The effect on work presenteeism of job retention vocational rehabilitation compared to a written self-help work advice pack for employed people with inflammatory arthritis: protocol for a multi-centre randomised controlled trial (the WORKWELL trial)

Abstract

Background Work problems are common in people with inflammatory arthritis. Up to 50% stop work within 10 years due to their condition and up to 67% report presenteeism (i.e. reduced work productivity), even amongst those with low disease activity. Job retention vocational rehabilitation (JRVR) may help prevent or postpone job loss and reduce presenteeism through work assessment, work-related rehabilitation and enabling job accommodations. This aims to create a better match between the person’s abilities and their job demands. The objectives of the Workwell trial are to test the overall effectiveness and cost-effectiveness of JRVR (WORKWELL) provided by additionally trained National Health Service (NHS) occupational therapists compared to a control group who receive self-help information both in addition to usual care. Methods Based on the learning from a feasibility trial (the WORK-IA trial: ISRCTN76777720), the WORKWELL trial is a multi-centre, pragmatic, individually-randomised parallel group superiority trial, including economic evaluation, contextual factors analysis and process evaluation. Two hundred forty employed adults with rheumatoid arthritis, undifferentiated inflammatory arthritis or psoriatic arthritis (in secondary care), aged 18 years or older with work instability will be randomised to one of two groups: a self-help written work advice pack plus usual care (control intervention); or WORKWELL JRVR plus a self-help written work advice pack and usual care. WORKWELL will be delivered by occupational therapists provided with additional JRVR training from the research team. The primary outcome is presenteeism as measured using the Work Limitations Questionnaire-25. A comprehensive range of secondary outcomes of work, health, contextual factors and health resource use are included. Outcomes are measured at 6- and 12- months (with 12-months as the primary end-point). A multi-perspective within-trial cost-effectiveness analyses will also be conducted. Discussion This trial will contribute to the evidence base for provision of JRVR to people with inflammatory arthritis. If JRVR is found to be effective in enabling people to keep working, the findings will support decision-making about provision of JRVR by rheumatology teams, therapy services and healthcare commissioners, and providing evidence of the effectiveness of JRVR and the economic impact of its implementation. Trial registration Clinical Trials.Gov: NCT03942783. Registered 08/05/2019 (https://clinicaltrials.gov/ct2/show/NCT03942783); ISRCTN Registry: ISRCTN61762297. Registered:13/05/2019 (http://www.isrctn.com/ISRCTN61762297). Retrospectively registered.

Management of Chronic Musculoskeletal Disorders in the Workplace from the Perspective of Older Employees: A Mixed Methods Research Study

“…Employers can discourage frequent or long-term absence from work by implementing strict sickness absence control procedures [ 75 , 89 ]. A causative relationship between the specific effects of CIDs and presenteeism has not been established, but there is some evidence to suggest that these conditions influence presenteeism behaviour [ 90 , 91 , 92 ].…”

Randomised evaluation of pre-notification of trial participants before self-report outcome data collection to improve retention: SWAT86

“…Irrespective of SWAT intervention, participants not responding to the questionnaire mailing within 2 weeks were subject to a standard reminder protocol which involved text, email, reposting and/or telephoning participants, as appropriate. 5…”

“…WORKWELL is a pragmatic, multi-centre individually-randomised trial of job-retention vocational rehabilitation for employed people with inflammatory arthritis which, unlike the ActWELL trial, uses participant self-report to collect outcome data. 5 The MRC-funded PROMETHEUS project resourced a replication of a pre-notification SWAT nested within WORKWELL. Our intervention differed from the ActWELL SWAT in the pre-notification being sent by letter or e-mail rather than postcard because the host trial gave participants a choice of data collection method (postal or online questionnaire).…”

The Workwell trial: protocol for the process evaluation of a randomised controlled trial of job retention vocational rehabilitation for employed people with inflammatory arthritis.

“…Therapists also had the opportunity for a formal telephone mentoring meeting with a Workwell trainer to discuss treatment plans for their rst participant. Thereafter regular mentoring sessions were offered to therapists to discuss participants' treatment [9].…”

“…A parallel economic evaluation is being undertaken. The Workwell trial protocol is published [9]. This paper presents the protocol for an embedded design mixed methods process evaluation alongside the Workwell trial.…”