Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies

Abstract

Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits) and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened.

Mapping European Welfare Models: State of the Art of Strategies for Professional Integration and Reintegration of Persons with Chronic Diseases

“…Persons with specific chronic health conditions considered in this study can mainly receive support in employment if their condition can be recognized as a “disability” in their countries (reaching a certain eligible degree of disability) or have a negative impact on their work ability. The fact that legislation for persons with disabilities does not always benefit people with chronic diseases could be related to the way how disability is defined in the country: the population that benefits from disability policies is considerably restricted for those countries that use a narrow definition of disability as a personal characteristic of a minority, while is broader for those countries adopting a more inclusive definition of disability, in line with the definition proposed by WHO [ 28 ]. Basing on the definition of disability of the Convention on the Rights of Persons with Disabilities, persons with disabilities are persons who have “long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others” [ 13 ].…”

Furthering the Evidence of the Effectiveness of Employment Strategies for People with Mental Disorders in Europe: A Systematic Review

“…Figure 1 shows the general search strategy used within the Pathway project. It is meaningful to mention that the original systematic review run within the scope of the PATHWAYS project included different categories of disease—such as mental disorders, musculoskeletal disorders, cancer, and neurological, metabolic, respiratory, and cardiovascular diseases—and different study designs [ 44 ]. This paper focuses on the results of parts of this systematic literature review, particularly the effectiveness of strategies for integration and re-integration to work for persons with MD.…”

“…The quality of the included studies was assessed with quality appraisal checklists for quantitative intervention studies: National Institute of Health and Clinical Excellence (NICE) in the UK [ 48 ]. Methodological Assessment for the Complete PATHWAYS Review has been published elsewhere [ 44 ].…”

“…Pathways aims to contribute to the European dialogue concerning the development of strategies and further recommendations for promoting the participation of PwCD, including MD, in the labor market. To assess the evidence of the employment strategies for PwCD, a comprehensive systematic review was carried out in PATHWAYS for a wide range of chronic conditions, including mental disorders (see Sabariego et al, 2018 [ 44 ]) as well as another review focused on qualitative studies [ 45 ]. Our interest was focused on the effectiveness of employment interventions within the European framework aiming at improving access to (competitive) work, return to work, and job maintenance for people with MD of working age.…”

Employment and Chronic Diseases: Suggested Actions for The Implementation of Inclusive Policies for The Participation of People with Chronic Diseases in the Labour Market

“…Faced with this evidence, the European PATHWAYS project (www.path-ways.eu), which identified the impact of chronic diseases on European socio-medical systems, has shown how the existing EU and national level legislations regarding inclusive work are not specifically addressed to people with chronic diseases [9][10][11]. Conversely, these legislations apply to specific population groups, such as people with disabilities, long-term unemployed and "fragile" groups, but do not necessarily answer the needs of people affected with one or more chronic diseases [12].…”