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Open Access 01-06-2013

Effect of Peer-Based Low Back Pain Information and Reassurance at the Workplace on Sick Leave: A Cluster Randomized Trial

Authors: Magnus Odeen, Camilla Ihlebæk, Aage Indahl, Marjon E. A. Wormgoor, Stein A. Lie, Hege R. Eriksen

Published in: Journal of Occupational Rehabilitation | Issue 2/2013

Abstract

Purpose To evaluate whether information and reassurance about low back pain (LBP) given to employees at the workplace could reduce sick leave. Methods A Cluster randomized controlled trial with 135 work units of about 3,500 public sector employees in two Norwegian municipalities, randomized into two intervention groups; Education and peer support (EPS) (n = 45 units), education and “peer support and access to an outpatient clinic” (EPSOC) (n = 48 units), and a control group (n = 42 units). Both interventions consisted of educational meetings based on a “non-injury model” and a “peer adviser” appointed by colleagues. Employees in the EPSOC group had access to an outpatient clinic for medical examination and further education. The control group received no intervention. The main outcome was sick leave based on municipal records. Secondary outcomes were self-reported pain, pain related fear of movement, coping, and beliefs about LBP from survey data of 1,746 employees (response rate about 50 %). Results EPS reduced sick leave by 7 % and EPSOC reduced sick leave by 4 % during the intervention year, while sick leave in the control group was increased by 7 % during the same period. Overall, Rate Ratios (RR) were statistically significant for EPSOC (RR = .84 (C.I = 0.71–.99) but not EPS (RR = .92 (C.I = 0.78–1.09)) in a mixed Poisson regression analysis. Faulty beliefs about LBP were reduced in both intervention groups. Conclusions Educational meetings, combined with peer support and access to an outpatient clinic, were effective in reducing sick leave in public sector employees.

NAV. Sykefraværsprosent 1. kvartal 2002-2011. Totalt, sektor, kjønn og Ia-avtale.—Jobb og helse—Tall og analyse—NAV [Internet]. 2011 [cited 2011 Jul 25]. Available from: http://www.nav.no/Om+NAV/Tall+og+analyse/Jobb+og+helse/281413.cms.

Waddell G. The back pain revolution. Edinburgh: Churchill Livingstone; 1998.

Brage S, Ihlebaek C, Natvig B, Bruusgaard D. Musculoskeletal disorders as causes of sick leave and disability benefits. Tidsskr Nor Laegeforen. 2010;130(23):2369–70.PubMedCrossRef

Andersson GB. The epidemiology of spinal disorders. In: Frymoyer J, editor. The adult spine: principles and practice. 2nd ed. Philadelphia: Lippincott-Raven Publishers; 1997. p. 93–141.

Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract.Res. Clin. Rheumatol. 2010;24(6):769–81.PubMedCrossRef

Foster NE, Bishop A, Thomas E, Main C, Horne R, Weinman J, et al. Illness perceptions of low back pain patients in primary care: what are they, do they change and are they associated with outcome? Pain. 2008;136(1–2):177–87.PubMedCrossRef

Burton AK, Balague F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, et al. Chapter 2. European guidelines for prevention in low back pain : November 2004. Eur Spine J. 2006;15(Suppl 2):S136–68.PubMedCrossRef

Van Oostrom SH, Driessen MT, De Vet HC, Franche RL, Schonstein E, Loisel P, et al. Workplace interventions for preventing work disability. Cochrane Database Syst Rev. 2009;2:CD006955.

Carroll C, Rick J, Pilgrim H, Cameron J, Hillage J. Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions. Disabil Rehabil. 2010;32(8):607–21.PubMedCrossRef

10.

Tveito TH, Hysing M, Eriksen HR. Low back pain interventions at the workplace: a systematic literature review. Occup Med (Lond). 2004;54(1):3–13.CrossRef

11.

Odeen M, Magnussen LH, Maeland S, Larun L, Eriksen HR, Tveito TH. Systematic review of active workplace interventions to reduce sickness absence. Occup Med (Lond). 2013;63(1):7–16.

12.

Indahl A, Holm SH, Bogduk N. Sensory motor control of the spine—a key to low-back pain? Eur. Musculoskeletal Rev. 2009;4(1):44–7.

13.

Sorensen PH, Bendix T, Manniche C, Korsholm L, Lemvigh D, Indahl A. An educational approach based on a non-injury model compared with individual symptom-based physical training in chronic LBP. A pragmatic, randomised trial with a one-year follow-up. BMC Musculoskelet Disord. 2010;11(1):212.PubMedCrossRef

14.

Brox JI, Storheim K, Grotle M, Tveito TH, Indahl A, Eriksen HR. Systematic review of back schools, brief education, and fear-avoidance training for chronic low back pain. Spine J. 2008;8(6):948–58.PubMedCrossRef

15.

Hagen EM, Eriksen HR, Ursin H. Does early intervention with a light mobilization program reduce long-term sick leave for low back pain? Spine. 2000;25(15):1973–6.PubMedCrossRef

16.

Hagen E, Grasdal A, Eriksen HR. Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study. Spine. 2003;28(20):2309–15. discussion 2316.CrossRef

17.

Indahl A, Haldorsen EH, Holm S, Reikeras O, Ursin H. Five-year follow-up study of a controlled clinical trial using light mobilization and an informative approach to low back pain. Spine. 1998;23(23):2625–30.PubMedCrossRef

18.

Indahl A, Velund L, Reikeraas O. Good prognosis for low back pain when left untampered. A randomized clinical trial. Spine. 1995;20(4):473–7.PubMedCrossRef

19.

Magnusson ML, Aleksiev A, Wilder DG, Pope MH, Spratt K, Lee SH, et al. European spine society—The acromed prize for spinal research 1995 unexpected load and asymmetric posture as etiologic factors in low back pain. Eur Spine J. 1996;5(1):23–35.PubMedCrossRef

20.

Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317–32.PubMedCrossRef

21.

Petrie KJ, Weinman J. Perceptions of health and illness : current research and applications. Amsterdam: Harwood Academic Publishers; 1997.

22.

Malmivaara A, Hakkinen U, Aro T, Heinrichs ML, Koskenniemi L, Kuosma E, et al. The treatment of acute low back pain–bed rest, exercises, or ordinary activity? N Engl J Med. 1995;332(6):351–5.PubMedCrossRef

23.

Werner EL, Lærum E, Wormgoor M, Lindh E, Indahl A. Peer support in an occupational setting preventing LBP-related sick leave. Occup Med. 2007;57:590–5.CrossRef

24.

Ursin H, Eriksen HR. The cognitive activation theory of stress. Psychoneuroendocrinology. 2004;29(5):567–92.PubMedCrossRef

25.

Sorensen G, Emmons K, Hunt MK, Johnston D. Implications of the results of community intervention trials. Annu Rev Public Health. 1998;19(1):379–416.PubMedCrossRef

26.

Eriksen HR, Ihlebæk C, Ursin H. A scoring system for subjective health complaints (SHC). Scand J Public Health. 1999;1:63–72.CrossRef

27.

Poulsen OM, Persson R, Kristiansen J, Andersen LL, Villadsen E, Ørbæk P. Distribution of subjective health complaints, and their association with register based sickness absence in the Danish working population. Scand J Public Health. 2013;41(2):150–7.PubMedCrossRef

28.

Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21–37.PubMedCrossRef

29.

Deyo RA. Low-Back Pain. Sci Am. 1998;(August):29–33.

30.

Odeen M, Westerlund H, Theorell T, Leineweber C, Eriksen H, Ursin H. Expectancies, socioeconomic status, and self-rated health: The use of simplified questionnaires. Int J Behav Med. 2012.

31.

Kori SH, Miller RP, Todd DD. Kinesiophobia: a new view of chronic pain behavior. Pain Manag. 1990;3:35–43.

32.

Swinkels-Meewisse EJC, Swinkels RAH, Verbeek AL, Vlaeyen JW, Oostendorp RA. Psychometric properties of the Tampa Scale for kinesiophobia and the fear-avoidance beliefs questionnaire in acute low back pain. Man Ther. 2003;8(1):29–36.PubMedCrossRef

33.

Indahl A. Når ryggen krangler. Rakkestad: Vadisholm forlag; 2003.

34.

Bates D, Maechler M, Bolker B. lme4: Linear mixed-effects models using S4 classes. R package version 0.999375-33. [Internet]. 2010 [cited 2011 Apr 7]. Available from: http://cran.r-project.org/web/packages/lme4/index.html.

35.

R Development Core Team. R: A language and environment for statistical computing. [Internet]. Vienna, Austria: R Foundation for Statistical Computing; 2010 [cited 2011 Apr 7]. Available from: http://www.r-project.org/.

36.

Daltroy LH, Iversen MD, Larson MG, Lew R, Wright E, Ryan J, et al. A controlled trial of an educational program to prevent low back injuries. N Engl J Med. 1997;337(5):322–8.PubMedCrossRef

37.

Eriksen HR, Ihlebaek C, Mikkelsen A, Gronningsaeter H, Sandal GM, Ursin H. Improving subjective health at the worksite: a randomized controlled trial of stress management training, physical exercise and an integrated health programme. Occup Med (Lond). 2002;52(7):383–91.CrossRef

38.

Tveito TH, Eriksen HR. Integrated health programme: a workplace randomized controlled trial. J Adv Nurs. 2009;65(1):110–9.PubMedCrossRef

39.

Haukka E, Leino-Arjas P, Viikari-Juntura E, Takala E-P, Malmivaara A, Hopsu L, et al. A randomised controlled trial on whether a participatory ergonomics intervention could prevent musculoskeletal disorders. Occup Environ Med. 2008;65(12):849–56.PubMedCrossRef

40.

Karjalainen K, Malmivaara A, van Tulder M, Roine R, Jauhiainen M, Hurri H, et al. Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. Cochrane Database Syst Rev. 2003;(2):CD002194.

41.

Frost P, Haahr JP, Andersen JH. Reduction of Pain-Related Disability in Working Populations. Spine. 2007;32(18):1949–54.PubMedCrossRef

42.

Symonds TL, Burton AK, Tillotson KM, Main CJ. Absence resulting from low back trouble can be reduced by psychosocial intervention at the work place. Spine. 1995;20(24):2738–45.PubMedCrossRef

43.

Lambeek LC, van Mechelen W, Knol DL, Loisel P, Anema JR. Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ. 2010;340:c1035.

44.

Driessen MT, Proper KI, van Tulder MW, Anema JR, Bongers PM, van der Beek AJ. The effectiveness of physical and organisational ergonomic interventions on low back pain and neck pain: a systematic review. Occup Environ Med. 2010;67(4):277–85.PubMedCrossRef

Title: Effect of Peer-Based Low Back Pain Information and Reassurance at the Workplace on Sick Leave: A Cluster Randomized Trial
Authors: Magnus Odeen
Camilla Ihlebæk
Aage Indahl
Marjon E. A. Wormgoor
Stein A. Lie
Hege R. Eriksen
Publication date: 01-06-2013
Publisher: Springer US
Published in: Journal of Occupational Rehabilitation / Issue 2/2013
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-013-9451-z

Keynote webinar | Spotlight on medication adherence

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Effect of Peer-Based Low Back Pain Information and Reassurance at the Workplace on Sick Leave: A Cluster Randomized Trial

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Keynote webinar | Spotlight on medication adherence

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