An early workplace dialogue with the employer in addition to physiotherapy significantly improved work ability in comparison with structured physiotherapy only.

The article concludes that of the Scandinavian countries, Sweden is ahead in terms of Arts on Prescription and has embraced the use of culture for health benefits on a different scale compared to Norway and Denmark. Denmark, in particular, is behind in recognising ways in which art and culture can benefit patients and for wider public health promotion. All three countries may benefit from the evidence provided by UK researchers.

Background and purposeAssessment of potential disparities in access to care is a vital part of achieving equity in health and healthcare. We have therefore studied the effect of socioeconomic status (SES) on the rates of knee and hip replacement due to osteoarthritis.MethodsThis was a cohort study in Skåne, Sweden. We included all residents aged ≥ 35 years with consultations between 2004 and 2013 for hip or knee osteoarthritis. We retrieved individual information on income, education, and occupation and evaluated the rates of knee and hip replacement according to SES, with adjustment for age and sex. Professionals, legislators, senior officials, and managers, and individuals with the longest education, served as the reference group.ResultsWe followed 50,498 knee osteoarthritis patients (59% women) and 20,882 hip osteoarthritis patients (58% women). The mutually adjusted rate of knee replacement was lower in those with an elementary occupation (hazard ratio (HR) = 0.81, 95% CI: 0.72–0.92), in craft workers and those with related trades (HR = 0.88, CI: 0.79–0.98), and in skilled agricultural/fishery workers (HR = 0.83, CI: 0.72–0.96), but higher in the 2 least educated groups (HR = 1.2 in both). The rate of hip replacement was lower in those with an elementary occupation (HR = 0.77, 95% CI: 0.68–0.87), in plant and machine operators/assemblers (HR = 0.83, CI: 0.75–0.93), and service workers/shop assistants (HR = 0.88, CI: 0.80–0.96). The rate of hip replacement was higher in the highest income group (HR = 1.1, 95% CI: 1.0–1.2).InterpretationThere was a lower rate of joint replacement in osteoarthritis patients working in professions often associated with lower socioeconomic status, suggesting inequity in access to care. However, the results are not unanimous, as the rate of knee replacement was higher in the least educated groups.

We found that physicians mainly rely on what patients were telling about their work situation when assessing work ability. But it was not clear if they should consider the patient's whole life situation, motivation and wishes. Protecting the physician-patient relationship was seen as important as well as the need for teamwork assessments and increased work place knowledge.

We followed a population-based cohort over a period of 10 years, including incident cases of both exposure and outcome and found a bidirectional relationship between pain and mental illness. Clinicians need to pay attention on both conditions, in patients seeking care due to mental illness or pain.