- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03827174
Return to Work in Patients With Chronic Pain (UWORKin)
Vocational Rehabilitation and Return to Work in Patients With Chronic Pain: a Randomised Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
New vocational rehabilitation models including the workplace are urgently needed for persons with chronic pain.
Return to work coordination means external and internal coordination regarding sick leave by help of a rehabilitation coordinator from health care. The goal is to establish a common return to work plan between employer and employee as dictated by Swedish law. The hypothesis is that return to work coordination is not sufficient. Additional effects on return to work and work ability from a behaviour change ability programme aiming to enhance work ability by targeting context at the workplace, physical and psychological functioning, and behavioral skills at work are expected.
The hypothesis is tested in a randomised controlled trial. Before the start of the trial a series of 3-6 experimental single case studies will be performed to study the implementation of the interventions more thoroughly.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Pernilla Åsenlöf, Professor
- Phone Number: +46704562831
- Email: pernilla.asenlof@neuro.uu.se
Study Contact Backup
- Name: Hedvig Zetterberg, PhD-student
- Phone Number: +46709845066
- Email: hedvig.zetterberg@neuro.uu.se
Study Locations
-
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Uppland
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Uppsala, Uppland, Sweden, 75226
- Uppsala University Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Chronic pain with a duration for more than 3 months
- On sick-leave 25%-100% from salaried employment or studies, for at least 30 days
- Identified employer or director of studies
- Ability to understand, speak, and write Swedish
Exclusion Criteria:
- Severe substance use disorder
- Severe psychiatric illness
- Recruited participants with employers who does not consent to participate
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Comparison intervention
Return To Work Coordination: external and internal coordination regarding sick leave.
Establishment of a common return to work plan between employer and employee.
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External and internal coordination regarding sick leave.
Establishment of a common return to work plan between employer och employee.
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Experimental: Experimental intervention
Return To Work Coordination + Behaviour Change Ability Programme Behaviour Change Ability Programme:
|
External and internal coordination regarding sick leave.
Establishment of a common return to work plan between employer och employee.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Return to work
Time Frame: Number of days during a 12-month period from baseline to 12 months post baseline.
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Average sick leave according to the Swedish Social Insurance registry, defined as net days.
|
Number of days during a 12-month period from baseline to 12 months post baseline.
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Work ability
Time Frame: 12 months
|
Self-report. Work Ability Index (WAI). The questionnaire covers 7 dimensions:
The dimensions have different scores. A total index is computed ranging from 7 to 49, where higher scores indicate higher work ability. |
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Work Ability
Time Frame: Baseline, 6 months, 24 months
|
Self-report. Work Ability Index (WAI). The questionnaire covers 7 dimensions:
The dimensions have different scores. A total index is computed ranging from 7 to 49, where higher scores indicate higher work ability. |
Baseline, 6 months, 24 months
|
Return to work
Time Frame: Baseline, 6 months, 24 months
|
Average sick leave according to the Swedish Social Insurance registry, defined as net days.
|
Baseline, 6 months, 24 months
|
Short-term sick leave < 2 weeks, number of days
Time Frame: 6 months, 12 months, 24 months
|
Self-reported number of days with sick-leave not exceeding two weeks
|
6 months, 12 months, 24 months
|
Health-related quality of life: EQ-5D
Time Frame: Baseline, 6 months, 12 months, 24 months
|
Self-report.
The EuroQoL - Five dimension (EQ-5D).
The five dimensions are: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Each scales ranges from 0 to 2, where a low score indicates better health.
The EQ-5D questionnaire also includes a visual analog scale where perceived health status is rated with a grade ranging from 0 (the worst possible health status) to 100 (the best possible health status).
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Baseline, 6 months, 12 months, 24 months
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Opioid use
Time Frame: Baseline, 6 months, 12 months, 24 months
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Interview: Time-Line-Follow-Back.
4-week recall regarding opioid medication yes/no and dose.
