Training GPs to improve their management of work-related problems: results of a cluster randomized controlled trial

Kock, C A De; Bor, Hans; Knottnerus, J. A.; Buijs, P.C.; Steenbeek, Romy; Lagro-Janssen, Antoine L. M.

doi:10.1080/13814788.2018.1517153

Cited by 12 publications

(17 citation statements)

References 22 publications

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“…Hence, not only the diagnostic procedure but also the motives for diagnostic decision-making [ 48 ] can explain the variation in the degree of intrusion perceived in the study at hand. Further, findings from a Dutch study [ 49 ] indicate that merely training GPs about work-related problems does not to improve GPs’ registration of work-related problems and occupation. It might therefore be of value to take greater account of the GPs’ own developed ways of working and motives for diagnostic decision-making, when implementing an intervention.…”

Section: Discussionmentioning

confidence: 99%

Positioning work related stress – GPs’ reasoning about using the WSQ combined with feedback at consultation

2020

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Background General practitioners (GPs) regularly handle cases related to stress and work capacity, but often find this work difficult. However, using an assessment tool in a structured way can increase GPs’ awareness of the risk for sick leave and need of referrals to preventive measures. Today there is no established methodical practice for this in primary health care. The aim of this study was to explore GPs’ reasoning about using the Work Stress Questionnaire combined with feedback at consultation as an early intervention to reduce sick leave. Methods A focus group study was performed with 23 GPs at six primary health care centres. The discussions were analysed based on a method by Krueger. Results Three themes emerged. Positioning work-related stress describes the need to make fundamental standpoints on stress and how it should be handled, to make sense of their work concerning work-related stress. Making use of resources focuses on GPs performing to the best of their ability using assigned resources to treat patients with stress-related ill health, even if the resources were perceived as insufficient. Practising daily work focuses on the GPs’ regular and preferred way of working set against the degree of intrusion and benefits. The two related themes making use of resources and practising daily work were mirrored through the third theme, positioning work-related stress, to form an understanding of how GPs should work with patients perceiving work-related stress. Conclusions The GPs own competence and tools, those of other professionals and the time allocated were seen as important when treating patients perceiving ill health due to work-related stress. When resources were insufficient though, the GPs questioned their responsibility for these patients. The results also indicate that the GPs viewed their ordinary consultative way of working as sufficient to identify these patients. The intervention was therefore not seen as useful for early treatment of patients at risk of sick leave due to work-related stress. However, prevention is an important part of the PHC’s responsibility, and strategies concerning stress-related ill health therefore need to be more thoroughly formulated and incorporated. Trial registration ClinicalTrials.gov, NCT02480855. Registered 20 May 2015.

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Section: Discussionmentioning

confidence: 99%

Positioning work related stress – GPs’ reasoning about using the WSQ combined with feedback at consultation

2020

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“…This study is a secondary analysis of data from a randomized controlled trial about the effectiveness of education of GPs to improve patients’ coping when confronted with work-related problems ( 22 ). We consider the study a prospective cohort study and we will report it according to the STROBE guidelines ( 25 ).…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, for most of those who do not think their health problem is work-related, work can still be an important contextual factor. Dutch patients appreciate an active role of GPs concerning their work ( 21 , 22 ). However, the extent to which Dutch GPs fulfil this role still appears to be limited, and they often do not acknowledge the work-relatedness of health problems ( 23 , 24 ).…”

Section: Introductionmentioning

confidence: 99%

Work-relatedness of the presented health problem and sickness absence

Kock¹,

Akkermans

Knottnerus

et al. 2019

Family Practice

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Background Perception by workers of their health problems as work-related is possibly associated with sickness absence (SA). The aim of this study was to to study the relationship between perceived work-relatedness of health problems and SA among workers who visit their GP, taking the influence of other potential determinants into account and to study the influence of these determinants on SA. Design and setting prospective cohort study in 32 Dutch GP practices. Methods A secondary analysis of RCT data among workers, aged 18–63 years, who visited their GP. We measured self-reported SA days in 12 months and high SA (>20 days in 12 months) and compared workers who perceived work-relatedness (WR+) with workers who did not (WR−). With multivariable linear and logistic regression models, we analyzed the influence of age, gender, experienced health, chronic illness, prior SA, number of GP consultations and perceived work ability. Results We analyzed data of 209 workers, 31% perceived work-relatedness. Geometric mean of SA days was 1.6 (95% CI: 0.9–3.0) for WR+− workers and 1.2 (95% CI: 0.8–1.8) for WR− workers (P = 0.42). Incidence of high SA was 21.5 and 13.3%, respectively (odds ratio 1.79; 95% CI: 0.84–3.84). SA was positively associated with chronic illness, prior SA, low perceived work ability and age over 50. Conclusions Perceived work-relatedness was not associated with SA. SA was associated with chronic illness, prior SA, low perceived work ability and age over 50.

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“…Intervention group GPs received educational training, control group GPs provided usual care. The results with respect to the patient level and GP level outcomes were recently published [32]. This paper reports on the cost-effectiveness of our intervention with respect to work-related self-efficacy and quality of life.…”

Section: Methodsmentioning

confidence: 99%

“…This paper reports on the cost-effectiveness of our intervention with respect to work-related self-efficacy and quality of life. Detailed information regarding the methodology of this trial has been published elsewhere [31, 32].…”

Section: Methodsmentioning

confidence: 99%

Affecting patients with work-related problems by educational training of their GPs: a cost-effectiveness study

et al. 2019

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Background Assessing the cost effectiveness of training aimed at increasing general practitioners’ (GP) work awareness and patients’ work-related self-efficacy and quality of life. Methods A cluster randomized controlled trial in twenty-six GP practices in the southeast of the Netherlands with 32 participating GPs. GPs working in an intervention group practice received training and GPs working in a control group practice delivered usual care. The training intervention consisted of lectures and workshops aimed at increasing GPs’ work awareness and more proactive counseling for patients with work-related problems (WRP). Subjects were working age patients with paid work for at least 12 h per week, who visited one of the participating GPs during the study period. As outcome measures we used the Return to Work Self Efficacy scale to assess patients’ work-related self-efficacy and the Euroquol to assess quality of life. We also measured health care costs and productivity costs. With a 4-item questionnaire we asked patients to assess their GPs’ work awareness. Data were collected at baseline, after 6 and 12 months. Results Data of 280 patients could be analyzed. The patient related outcomes did not improve after GP training. The change in GP work awareness and the overall mean cost difference (of €770) in favor of the intervention group were not significant. Conclusions The training intervention presented in this paper was not cost-effective. Training which is further personalized and targeted at high risk groups with respect to WRP, is more likely to be cost effective. Electronic supplementary material The online version of this article (10.1186/s12875-019-0924-9) contains supplementary material, which is available to authorized users.

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Training GPs to improve their management of work-related problems: results of a cluster randomized controlled trial

Cited by 12 publications

References 22 publications

Positioning work related stress – GPs’ reasoning about using the WSQ combined with feedback at consultation

Positioning work related stress – GPs’ reasoning about using the WSQ combined with feedback at consultation

Work-relatedness of the presented health problem and sickness absence

Affecting patients with work-related problems by educational training of their GPs: a cost-effectiveness study

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