Early interventions to promote work participation in people with regional musculoskeletal pain: a systematic review and meta-analysis

Cochrane, Andy; Higgins, Noelle; FitzGerald, Oliver; Ashton, Jennifer; Corcoran, O; Desmond, Deirdre

doi:10.1177/0269215517699976

Cited by 16 publications

(28 citation statements)

References 41 publications

(150 reference statements)

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“…Specifically, treatment strategies that promote mastery of functional activities and problem-solving abilities can enhance confidence and self-efficacy [14]. For most workers, firstline interventions that include reassurance about activity and work and work/workplace accommodation will be sufficient, while more structured vocational rehabilitation should be reserved for those who do not respond to conservative management [8].…”

Section: Discussionmentioning

confidence: 99%

“…Research to date has tended to concentrate on the association between psychosocial variables and work-related outcomes in individuals already off work with long-lasting MSDs [6] and the majority of intervention studies for MSDs have focused on reducing sickness absence and facilitating return to work [7,8]. Reductions in psychosocial risk factors have been associated with higher probability of return to work in people with chronic MSD (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Work Outcomes in Patients Who Stay at Work Despite Musculoskeletal Pain

et al. 2017

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Purpose To assess self-reported work impacts and associations between psychosocial risk factors and work impairment amongst workers seeking care for musculoskeletal pain while continuing to work. Methods Patients were recruited from Musculoskeletal Assessment Clinics at 5 hospitals across Ireland. Participants completed questionnaires including assessments of work impairment (Work Productivity and Activity Impairment Questionnaire), work ability (single item from the Work Ability Index) and work performance (Work Role Functioning Questionnaire; WRFQ). Logistic and hierarchical regressions were conducted to analyse the relation between psychosocial variables and work outcomes. Results 155 participants (53.5% female; mean age = 46.50 years) who were working at the time of assessment completed the questionnaires. Absenteeism was low, yet 62.6% were classified as functioning poorly according to the WRFQ; 52.3% reported having poor work ability. Logistic regression analyses indicated that higher work role functioning was associated with higher pain self-efficacy (OR 1.51); better work ability was associated with older age (OR 1.063) and lower functional restriction (OR 0.93); greater absenteeism was associated with lower pain self-efficacy (OR 0.65) and poorer work expectancy (OR 1.18). Multiple regression analysis indicated that greater presenteeism was associated with higher pain intensity (β = 0.259) and lower pain self-efficacy (β = - 0.385). Conclusions While individuals continue to work with musculoskeletal pain, their work performance can be adversely affected. Interventions that target mutable factors, such as pain self-efficacy, may help reduce the likelihood of work impairment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Work Outcomes in Patients Who Stay at Work Despite Musculoskeletal Pain

et al. 2017

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“…In another systematic review multidisciplinary rehabilitation was found to be more effective for work outcomes compared with physical treatment, but not more effective than usual care (Kamper et al 2015). However, a recent review of early multicomponent interventions for chronic pain suggested only limited effectiveness in reducing SA (Cochrane et al 2017). …”

Section: Introductionmentioning

confidence: 99%

“…Prior reviews have aimed at investigating subgroups to further understand the influence of these and other important factors. However, since too few trials have reported relevant data these analyses are lacking (Arends et al 2012; Cochrane et al 2017; Kamper et al 2015), or studies may have been under-powered, and therefore, yielded non-significant effects (Nieuwenhuijsen et al 2014). …”

Section: Introductionmentioning

confidence: 99%

Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders: a systematic review and meta-analysis of randomized-controlled trials

Finnes

Enebrink

Ghaderi

et al. 2018

Int Arch Occup Environ Health

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PurposeCommon mental disorders (CMDs) and musculoskeletal disorders are highly prevalent in the population and cause significant distress and disability, and high costs to society. The main objective of this systematic review and meta-analysis was to examine the outcome and comparative effectiveness of psychological interventions in reducing sickness absence (SA) due to CMDs or musculoskeletal disorders, compared to a waitlist control group, usual care or another clinical intervention.MethodsWe reviewed 3515 abstracts of randomized controlled trials published from 1998 to 2017. Of these, 30 studies were included in the analysis.ResultsThe psychological interventions were overall more effective than treatment as usual in reducing SA (small effect sizes), but not compared to other clinical interventions. Results were similar for studies on CMDs and musculoskeletal pain. A few significant moderating effects were found for treatment-specific variables. However, these were difficult to interpret as they pointed in different directions.ConclusionThere was a small but significant effect of psychological treatments in reducing SA. We identified areas of improvement such as methodological problems among the included studies and failure to specifically address RTW in the interventions that were evaluated. Clinical implications of the findings, and ways of improving methodological rigour of future studies are discussed.Electronic supplementary materialThe online version of this article (10.1007/s00420-018-1380-x) contains supplementary material, which is available to authorized users.

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“…• early multidisciplinary interventions such as back school programs, case-manager-led programs, and physical-activity interventions; • stepped-care interventions; and • stratified primary-care management for low-back pain. (80)(81)(82)(83) For findings about which health professionals are best-positioned to assist patients in managing chronic pain, one medium-quality review found that compared to a control group, individuals receiving pharmacist-led medication review had small improvements in physical functioning and a significant improvement in patient Evidence >> Insight >> Action satisfaction. (84) One recent medium-quality review and one economic evaluation found that chiropractors are cost-effective for the management of chronic low-back pain.…”

Section: Delivery System Designmentioning

confidence: 99%

Interactions between analgesic drug therapy and mindfulness-based interventions for chronic pain in adults: protocol for a systematic scoping review

Park

Mohiuddin

Poulin

et al. 2019

PR9

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Introduction: Most current chronic pain treatment strategies have limitations in effectiveness and tolerability, and accumulating evidence points to the added benefits of rational combinations of different therapies. However, most published clinical trials of treatment combinations have involved combinations of 2 drugs, whereas very little research has been performed to characterize interactions between drug and nondrug interventions. Mindfulness-based interventions (MBIs) have been emerging as a safe and potentially effective treatment option in the management of chronic pain, but it is unclear how MBIs can and should be integrated with various other pain treatment interventions. Thus, we seek to review available clinical trials of MBIs for chronic pain to evaluate available evidence on the interactions between MBIs and various pharmacological treatments. Methods: A detailed search of trials of MBIs for the treatment of chronic pain in adults will be conducted on the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and PsycINFO from their inception until the date the searches are run to identify relevant randomized controlled trials. Primary outcomes will include the following: (1) what concomitant analgesic drug therapies (CADTs) were allowed; (2) if and how trials controlled for CADTs and analyzed their interaction; and (3) results of available analyses of interactions between the MBI and CADT. Perspective: This review is expected to synthesize available evidence describing the interactions between MBIs and various studied drug therapies for chronic pain. Available evidence may help inform the rational integration of MBIs with drug therapy for chronic pain.

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Early interventions to promote work participation in people with regional musculoskeletal pain: a systematic review and meta-analysis

Abstract: There is uncertainty as to the effectiveness of early multicomponent interventions owing to the clinical heterogeneity and varying health and social insurance systems across the trials.

Cited by 16 publications

References 41 publications

Work Outcomes in Patients Who Stay at Work Despite Musculoskeletal Pain

Work Outcomes in Patients Who Stay at Work Despite Musculoskeletal Pain

Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders: a systematic review and meta-analysis of randomized-controlled trials

Interactions between analgesic drug therapy and mindfulness-based interventions for chronic pain in adults: protocol for a systematic scoping review

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