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BMC Primary Care
Published in: BMC Primary Care 1/2020

Open Access 01-12-2020 | Care | Research article

Effects of a vocational rehabilitation programme on return to work among sick-listed primary health care patients: a population-based matched, case-control study

Authors: Anna-Sophia von Celsing, Per Kristiansson, Kurt Svärdsudd, Thorne Wallman

Published in: BMC Primary Care | Issue 1/2020

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Abstract

Background

To evaluate the efficacy of a multidisciplinary vocational programme in sick-listed, primary health care patients as compared to matched non-programme patients.

Methods

The design was a 3-year prospective population-based, matched case-control study. It was set in a large primary healthcare centre in the city of Eskilstuna, Sweden. The subjects were 943 sickness-certified patients (482 women and 461 men). 170 high-risk patients and a matched control group (n = 340) with similar risk for not returning to work within expected time, based on propensity score was created. The intervention group passed a multidisciplinary medical assessment and a coordinated vocational programme, while the control group received usual care by their general practitioner. Main outcome was sick leave conclusion and the day when it occurred.

Results

The follow-up time was subdivided into four periods. During the first two periods, days 1–14 and days 15–112 after baseline, the intervention group had a significantly lower sick leave conclusion rate than the control group (hazard ratios, (HR) 0.32, 95% CI 0.20–0.51, p <  0.0001 and 0.47, 95% CI 0.35–0.64). During the third period, days 113–365, the intervention group had an insignificantly lower conclusion rate (HR 0.70, 95% CI 0.46–1.08, p = 0.10), and during the fourth follow-up period, days 366–1096, the intervention group had an insignificantly higher conclusion rate than the control group (HR 1.16, 95% CI 0.69–1.96, p = 0.58). Across the total follow-up period, the intervention group had a lower conclusion rate than the control group (HR 0.55, 95% CI 0.45–0.66, p <  0.0001).

