Effectiveness of adding a workplace intervention to an inpatient multimodal occupational rehabilitation program: A randomized clinical trial

Martin Skagseth, Marius S Fimland, Marit B Rise, Roar Johnsen, Petter C Borchgrevink, Lene Aasdahl, Martin Skagseth, Marius S Fimland, Marit B Rise, Roar Johnsen, Petter C Borchgrevink, Lene Aasdahl

Abstract

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.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Participation flow through the study. NAV registers=social security register from Norwegian Labor and Welfare Administration; I-MORE=inpatient multimodal occupational rehabilitation; I-MORE+WI=inpatient multimodal occupational rehabilitation with workplace intervention.
Figure 2
Figure 2
Cumulative number of days (median) on medical benefits for participants in standard inpatient multimodal occupational rehabilitation (I-MORE; dashed line) and standard inpatient multimodal occupational rehabilitation with workplace intervention (I-MORE+WI; solid line) during 12 months of follow-up. Adjusted for employment fraction and transformed to whole workdays according to a 5-day work week.
Figure 3
Figure 3
Survival curves from the Kaplan Meier analysis showing time to sustainable return to work for participants in standard inpatient multimodal occupational rehabilitation (I-MORE; dashed line) and standard inpatient multimodal occupational rehabilitation with workplace intervention (I-MORE+WI; solid line) during 12 months of follow-up.