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Baseline, 6 months, 12 months, 24 months
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Substance use disorder
Time Frame: Baseline, 6 months, 12 months, 24 months
|
Interview: Mini International Neuropsychiatric Interview, Part J (Substance use). Response format yes/no. Mild substance use disorder = 2-3 symptoms Moderate substance use disorder = 4-5 symptoms Severe substance use disorder = 6 or more symptoms |
Baseline, 6 months, 12 months, 24 months
|
Pain severity: The Brief Pain Inventory
Time Frame: Baseline, 6 months, 12 months, 24 months
|
Self-report.
The Brief Pain Inventory.
Severity is measured with 4 items where worst, least, average, and current pain during the past week are scored.
Each scale ranges from 0-10, where 0 = 'no pain' and 10 = 'pain as bad as can be'.
Each of the severity scales will be presented separately.
|
Baseline, 6 months, 12 months, 24 months
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Pain interference: The Brief Pain Inventory
Time Frame: Baseline, 6 months, 12 months, 24 months
|
Self-report.
The Brief Pain Inventory.
Interference is measured with 7 items (general activity, mood, working ability, normal work, relations with other people, sleep, and enjoyment of life).
Each scale ranges from 0 to 10, where 0 ='does not interfere', and 10 = 'completely interferes'.
Interference is scored as the mean of the seven interference items.
Higher scores indicate higher pain interference.
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Baseline, 6 months, 12 months, 24 months
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Balance
Time Frame: Baseline, 6 months, 12 months
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The MiniBESTest
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Baseline, 6 months, 12 months
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Functional lifting capacity
Time Frame: Baseline, 6 months, 12 months
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Progressive Isoinertial Lifting Evaluation (PILE): cervical lifting test
|
Baseline, 6 months, 12 months
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Grip strength
Time Frame: Baseline, 6 months, 12 months
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Dynamometer GRIPPIT (name of brand)
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Baseline, 6 months, 12 months
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Catastrophizing
Time Frame: Baseline, 6 months, 12 months
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Self-report, The Pain Catastrophizing Scale (PCS) - Swedish version.
13 items, ranging from 0 to 4 where 0 = 'not at all', 4 = 'all the time'.
A total score is calculated ranging from 0 to 52 where higher scores indicate higher catastrophizing.
|
Baseline, 6 months, 12 months
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Fear of movement and reinjury
Time Frame: Baseline, 6 months, 12 months
|
Self-report, The Tampa Scale of Kinesiophobia-11 (TSK-11), Swedish version.
11 items ranging from 1 to 4 where 1 = 'does not agree at all', 4 = 'totally agree'.
A total score is calculated ranging from 11 to 44 where higher scores indicate higher fear of movement/kinesiophobia.
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Baseline, 6 months, 12 months
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Psychological inflexibility in pain
Time Frame: Baseline, 6 months, 12 months
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Self-report.
Psychological inflexibility in pain (PIPS) is a 12-item scale used to assess psychological inflexibility (i.e.
avoidance, acceptance, fusion, values orientation, dirty discomfort) in people with chronic pain.
Two main components are measured: 1) Avoidance of pain (items: 1,2,4,5,7,8,10,11), 2) Fusion with pain thoughts (items: 3,6,9,12) Scoring: Respondents are asked to rate items on a 7-point scale that ranges from 1= 'never true' to 7 = 'always true'.
Scores are summed to a total score and to two subscale scores.
Higher scores indicate greater levels of psychological inflexibility.
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Baseline, 6 months, 12 months
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Depressive symptoms
Time Frame: Baseline, 6 months, 12 months, 24 months
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Self-report: Patient Health Questionnaire - 9 (PHQ-9), Swedish version.
9 items ranging from 0 ='not at all', to 3 ='almost every day'. 1 item ranging from 0 ='no difficulties, to 3 = 'extreme difficulties'.
The first 9 items are summed to a sum score ranging from 0 to 27, where: 0-4 = no signs of depression, 5-9 = mild depression, 10-14 = moderate depression, 15-19 = moderately severe depression, 20-27 = severe depression.
