intervention for sick-listed employees with distress T2 - Occup Environ Med TI - Economic evaluation of a workplace intervention for sick-listed employees with distress UR - https://www.ncbi.nlm.nih.gov/pubmed/20798027 VL - 67 ID - 3525 ER - TY - JOUR AB - OBJECTIVES: To evaluate the effectiveness of a participatory workplace intervention compared with usual care for sick-listed employees with distress, with regard to return to work (RTW) within the 12-month follow-up. METHODS: Employees with distress and sick-listed for 2-8 weeks were randomised to a workplace intervention (n=73) or to usual care (n=72). The participatory workplace intervention is a stepwise process involving the sick-listed employee and their supervisor, aimed at reducing obstacles for RTW by reaching consensus about an action plan for RTW. Outcome variables were lasting RTW, cumulative sickness absence and stress-related symptoms. RESULTS: Overall, an HR of 0.99 (95% CI 0.70 to 1.39) indicated no effect of the workplace intervention on lasting RTW. However, the workplace intervention significantly reduced the time until lasting RTW for employees who at baseline intended to return to work despite symptoms with an HR of 2.05 (95% CI 1.22 to 3.45). Employees who intended to return to work despite symptoms returned to work after 55 days in the workplace intervention group and 120 days in the usual care group. No such effect of the intervention was found for employees without baseline intentions to return to work despite symptoms (HR=0.78, 95% CI 0.47 to 1.28). CONCLUSIONS: No overall effect of the participatory workplace intervention on lasting RTW was found. The workplace intervention appeared effective on lasting RTW for employees who at baseline intended to return to work despite symptoms. For employees who showed no baseline intention to return to work, the intervention did not have any effect. Other approaches are needed for this subgroup. This trial has been registered at the Dutch National Trial Register ISRCTN92307123. AD - Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, Van der Boechorststraat 7, Amsterdam 1081 BT, The Netherlands. AN - 20363809 AU - van Oostrom, S. H. AU - van Mechelen, W. AU - Terluin, B. AU - de Vet, H. C. AU - Knol, D. L. AU - Anema, J. R. CN - Medline 211026 DA - Sep DB - Medline DO - 10.1136/oem.2009.050849 DP - NLM ET - 20100402 IS - 9 J2 - Occup Environ Med KW - Adult Anxiety/rehabilitation Depression/rehabilitation Epidemiologic Methods Female Humans Male Middle Aged Occupational Health Services/*methods Prognosis Sick Leave/statistics & numerical data Stress, Psychological/*rehabilitation Treatment Outcome Workplace/psychology L1 - internal-pdf://0708213218/3527-van Oostrom-2010.pdf LA - English M3 - Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - van Oostrom, Sandra H van Mechelen, Willem Terluin, Berend de Vet, Henrica C W Knol, Dirk L Anema, Johannes R eng Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2010/04/07 Occup Environ Med. 2010 Sep;67(9):596-602. doi: 10.1136/oem.2009.050849. Epub 2010 Apr 2. PY - 2010 SN - 1470-7926 (Electronic) 1351-0711 (Linking) SP - 596-602 ST - A workplace intervention for sick-listed employees with distress: results of a randomised controlled trial T2 - Occup Environ Med TI - A workplace intervention for sick-listed employees with distress: results of a randomised controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/20363809 VL - 67 ID - 3527 ER - TY - JOUR AB - STUDY DESIGN: A randomized controlled trial in occupational health practice was conducted. OBJECTIVE: To study the efficacy of early management of workers with low back pain by occupational physicians, as compared with management by the supervisor only. SUMMARY OF BACKGROUND DATA: Health care and university workers with back pain and on sick leave for less than 1 month were included in the study. METHODS: Patients with low back pain for at least 10 days on sick leave were randomly assigned to early management by the occupational physician (n = 61) or to a reference group with management by the worker's supervisor during the first 3 months of sick leave (n = 59). The patients were observed for 1 year and compared in terms of time until return to work, pain intensity, functional