References

    1. Waddell G, Burton AK. Is Work Good for Your Health and Well-Being? London: The Stationery Office; 2006.
    1. OECD. Mental Health and Work. Norway;Paris: OECD Library; 2013. Available from .
    1. OECD. Sickness, Disability and Work:Breaking the Barriers. Paris: OECD Publishing; 2010.
    1. Myhre K, Marchand GH, Leivseth G, Keller A, Bautz-Holter E, Sandvik L, et al. The effect of work-focused rehabilitation among patients with neck and back pain:a randomized controlled trial. Spine. 2014 Nov;39(24):1999–2006. .
    1. Aasdahl L, Pape K, Vasseljen O, Johnsen R, Gismervik S, Jensen C, et al. Effects of inpatient multicomponent occupational rehabilitation versus less comprehensive outpatient rehabilitation on somatic and mental health:secondary outcomes of a randomized clinical trial. J Occup Rehabil. 2017 Sep;27(3):456–66. .
    1. Reme SE, Grasdal AL, Løvvik C, Lie SA, Øverland S. Work-focused cognitive-behavioural therapy and individual job support to increase work participation in common mental disorders:a randomised controlled multicentre trial. Occup Environ Med. 2015 Oct;72(10):745–52. .
    1. Norlund A, Ropponen A, Alexanderson K. Multidisciplinary interventions:review of studies of return to work after rehabilitation for low back pain. J Rehabil Med. 2009 Feb;41(3):115–21. .
    1. Lagerveld SE, Blonk RW, Brenninkmeijer V, Wijngaards-de Meij L, Schaufeli WB. Work-focused treatment of common mental disorders and return to work:a comparative outcome study. J Occup Health Psychol. 2012 Apr;17(2):220–34. .
    1. Hoefsmit N, Houkes I, Nijhuis FJ. Intervention characteristics that facilitate return to work after sickness absence:a systematic literature review. J Occup Rehabil. 2012 Dec;22(4):462–77. .
    1. Cullen KL, Irvin E, Collie A, Clay F, Gensby U, Jennings PA, et al. Effectiveness of workplace interventions in return-to-work for musculoskeletal, pain-related and mental health conditions:an update of the evidence and messages for practitioners. J Occup Rehabil. 2018 Mar;28(1):1–15. .
    1. Carroll C, Rick J, Pilgrim H, Cameron J, Hillage J. Workplace involvement improves return to work rates among employees with back pain on long-term sick leave:a systematic review of the effectiveness and cost-effectiveness of interventions. Disabil Rehabil. 2010;32(8):607–21. .
    1. Williams-Whitt K, Bültmann U, Amick B, 3rd, Munir F, Tveito TH, Anema JR Hopkinton Conference Working Group on Workplace Disability Prevention. Workplace interventions to prevent disability from both the scientific and practice perspectives:a comparison of scientific literature, grey literature and stakeholder observations. J Occup Rehabil. 2016 Dec;26(4):417–33. .
    1. van Vilsteren M, van Oostrom SH, de Vet HC, Franche RL, Boot CR, Anema JR. Workplace interventions to prevent work disability in workers on sick leave. Cochrane Database Syst Rev. 2015 Oct;10:CD006955.
    1. Aasdahl L, Pape K, Vasseljen O, Johnsen R, Gismervik S, Halsteinli V, et al. 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. J Occup Rehabil. 2018 Mar;28(1):170–9. .
    1. Brendbekken R, Eriksen HR, Grasdal A, Harris A, Hagen EM, Tangen T. Return to work in patients with chronic musculoskeletal pain:multidisciplinary intervention versus brief intervention:a randomized clinical trial. J Occup Rehabil. 2017 Mar;27(1):82–91. .
    1. Braathen TN, Veiersted KB, Heggenes J. Improved work ability and return to work following vocational multidisciplinary rehabilitation of subjects on long-term sick leave. J Rehabil Med. 2007 Jul;39(6):493–9. .
    1. Gismervik S, Aasdahl L, Vasseljen O, Fors EA, Rise MB, Johnsen R, et al. Inpatient multimodal occupational rehabilitation reduces sickness absence in individuals with musculoskeletal and common mental health disorders:a randomised clinical trial. Submitted:Scand J Work Environ Health. 2019
    1. Fimland MS, Vasseljen O, Gismervik S, Rise MB, Halsteinli V, Jacobsen HB, et al. Occupational rehabilitation programs for musculoskeletal pain and common mental health disorders:study protocol of a randomized controlled trial. BMC Public Health. 2014 Apr;14:368. .
    1. Rise MB, Gismervik SO, Johnsen R, Fimland MS. Sick-listed persons'experiences with taking part in an in-patient occupational rehabilitation program based on Acceptance and Commitment Therapy:a qualitative focus group interview study. BMC Health Serv Res. 2015 Nov;15:526. .
    1. Rise MB, Skagseth M, Klevanger NE, Aasdahl L, Borchgrevink P, Jensen C, et al. Design of a study evaluating the effects, health economics, and stakeholder perspectives of a multi-component occupational rehabilitation program with an added workplace intervention - a study protocol. BMC Public Health. 2018 Feb;18(1):219. .
    1. Schulz KF, Altman DG, Moher D CONSORT Group. CONSORT 2010 Statement:updated guidelines for reporting parallel group randomised trials. BMC Med. 2010 Mar;8:18. .
    1. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy:model, processes and outcomes. Behav Res Ther. 2006 Jan;44(1):1–25. .
    1. NAV A conversation about working possibilities. Affaires DoLaS. .
    1. Anema JR, Steenstra IA, Bongers PM, de Vet HC, Knol DL, Loisel P, et al. Multidisciplinary rehabilitation for subacute low back pain:graded activity or workplace intervention or both?A randomized controlled trial. Spine. 2007 Feb;32(3):291–8. .
    1. Lambeek LC, van MW KDL, Loisel P, Anema JR. Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ. 2010;340:c1035. .
    1. Loisel P, Abenhaim L, Durand P, Esdaile JM, Suissa S, Gosselin L, et al. A population-based, randomized clinical trial on back pain management. Spine. 1997 Dec;22(24):2911–8. .
    1. Efron B. The Efficiency of Cox's Likelihood Function for Censored Data. J Am Stat Assoc. 1977;72(359):557–65. .
    1. Schoenfeld D. Partial residuals for the proportional hazards regression model. Biometrika. 1982;69(1):239–41. .
    1. Anema JR, Steenstra IA, Bongers PM, de Vet HC, Knol DL, Loisel P, et al. Multidisciplinary rehabilitation for subacute low back pain:graded activity or workplace intervention or both?A randomized controlled trial. Spine. 2007 Feb;32(3):291–8. .
    1. Bültmann U, Sherson D, Olsen J, Hansen CL, Lund T, Kilsgaard J. Coordinated and tailored work rehabilitation:a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders. J Occup Rehabil. 2009 Mar;19(1):81–93. .
    1. Bültmann U, Sherson D, Olsen J, Hansen CL, Lund T, Kilsgaard J. Coordinated and tailored work rehabilitation:a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders. J Occup Rehabil. 2009 Mar;19(1):81–93. .
    1. Franche RL, Cullen K, Clarke J, Irvin E, Sinclair S, Frank J Institute for Work &Health (IWH) Workplace-Based RTW Intervention Literature Review Research Team. Workplace-based return-to-work interventions:a systematic review of the quantitative literature. J Occup Rehabil. 2005 Dec;15(4):607–31. .
    1. Nieuwenhuijsen K, Faber B, Verbeek JH, Neumeyer-Gromen A, Hees HL, Verhoeven AC, et al. Interventions to improve return to work in depressed people. Cochrane Database Syst Rev. 2014 Dec;12:CD006237.
    1. Palmer KT, Harris EC, Linaker C, Barker M, Lawrence W, Cooper C, et al. Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss:a systematic review. Rheumatology (Oxford) 2012 Feb;51(2):230–42. .
    1. Schandelmaier S, Ebrahim S, Burkhardt SC, de Boer WE, Zumbrunn T, Guyatt GH, et al. Return to work coordination programmes for work disability:a meta-analysis of randomised controlled trials. PLoS One. 2012;7(11):e49760. .

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