Effectiveness of guideline-based care by occupational physicians on the return-to-work of workers with common mental disorders: design of a cluster-randomised controlled trial

Beurden, Karlijn M. van; Brouwers, Evelien P. M.; Joosen, Margot C. W.; Terluin, Berend; Klink, Jac J. L. van der; Weeghel, Jaap van

doi:10.1186/1471-2458-13-193

Cited by 22 publications

(29 citation statements)

References 26 publications

(34 reference statements)

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“…The studies carried out in OH settings [33][34][35][36][37][38][39][40] were heterogeneous. They encompassed a wide range of interventions from psychological interventions, problem-solving and return on reduced hours, to interventions with occupational physicians and adherence to guidelines.…”

Section: Summary Of the Results Of The Reviewmentioning

confidence: 99%

Collaborative case management to aid return to work after long-term sickness absence: a pilot randomised controlled trial

et al. 2018

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BackgroundDespite high levels of employment among working-age adults in the UK, there is still a significant minority who are off work with ill health at any one time (so-called ‘sickness absence’). Long-term sickness absence results in significant costs to the individual, to the employer and to wider society.ObjectiveThe overall objective of the intervention was to improve employee well-being with a view to aiding return to work. To meet this aim, a collaborative case management intervention was adapted to the needs of UK employees who were entering or experiencing long-term sickness absence.DesignA pilot randomised controlled trial, using permuted block randomisation. Recruitment of patients with long-term conditions in settings such as primary care was achieved by screening of routine records, followed by mass mailing of invitations to participants. However, the proportion of patients responding to such invitations can be low, raising concerns about external validity. Recruitment in the Case Management to Enhance Occupational Support (CAMEOS) study used this method to test whether or not it would transfer to a population with long-term sickness absence in the context of occupational health (OH).ParticipantsEmployed people on long-term sickness absence (between 4 weeks and 12 months). The pilot was run with two different collaborators: a large organisation that provided OH services for a number of clients and a non-profit community-based organisation.InterventionCollaborative case management was delivered by specially trained case managers from the host organisations. Sessions were delivered by telephone and supported use of a self-help handbook. The comparator was usual care as provided by participants’ general practitioner (GP) or OH provider. This varied for participants according to the services available to them. Neither participants nor the research team were blind to randomisation.Main outcome measuresRecruitment rates, intervention delivery and acceptability to participants were the main outcomes. Well-being, as measured by the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), and return-to-work rates were also recorded.ResultsIn total, over 1000 potentially eligible participants were identified across the sites and invited to participate. However, responses were received from just 61 of those invited (5.5%), of whom 16 (1.5%) were randomised to the trial (seven to treatment, nine to control). Detailed information on recruitment methods, intervention delivery, engagement and acceptability is presented. No harms were reported in either group.ConclusionsThis pilot study faced a number of barriers, particularly in terms of recruitment of employers to host the research. Our ability to respond to these challenges faced several barriers related to the OH context and the study set up. The intervention seemed feasible and acceptable when delivered, although caution is required because of the small number of randomised participants. However, employees’ lack of engagement in the research might imply that they did not see the intervention as valuable.Future workDeveloping effective and acceptable ways of reducing sickness absence remains a high priority. We discuss possible ways of overcoming these challenges in the future, including incentives for employers, alternative study designs and further modifications to recruitment methods.Trial registrationCurrent Controlled Trials ISRCTN33560198.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 6, No. 2. See the NIHR Journals Library website for further project information.

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Section: Summary Of the Results Of The Reviewmentioning

confidence: 99%

Collaborative case management to aid return to work after long-term sickness absence: a pilot randomised controlled trial

et al. 2018

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“…A power calculation was performed to determine the number of participants needed to detect at least a 15% [35] difference between the intervention group and the control group concerning the primary outcome, i.e. the number of registered sick leave days (i.e.…”

Section: Methods and Designmentioning

confidence: 99%

Early identification in primary health care of people at risk for sick leave due to work-related stress – study protocol of a randomized controlled trial (RCT)

et al. 2016

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BackgroundEarly identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. Tho date, no established method to do this exists. This project’s aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence. This paper presents the study design, procedure and outcome measurements, as well as allocation and baseline characteristics of the study population.Method/designThe study is a two-armed randomized controlled trial with follow-up at 3, 6 and 12 months. Non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers (PHCC) were eligible to participate. At baseline work-related stress was measured by the Work Stress Questionnaire (WSQ), combined with feedback at consultation, at PHCC. The preventive intervention included early identification of work-related stress by the WSQ, GP training in the use of WSQ, GP feedback at consultation and finding suitable preventive measures. A process evaluation was used to explore how to facilitate future implementation and structural use of the WSQ at the PHCC. The primary outcome to compare the preventive sick leave intervention by the general practitioner (GP) versus treatment as usual is sick leave data obtained from the Swedish Social Insurance Agency register.DiscussionEarly screening for sick leave due to work-related stress makes it possible not only to identify those at risk for sick leave, but also to put focus on the patient’s specific work-related stress problems, which can be helpful in finding suitable preventive measures. This study investigates if use of the WSQ by GPs at PHCCs, combined with feedback at consultation, prevents future sickness absence.Trial registrationClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015

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“…The data of the current study were gathered as part of a larger study, a cluster-randomized controlled trial, examining the effect of an intervention to enhance guideline adherence in occupational physicians [19]. In the larger study, the inclusion criteria were: age 18-64 years, a first period of sickness absence between January 1st 2012 and January 15th 2013, receiving guidance by an occupational physician who participated in the study and who had diagnosed that mental health problems were the primary reason for sick absence (according to the Dutch Classification of Diseases, based on the ICD-10 [20], and adequate mastery of the Dutch language).…”

Section: Study Subjects and Proceduresmentioning

confidence: 99%

Use of a mental health guideline by occupational physicians and associations with return to work in workers sick-listed due to common mental disorders: a retrospective cohort study

Beurden

Joosen

Terluin

et al. 2017

Disability and Rehabilitation

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Overall, the guideline adherence of occupational physicians was not related to earlier return to work. However, there was considerable room for improvement in guideline use. Whether this leads to earlier return to work is still an ununanswered question. Implications for Rehabilitation Adherence of occupational physicians to an evidence-based occupational mental health guideline was low. Regular contact between occupational physician and employer was associated with earlier full return to work in workers with common mental disorders. It is important to focus on how implementation problems and barriers for guideline use can be overcome, in order to improve the quality of occupational mental health care and to potentially reduce sickness absence duration in workers with common mental disorders.

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Effectiveness of guideline-based care by occupational physicians on the return-to-work of workers with common mental disorders: design of a cluster-randomised controlled trial

Cited by 22 publications

References 26 publications

Collaborative case management to aid return to work after long-term sickness absence: a pilot randomised controlled trial

Collaborative case management to aid return to work after long-term sickness absence: a pilot randomised controlled trial

Early identification in primary health care of people at risk for sick leave due to work-related stress – study protocol of a randomized controlled trial (RCT)

Use of a mental health guideline by occupational physicians and associations with return to work in workers sick-listed due to common mental disorders: a retrospective cohort study

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