disability, and general health perception. The occupational physicians were provided with management guidelines. RESULTS: No significant differences were found after 3 and 12 months of follow-up evaluation in terms of time until return to work (hazard ratio, 1.3; 95% CI, 0.90-1.90) or in terms of other health outcomes. Recurrences, however, occurred more frequently in the intervention group, but the total duration of sick leave in 1 year did not differ between the groups. CONCLUSIONS: The findings do not show a significant positive effect of an early intervention by occupational physicians on workers with low back pain. This might reflect the early phase of disability or the low intensity of the intervention resulting from overestimation of the physicians' compliance with the guidelines. AD - Coronel Institute for Occupational and Environmental Health, Academic Medical Center, Division of Public Health, University of Amsterdam, The Netherlands. j.h.verbeek@amc.uva.nl AN - 12221346 AU - Verbeek, J. H. AU - van der Weide, W. E. AU - van Dijk, F. J. CN - Medline 211026 DA - Sep 1 DB - Medline DO - 10.1097/00007632-200209010-00006 DP - NLM IS - 17 J2 - Spine KW - Adult Back Pain/*rehabilitation Disability Evaluation Disease Management Female Follow-Up Studies Guideline Adherence Health Status Humans Male Netherlands Occupational Health Services/*methods/standards *Outcome and Process Assessment, Health Care Pain Measurement Recurrence Sick Leave/statistics & numerical data L1 - internal-pdf://0838552914/3558-Verbeek-2002.pdf LA - English M3 - Clinical Trial Randomized Controlled Trial N1 - Verbeek, Jos H van der Weide, Willeke E van Dijk, Frank J eng Clinical Trial Randomized Controlled Trial 2002/09/11 Spine (Phila Pa 1976). 2002 Sep 1;27(17):1844-51; discussion 1851. doi: 10.1097/00007632-200209010-00006. PY - 2002 SN - 1528-1159 (Electronic) 0362-2436 (Linking) SP - 1844-51; discussion 1851 ST - Early occupational health management of patients with back pain: a randomized controlled trial T2 - Spine (Phila Pa 1976) TI - Early occupational health management of patients with back pain: a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/12221346 VL - 27 ID - 3558 ER - TY - JOUR AB - INTRODUCTION: Within the labour force workers without an employment contract represent a vulnerable group. In most cases, when sick-listed, these workers have no workplace/employer to return to. Therefore, the aim of this study was to evaluate the effectiveness on return-to-work of a participatory return-to-work program compared to usual care for unemployed workers and temporary agency workers, sick-listed due to musculoskeletal disorders. METHODS: The workers, sick-listed for 2-8 weeks due to musculoskeletal disorders, were randomly allocated to the participatory return-to-work program (n = 79) or to usual care (n = 84). The new program is a stepwise procedure aimed at making a consensus-based return-to-work plan, with the possibility of a temporary (therapeutic) workplace. Outcomes were measured at baseline, 3, 6, 9 and 12 months. The primary outcome measure was time to sustainable first return-to-work. Secondary outcome measures were duration of sickness benefit, functional status, pain intensity, and perceived health. RESULTS: The median duration until sustainable first return-to-work was 161 days in the intervention group, compared to 299 days in the usual care group. The new return-to-work program resulted in a non-significant delay in RTW during the first 90 days, followed by a significant advantage in RTW rate after 90 days (hazard ratio of 2.24 [95% confidence interval 1.28-3.94] P = 0.005). No significant differences were found for the measured secondary outcomes. CONCLUSIONS: The newly developed participatory return-to-work program seems to be a promising intervention to facilitate work resumption and reduce work disability among temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders. AD - Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. s.vermeulen@vumc.nl AN - 21336673 AU - Vermeulen, S. J. AU - Anema, J. R. AU - Schellart, A. J. AU - Knol, D. L. AU - van Mechelen, W. AU - van der Beek, A. J. C2 - PMC3173632 CN - Medline 211026 DA - Sep DB - Medline DO - 10.1007/s10926-011-9291-7 DP - NLM IS - 3 J2 - J Occup Rehabil KW - Adult *Employment Female Humans Kaplan-Meier Estimate Male Middle Aged Musculoskeletal Diseases/*rehabilitation Netherlands *Occupational Health Services Patient Participation Program Evaluation Proportional Hazards Models *Referral and Consultation *Sick Leave Time Factors Treatment Outcome Work Capacity Evaluation L1 - internal-pdf://1523763471/3562-Vermeulen-2011.