Design of a randomized controlled trial on the effects of Counseling of mental health problems by Occupational Physicians on return to work: the CO-OP-study

Abstract

Background: Mental health problems often lead to prolonged sick leave. In primary care, the usual approach towards these patients was the advice to take rest and not return to work before all complaints had disappeared. When complaints persist, these patients are often referred to psychologists from primary and specialized secondary care. As an alternative, ways have been sought to activate the Dutch occupational physician (OP) in primary care. Early 2000, the Dutch Association of Occupational Physicians (NVAB) published a guideline concerning the management by OPs of employees with mental health problems. The guideline received positive reactions from employees, employers and Dutch OPs. This manuscript describes the design of a study, which aims to assess the effects of the guideline, compared with usual care.

Return to work and occupational physicians’ management of common mental health problems – process evaluation of a randomized controlled trial

“…Details of the study design and the guideline have been reported elsewhere (10). A brief summary is presented below.…”

“…In the guideline group, the intervention consisted of treatment by an OP according to the Dutch guideline Return to work and physician's management of mental problems on how to manage workers with common mental health problems (4,5,10). The guideline focuses on five constructs in the management of common mental health problems.…”

“…The RCT evaluated the effect of the Dutch national guideline on OP management of workers with common mental health problems (10). Subjects in the intervention or guideline group were treated by OP trained to provide guideline-based care.…”

“…We conducted a randomized controlled trial (RCT) with a 12-month follow-up to evaluate the effectiveness of the OP guideline compared to usual care (10). The use of the guideline did not result in better return-towork outcomes (11).…”

Effects of a Multidisciplinary Stress Treatment Programme on Patient Return to Work Rate and Symptom Reduction: Results from a Randomised, Wait-List Controlled Trial

“…Other findings imply that the amount of contact and the number of consultations is important for the effect of the intervention. Thus, small-scale interventions do not seem to work, while more comprehensive interventions have shown an effect on RTW in a 1-year follow-up [16,21,22,23,24,25,26]. This effect seems to be the highest after a few weeks [10,18].…”