Conclusions

No positive significant effects of the rehabilitation programme on time to sick leave conclusion were found.
Literature
1.
von Celsing AS, Svardsudd K, Eriksson HG, Bjorkegren K, Eriksson M, Wallman T. Determinants for return to work among sickness certified patients in general practice. BMC Public Health. 2012;12:1077.CrossRef
2.
Henderson M, Glozier N, Holland EK. Long term sickness absence. BMJ. 2005;330(7495):802–3.CrossRef
3.
Wallman T, Wedel H, Palmer E, Rosengren A, Johansson S, Eriksson H, et al. Sick-leave track record and other potential predictors of a disability pension. A population based study of 8,218 men and women followed for 16 years. BMC Public Health. 2009;9:104.CrossRef
4.
Wadell G, Burton AK. Is work good for your health and well-being? Norwich: The Stationary Office; 2006.
5.
Lund T, Kivimaki M, Labriola M, Villadsen E, Christensen KB. Using administrative sickness absence data as a marker of future disability pension: the prospective DREAM study of Danish private sector employees. Occup Environ Med. 2008;65(1):28–31.CrossRef
6.
Labriola M. Conceptual framework of sickness absence and return to work, focusing on both the individual and the contextual level. Work. 2008;30(4):377–87.PubMed
7.
Alexanderson K, Kivimaki M, Ferrie JE, Westerlund H, Vahtera J, Singh-Manoux A, et al. Diagnosis-specific sick leave as a long-term predictor of disability pension: a 13-year follow-up of the GAZEL cohort study. J Epidemiol Community Health. 2012;66(2):155–9.CrossRef
8.
Lidwall U, Bergendorff S, Voss M, Marklund S. Long-term sickness absence: changes in risk factors and the population at risk. Int J Occup Med Environ Health. 2009;22(2):157–68.CrossRef
9.
Roelen CA, Koopmans PC, Schreuder JA, Anema JR, van der Beek AJ. The history of registered sickness absence predicts future sickness absence. Occup Med (Lond). 2011;61(2):96–101.CrossRef
10.
Cornelius LR, van der Klink JJ, Groothoff JW, Brouwer S. Prognostic factors of long term disability due to mental disorders: a systematic review. J Occup Rehabil. 2011;21(2):259–74.CrossRef
11.
Gjesdal S, Bratberg E. The role of gender in long-term sickness absence and transition to permanent disability benefits. Results from a multiregister based, prospective study in Norway 1990-1995. Eur J Pub Health. 2002;12(3):180–6.CrossRef
12.
Shiels C, Gabbay MB, Ford FM. Patient factors associated with duration of certified sickness absence and transition to long-term incapacity. Br J Gen Pract. 2004;54(499):86–91.PubMedPubMedCentral
13.
von Celsing AS, Svardsudd K, Wallman T. Predicting return to work among sickness-certified patients in general practice: properties of two assessment tools. Ups J Med Sci. 2014;119(3):268–77.CrossRef
14.
Hoefsmit N, Houkes I, Nijhuis FJ. Intervention characteristics that facilitate return to work after sickness absence: a systematic literature review. J Occup Rehabil. 2012;22(4):462–77.CrossRef
15.
Norlund A, Ropponen A, Alexanderson K. Multidisciplinary interventions: review of studies of return to work after rehabilitation for low back pain. J Rehabil Med. 2009;41(3):115–21.CrossRef
16.
Johansson P, Lindahl E. Locking-in effects due to early interventions? An evaluation of a multidisciplinary screening programs for avoiding long-term sickness. Eval Rev. 2012;36(5):323–45.CrossRef
17.
The Swedish Ministry on Social Affairs. Stockholm. The Act on General Insurance. SFS 1962:381.
18.
World Health Organization. International Classification of Diseases and Related Health Problems (ICD) 10 system. Version 1997.
19.
Bogefeldt J, Grunnesjo MI, Svardsudd K, Blomberg S. Sick leave reductions from a comprehensive manual therapy programme for low back pain: the Gotland low Back pain study. Clin Rehabil. 2008;22(6):529–41.CrossRef
20.
Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70(1):41–55.CrossRef
21.
Suoyrjo H, Oksanen T, Hinkka K, Kivimaki M, Klaukka T, Pentti J, et al. The effectiveness of vocationally oriented multidisciplinary intervention on sickness absence and early retirement among employees at risk: an observational study. Occup Environ Med. 2009;66(4):235–42.CrossRef
22.
Kuoppala J, Lamminpaa A. Rehabilitation and work ability: a systematic literature review. J Rehabil Med. 2008;40(10):796–804.CrossRef
23.
Haldorsen EM, Grasdal AL, Skouen JS, Risa AE, Kronholm K, Ursin H. Is there a right treatment for a particular patient group? Comparison of ordinary treatment, light multidisciplinary treatment, and extensive multidisciplinary treatment for long-term sick-listed employees with musculoskeletal pain. Pain. 2002;95(1–2):49–63.CrossRef
24.
Carlsson L, Englund L, Hallqvist J, Wallman T. Early multidisciplinary assessment was associated with longer periods of sick leave: a randomized controlled trial in a primary health care Centre. Scand J Prim Health Care. 2013;31(3):141–6.CrossRef
25.
Jensen OK, Stengaard-Pedersen K, Jensen C, Nielsen CV. Prediction model for unsuccessful return to work after hospital-based intervention in low back pain patients. BMC Musculoskelet Disord. 2013;14:140.CrossRef
26.
Anema JR, Steenstra IA, Bongers PM, de Vet HC, Knol DL, Loisel P, et al. Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both? A randomized controlled trial. Spine (Phila Pa 1976). 2007;32(3):291–8 discussion 9-300.CrossRef
27.
Momsen AH, Stapelfeldt CM, Nielsen CV, Nielsen MB, Aust B, Rugulies R, et al. Effects of a randomized controlled intervention trial on return to work and health care utilization after long-term sickness absence. BMC Public Health. 2016;16(1):1149.CrossRef
28.
Vogel N, Schandelmaier S, Zumbrunn T, Ebrahim S, de Boer WE, Busse JW, et al. Return-to-work coordination programmes for improving return to work in workers on sick leave. Cochrane Database Syst Rev. 2017;3:CD011618.PubMed
29.
30.
Fleten N, Johnsen R, Forde OH. Length of sick leave - why not ask the sick-listed? Sick-listed individuals predict their length of sick leave more accurately than professionals. BMC Public Health. 2004;4:46.CrossRef
31.
Berglind H, Gerner U. Motivation and return to work among the long-term sicklisted: an action theory perspective. Disabil Rehabil. 2002;24(14):719–26.CrossRef
32.
Heijbel B, Josephson M, Jensen I, Stark S, Vingard E. Return to work expectation predicts work in chronic musculoskeletal and behavioral health disorders: prospective study with clinical implications. J Occup Rehabil. 2006;16(2):173–84.CrossRef
Metadata
Title
Effects of a vocational rehabilitation programme on return to work among sick-listed primary health care patients: a population-based matched, case-control study
Authors
Anna-Sophia von Celsing
Per Kristiansson
Kurt Svärdsudd
Thorne Wallman
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Primary Care / Issue 1/2020
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-020-01123-y

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