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Vermeulen, Sylvia J Anema, Johannes R Schellart, Antonius J M Knol, Dirk L van Mechelen, Willem van der Beek, Allard J eng L30 TR001047/TR/NCATS NIH HHS/ Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2011/02/22 J Occup Rehabil. 2011 Sep;21(3):313-24. doi: 10.1007/s10926-011-9291-7. PY - 2011 SN - 1573-3688 (Electronic) 1053-0487 (Print) 1053-0487 (Linking) SP - 313-24 ST - A participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders: results of a randomized controlled trial T2 - J Occup Rehabil TI - A participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders: results of a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/21336673 VL - 21 ID - 3562 ER - TY - JOUR AB - OBJECTIVES: The purpose of this study was to assess the effects of early part-time sick leave on return to work (RTW) and sickness absence among patients with musculoskeletal disorders. METHODS: A randomized controlled trial was conducted in six occupational health units of medium- and large-size enterprises. Patients aged 18-60 years with musculoskeletal disorders (N=63) unable to perform their regular work were randomly allocated to part- or full-time sick leave. In the former group, workload was reduced by restricting work time by about a half. Remaining work tasks were modified when necessary, as specified in a "fit note" from the physician. The main outcomes were time to return to regular work activities and sickness absence during 12-month follow-up. RESULTS: Time to RTW sustained for >/=4 weeks was shorter in the intervention group (median 12 versus 20 days, P=0.10). Hazard ratio of RTW adjusted for age was 1.60 [95% confidence interval (95% CI) 0.98-2.63] and 1.76 (95% CI 1.21-2.56) after further adjustment for pain interference with sleep and previous sickness absence at baseline. Total sickness absence during the 12-month follow-up was about 20% lower in the intervention than the control group. Compliance with the intervention was high with no discontinuations of part-time sick leave due to musculoskeletal reasons. CONCLUSIONS: Early part-time sick leave may provide a faster and more sustainable return to regular duties than full-time sick leave among patients with musculoskeletal disorders. This is the first study to show that work participation can be safely increased with early part-time sick leave. AD - Finnish Institute of Occupational Health, Topeliuksenkatu 41a A, 00250 Helsinki, Finland. eira.viikari-juntura@ttl.fi AN - 22033811 AU - Viikari-Juntura, E. AU - Kausto, J. AU - Shiri, R. AU - Kaila-Kangas, L. AU - Takala, E. P. AU - Karppinen, J. AU - Miranda, H. AU - Luukkonen, R. AU - Martimo, K. P. CN - Medline 211026 DA - Mar DB - Medline DO - 10.5271/sjweh.3258 DP - NLM ET - 20111027 IS - 2 J2 - Scand J Work Environ Health KW - Adolescent Adult Confidence Intervals Female Health Status Health Status Indicators Humans Kaplan-Meier Estimate Male Middle Aged Musculoskeletal Diseases/*epidemiology/rehabilitation Occupational Health/*statistics & numerical data *Occupational Therapy Pain/*epidemiology Pain Measurement Proportional Hazards Models Sick Leave/*statistics & numerical data Statistics as Topic Surveys and Questionnaires Time Factors *Work Capacity Evaluation Young Adult L1 - internal-pdf://2584472260/3575-Viikari-Juntura-2012.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Viikari-Juntura, Eira Kausto, Johanna Shiri, Rahman Kaila-Kangas, Leena Takala, Esa-Pekka Karppinen, Jaro Miranda, Helena Luukkonen, Ritva Martimo, Kari-Pekka eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Finland 2011/10/29 Scand J Work Environ Health. 