Effect of peer-based low back pain information and reassurance at the workplace on sick leave: a cluster randomized trial

Magnus Odeen, Camilla Ihlebæk, Aage Indahl, Marjon E A Wormgoor, Stein A Lie, Hege R Eriksen, Magnus Odeen, Camilla Ihlebæk, Aage Indahl, Marjon E A Wormgoor, Stein A Lie, Hege R Eriksen

Abstract

Purpose: To evaluate whether information and reassurance about low back pain (LBP) given to employees at the workplace could reduce sick leave.

Methods: A Cluster randomized controlled trial with 135 work units of about 3,500 public sector employees in two Norwegian municipalities, randomized into two intervention groups; Education and peer support (EPS) (n = 45 units), education and "peer support and access to an outpatient clinic" (EPSOC) (n = 48 units), and a control group (n = 42 units). Both interventions consisted of educational meetings based on a "non-injury model" and a "peer adviser" appointed by colleagues. Employees in the EPSOC group had access to an outpatient clinic for medical examination and further education. The control group received no intervention. The main outcome was sick leave based on municipal records. Secondary outcomes were self-reported pain, pain related fear of movement, coping, and beliefs about LBP from survey data of 1,746 employees (response rate about 50 %).

Results: EPS reduced sick leave by 7 % and EPSOC reduced sick leave by 4 % during the intervention year, while sick leave in the control group was increased by 7 % during the same period. Overall, Rate Ratios (RR) were statistically significant for EPSOC (RR = .84 (C.I = 0.71-.99) but not EPS (RR = .92 (C.I = 0.78-1.09)) in a mixed Poisson regression analysis. Faulty beliefs about LBP were reduced in both intervention groups.

Conclusions: Educational meetings, combined with peer support and access to an outpatient clinic, were effective in reducing sick leave in public sector employees.

Figures

Fig. 1
Fig. 1
Flow chart of participants: EPS Education and Peer Support. EPSOC Education, Peer Support and Outpatient Clinic. *Included in poisson analysis according to intention to treat principle
Fig. 2
Fig. 2
Mixed Poisson regression model adjusted of the effect of the intervention on change in sick leave for both municipalities and the whole sample. X axis represents time in years and the Y axis represents percentage sick leave

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