Item 10 is reported as a single item where high scores indicate high interference with daily function.
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Baseline, 6 months, 12 months, 24 months
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Generalised Anxiety Disorder
Time Frame: Baseline, 6 months, 12 months, 24 months
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Self-report: Generalised Anxiety Disorder (GAD-7).
7 items ranging from 0 ='not at all', to 3 ='almost every day'. 1 item ranging from 0 ='no difficulties, to 3 = 'extreme difficulties'. 1 item ranging from 0 ='not at all, to 3 = 'very disturbing'.
The first 7 items are summed to a sum score ranging from 0 to 21, where: 0-4 = no signs of anxiety, 5-9 = mild GAD, 10-14 = moderate GAD, 15-21 = severe GAD.
Item 8 is reported as a single item where higher score means higher interference.
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Baseline, 6 months, 12 months, 24 months
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Experience of injustice
Time Frame: Baseline, 6 months, 12 months
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Self-report: Injustice Experience Questionnaire (IEQ), Swedish version. 12 items ranging from 0 ='never, to 4 ='all the time'. A total score is computed by summing the scores to all 12 items, ranging from 0-48 where higher scores indicate higher experience of injustice. Two subscales is used. 1) Blame/unfairness by summing items 3, 7, 9, 10, 11, 23. 2) Severity/irreparability by summing 1, 2, 4, 5, 6, 8. |
Baseline, 6 months, 12 months
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Cognitive function
Time Frame: Baseline, 6 months, 12 months
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The Cambridge Neuropsychological Test Automated Battery (CANTAB): Spatial Working Memory, Paired Associates Learning, Delayed Match to Sample and Stocking of Cambridge (SOC).
|
Baseline, 6 months, 12 months
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Physical activity level
Time Frame: Baseline, 6 months, 12 months
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Accelerometer during one week.
Time spent in sedentary, low, moderate and vigorous physical activity.
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Baseline, 6 months, 12 months
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Sleep
Time Frame: Baseline, 6 months, 12 months
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Sleep pattern: Actigraph during night and days for one week.
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Baseline, 6 months, 12 months
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Global goal achievement
Time Frame: 6 months, 12 months, 24 months
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Self-report.
Patient global impression of change (PGIC).
The measure reflects participant's beliefs about the efficacy of treatment.
The patient rates overall improvement on a 7-point scale where 3 = 'very much improved', 2 = 'much improved', 1 = 'minimally improved', 0 = 'no change', -1 = 'minimally worse', -2 = 'much worse', and -3 ='very much worse'.
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6 months, 12 months, 24 months
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Explorative identification of change in biomarkers
Time Frame: Changes from baseline to 6 months.
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Biomarkers will be explored by use of the OLINK (name of brand) panel which enables analysis of 92 inflammation-related protein biomarkers.
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Changes from baseline to 6 months.
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient-specific goals for return to work
Time Frame: Baseline, 6 months, 12 months
|
Patient Goal Priority Questionnaire (PGPQ-WORK).
Patient-specific questionnaire where the participant list 1-3 work-related activities that he or she wish to be able to perform better as a result of treatment.
Activity, self-efficacy, fear of performance, and expected outcome level is then rated for each activity separately on 4 11-point numerical rating scales where higher scores indicate worse outcomes.
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Baseline, 6 months, 12 months
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Self-efficacy to support return to work (employer): Number of items
Time Frame: Baseline, 6 months
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Study specific questions regarding the employer's self-efficacy to support the employee to return to work.
Number of items is tied to individual process analysis of what is required to return to work in each specific case.
|
Baseline, 6 months
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Number of participants who report adverse events associated with treatment
Time Frame: Up to 6 months
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Adverse events will be measured with a study-specific diary including a check-list and open ended questions.
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Up to 6 months
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Pernilla Åsenlöf, Professor, Department of Neuroscience, Uppsala University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 160069 (AFA)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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