2012 Mar;38(2):134-43. doi: 10.5271/sjweh.3258. Epub 2011 Oct 27. PY - 2012 SN - 1795-990X (Electronic) 0355-3140 (Linking) SP - 134-43 ST - Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial T2 - Scand J Work Environ Health TI - Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/22033811 VL - 38 ID - 3575 ER - TY - JOUR AB - OBJECTIVES: Major depressive disorder (MDD) is associated with absenteeism. In this study, the effectiveness of collaborative care, with a focus on return to work (RTW), was evaluated in its effect on depressive symptoms and the duration until RTW in sick-listed workers with MDD in the occupational health setting. METHODS: In this randomised controlled trial, 126 sick-listed workers with MDD were randomised to usual care (N=61) or collaborative care (N=65). Collaborative care was applied by the occupational physician care manager, supported by a web-based tracking system and a consultant psychiatrist. Primary outcome measure was time to response. Secondary outcome measures were time to remission, depressive symptoms as continuous measure and the duration until full RTW. RESULTS: Collaborative care participants had a shorter time to response, with a difference of 2.8 months. However, no difference was found on time to remission or depressive symptoms as continuous measure. With a mean of 190 days in the collaborative care group, and 210 days in the usual care group, the groups did not differ significantly from each other in the duration until full RTW. Adherence to the collaborative care intervention was low. CONCLUSIONS: These results do not justify a widespread implementation of collaborative care in occupational healthcare, as it was operationalised in this study. However, since the study might have been underpowered for RTW and because treatment integrity was low, further research, with larger sample sizes, is needed to develop the best fitting (collaborative care) model for addressing RTW in depressed sick-listed workers. TRIAL REGISTRATION: : ISRCTN78462860. AD - Netherlands Institute of Mental Health and Addiction, the Trimbos-institute, PO Box 725, 3500 AS Utrecht, The Netherlands. mvlasveld@trimbos.nl AN - 23112266 AU - Vlasveld, M. C. AU - van der Feltz-Cornelis, C. M. AU - Ader, H. J. AU - Anema, J. R. AU - Hoedeman, R. AU - van Mechelen, W. AU - Beekman, A. T. CN - Medline 211026 DA - Apr DB - Medline DO - 10.1136/oemed-2012-100793 DP - NLM ET - 20121030 IS - 4 J2 - Occup Environ Med KW - *Absenteeism Adult Consultants *Cooperative Behavior Delivery of Health Care/*methods Depression/*therapy Depressive Disorder, Major/*therapy Female Humans Internet Male Netherlands Occupational Health Services/*methods Outcome Assessment, Health Care Patient Compliance Program Evaluation Psychiatry Remission Induction *Return to Work Sick Leave L1 - internal-pdf://0448561676/3597-Vlasveld-2013.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Vlasveld, Moniek C van der Feltz-Cornelis, Christina M Ader, Herman J Anema, Johannes R Hoedeman, Rob van Mechelen, Willem Beekman, Aartjan T F eng Randomized Controlled Trial Research Support, Non-U.S. Gov't England 2012/11/01 Occup Environ Med. 2013 Apr;70(4):223-30. doi: 10.1136/oemed-2012-100793. Epub 2012 Oct 30. PY - 2013 SN - 1470-7926 (Electronic) 1351-0711 (Linking) SP - 223-30 ST - Collaborative care for sick-listed workers with major depressive disorder: a randomised controlled trial from the Netherlands Depression Initiative aimed at return to work and depressive symptoms T2 - Occup Environ Med TI - Collaborative care for sick-listed workers with major depressive disorder: a randomised controlled trial from the Netherlands Depression Initiative aimed at return to work and depressive symptoms UR - https://www.ncbi.nlm.nih.gov/pubmed/23112266 VL - 70 ID - 3597 ER - TY - JOUR AB - BACKGROUND: Common mental disorders are strongly associated with long-term sickness absence, which has negative consequences for the individual employee's quality of life and leads to substantial costs for society. It is important to focus on return to work (RTW) during treatment of sick-listed employees with common mental disorders. Factors such as self-efficacy and the intention to resume work despite having symptoms are important in the RTW process. We developed "E-health module embedded in Collaborative Occupational health care" (ECO) as a blended Web-based intervention with 2 parts: an eHealth module (Return@Work) for the employee aimed at changing cognitions of the employee regarding RTW and a decision aid via email supporting the occupational physician with advice regarding treatment and referral options based on monitoring the employee's progress during treatment. OBJECTIVE: This study evaluated the effect of a blended eHealth intervention (ECO) versus care as usual on time to RTW of sick-listed employees with common mental disorders. METHODS: The study was a 2-armed cluster randomized controlled trial. Employees sick-listed between 4 and 26 weeks with common mental disorder symptoms were recruited by their occupational health service or employer. The employees were followed up to 12 months. The primary outcome measures were time to first RTW (partial or full) and time to full RTW. Secondary outcomes were response and remission of the common mental disorder symptoms (self-assessed). RESULTS: A total of 220 employees were included: 131 participants were randomized to the ECO intervention and 89 to care as usual (CAU). The duration until first RTW differed significantly between the groups. The median duration was 77.0 (IQR 29.0-152.3) days in the CAU group and 50.0 (IQR 20.8-99.0) days in the ECO group (hazard ratio [HR] 1.390, 95% CI 1.034-1.870, P=.03). No significant difference was found for duration until full RTW. Treatment response of common mental disorder symptoms did not differ significantly between the groups, but at 9 months after baseline significantly more participants in the ECO group achieved remission than in the CAU group (OR 2.228, 95% CI 1.115-4.453, P=.02). CONCLUSIONS: The results of this study showed that in a group of sick-listed employees with common mental disorders, applying the blended eHealth ECO intervention led to faster first RTW and more remission of common mental disorder symptoms than CAU. TRIAL REGISTRATION: Netherlands Trial Register NTR2108; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2108. (Archived by WebCite at http://www.webcitation.org/6YBSnNx3P). AD - Trimbos Institute, Netherlands institute of mental health and addiction, Utrecht, Netherlands. dvolker@trimbos.nl. AN - 25972279 AU - Volker, D. AU - Zijlstra-Vlasveld, M. C. AU - Anema, J. R. AU - Beekman, A. T. AU - Brouwers, E. P. AU - Emons, W. H. AU - van Lomwel, A. G. AU - van der Feltz-Cornelis, C. M. C1 - Conflicts of Interest: D Volker, Dr MC Zijlstra-Vlasveld, and Prof Dr CM van der Feltz-Cornelis reported that their employer (Trimbos-institute) received grants from ZonMw and grants from Achmea SZ when conducting this study. Prof Dr CM van der Feltz-Cornelis reported grants from Eli Lilly outside the submitted work. Prof Dr JR Anema reported being a chair in Insurance Medicine paid by the Dutch Social Security Agency and is a stockholder of Evalua LTD. Dr ATF Beekman reported grants from Eli Lilly, grants from Astra Zeneca, grants from Jansen, grants from Shire, personal fees from Eli Lilly, and personal fees from Lundbeck when conducting this study. Dr EPM Brouwers, Dr WHM Emons, and Dr AGC van Lomwel had nothing to disclose. C2 - PMC4468600 CN - Medline 211026 DA - May 13 DB - Medline DO - 10.2196/jmir.4097 DP - NLM ET - 20150513 IS - 5 J2 - J Med Internet Res KW - Adult Anxiety Disorders/therapy Cooperative Behavior Depressive Disorder/therapy Female Humans *Internet Male Mental Disorders/*therapy Middle Aged Netherlands Occupational Health Services Proportional Hazards Models Quality of Life *Return to Work Self Efficacy *Sick Leave Somatoform Disorders/therapy Therapy, Computer-Assisted/*methods Treatment Outcome anxiety depression mental health occupational health randomized controlled trial sick leave L1 - internal-pdf://0280063768/3604-Volker-2015.pdf LA - English M3 - Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Volker, Danielle Zijlstra-Vlasveld, Moniek C Anema, Johannes R Beekman, Aartjan Tf Brouwers, Evelien Pm Emons, Wilco Hm van Lomwel, A Gijsbert C van der Feltz-Cornelis, Christina M eng Randomized Controlled Trial Research Support, Non-U.S. Gov't Canada 2015/05/15 J Med Internet Res. 2015 May 13;17(5):e116. doi: 10.2196/jmir.4097. PY - 2015 SN - 1438-8871 (Electronic) 1439-4456 (Print) 1438-8871 (Linking) SP - e116 ST - Effectiveness of a blended web-based intervention on return to work for sick-listed employees with common mental disorders: results of a cluster randomized controlled trial T2 - J Med Internet Res TI - Effectiveness of a blended web-based intervention on return to work for sick-listed employees with common mental disorders: results of a cluster randomized controlled trial UR - https://www.ncbi.nlm.nih.gov/pubmed/25972279 VL - 17 ID - 3604 ER - TY - JOUR AB - Purpose The aim of this study was to assess short and long-term effectiveness of brief coping-focused psychotherapy (Brief-PsT) compared with short-term psychotherapy (Short-PsT) on work-participation (WP) and mental health. Both treatments were preceded by group education. Methods All participants were on, or at risk of, sick leave due to common mental complaints. Patients were selected for inclusion in this study based on levels of self-reported symptoms ('some' or 'seriously affected') of anxiety and depression. They were randomized to Brief-PsT (n = 141) or Short-PsT with a more extended focus (n = 143). Primary outcome was the transition of WP-state from baseline to 3 months follow-up. In addition, WP at 12 and 24 months follow-up were assessed. The secondary outcome, clinical recovery rate (CR-rate) was obtained from the Beck Depression and Beck Anxiety Inventories, at 2-year follow-up. In addition, self-reported mental health symptom severity, self-efficacy, subjective health complaints and life satisfaction were assessed. Results At 3 months follow-up, the increase in WP was significantly greater in Brief-PsT than in Short-PsT (p = 0.039). At 3 months, 60% in Brief-PsT and 51% in Short-PsT was at work, partial or full. Thereafter, these differences diminished, 84% and 80% were at work at 2-year follow up. The 2-year follow-up of the secondary outcome measurements was completed by 53% in Brief-PsT and 57% in Short PsT. CR-rate was significantly greater in Brief-PsT compared with the Short-PsT (69% vs. 51%, p = 0.024). Furthermore, there was a greater reduction in the number of subjective health complaints in Brief-PsT (4.0 vs. 1.9 p = 0.012). All other measurements favoured Brief-PsT as well, but did not reach statistical significance. Conclusions Brief coping-focused psychotherapy added to group education for persons with depression or anxiety complaints seemed more effective in enhancing early work participation compared with additional short-term psychotherapy of standard duration with more extended focus. Clinical recovery rate and decline of comorbid subjective health complaints at 2-year follow-up were also in favour of the brief coping-focused program. AD - Division Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway. marjon.wormgoor@siv.no. Division Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway. Division of Mental Health & Addiction, Vestfold Hospital Trust, Tonsberg, Norway. Department of Psychology, University of Oslo, Oslo, Norway. AN - 31222615 AU - Wormgoor, M. E. A. AU - Indahl, A. AU - Andersen, E. AU - Egeland, J. CN - Medline 211026 DA - Mar DB - Medline DO - 10.1007/s10926-019-09841-6 DP - NLM IS - 1 J2 - J Occup Rehabil KW - *Adaptation, Psychological Adult Anxiety/*therapy *Diagnostic Self Evaluation Female Follow-Up Studies Humans Male Mental Disorders/*therapy Mental Health Middle Aged *Personal Satisfaction Psychotherapy, Brief/*methods Self Efficacy Sick Leave Work Engagement Psychotherapy Return to work L1 - internal-pdf://4079829966/3681-Wormgoor-2020.pdf LA - English M3 - Pragmatic Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't N1 - Wormgoor, M E A Indahl, A Andersen, E Egeland, J eng Pragmatic Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't Netherlands 2019/06/22 J Occup Rehabil. 2020 Mar;30(1):22-39. doi: 10.1007/s10926-019-09841-6. PY - 2020 SN - 1573-3688 (Electronic) 1053-0487 (Linking) SP - 22-39 ST - Effectiveness of Briefer Coping-Focused Psychotherapy for Common Mental Complaints on Work-Participation and Mental Health: A Pragmatic Randomized Trial with 2-Year Follow-Up T2 - J Occup Rehabil TI - Effectiveness of Briefer Coping-Focused Psychotherapy for Common Mental Complaints on Work-Participation and Mental Health: A Pragmatic Randomized Trial with 2-Year Follow-Up UR - https://www.ncbi.nlm.nih.gov/pubmed/31222615 VL - 30 ID - 3681 ER -