Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trial
OBJECTIVES: In case of long-term sick leave, gradually increasing workload appears to be an effective component of work-directed interventions to reduce sick leave due to common mental disorders (CMD). CMD are defined as stress-related, adjustment, anxiety, or depressive disorders. We developed an e...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Nordic Association of Occupational Safety and Health (NOROSH)
2013-03-01
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| Series: | Scandinavian Journal of Work, Environment & Health |
| Subjects: | |
| Online Access: |
https://www.sjweh.fi/show_abstract.php?abstract_id=3320
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| _version_ | 1829485659509751808 |
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| author | Erik Noordik Jac J van der Klink Ronald B Geskus Michiel R de Boer Frank JH van Dijk Karen Nieuwenhuijsen |
| author_facet | Erik Noordik Jac J van der Klink Ronald B Geskus Michiel R de Boer Frank JH van Dijk Karen Nieuwenhuijsen |
| author_sort | Erik Noordik |
| collection | DOAJ |
| description | OBJECTIVES: In case of long-term sick leave, gradually increasing workload appears to be an effective component of work-directed interventions to reduce sick leave due to common mental disorders (CMD). CMD are defined as stress-related, adjustment, anxiety, or depressive disorders. We developed an exposure-based return-to-work (RTW-E) intervention and evaluated the effect on time-to-full return to work (RTW) among workers who were on sick leave due to CMD in comparison to those treated with care-as-usual (CAU). CAU is guideline-directed and consists of problem-solving strategies and graded activities. METHODS: Using a two-armed cluster-randomized trial, we randomized 56 occupational physicians (OP). Of these, 35 OP treated 160 workers at the start of their sick leave; 75 workers received RTW-E and 85 workers received CAU. These workers were followed over a 12-month follow-up period. The time-to-full RTW lasting ≥28 days without recurrence was the primary outcome measure. To evaluate differences between groups, we used intention-to-treat and multilevel Cox’s regression analysis. RESULTS: The median time-to-full RTW differed significantly between groups [hazard ratio (HR) 0.55; 95% confidence interval (95% CI) 0.33–0.89]. The workers receiving RTW-E (209 days; 95% CI 62–256) had a prolonged time-to-full RTW compared to workers receiving CAU (153 days; 95% CI 128–178). CONCLUSIONS: Workers on sick leave due to CMD treated with RTW-E showed a prolonged time-to-full RTW compared to those treated with CAU. We recommend that OP do not apply RTW-E but continue counseling workers on sick leave due to CMD according to CAU. |
| first_indexed | 2024-12-14T22:50:41Z |
| format | Article |
| id | doaj.art-fc9b5db54ef040ba9718047d633f7123 |
| institution | Directory Open Access Journal |
| issn | 0355-3140 1795-990X |
| language | English |
| last_indexed | 2024-12-14T22:50:41Z |
| publishDate | 2013-03-01 |
| publisher | Nordic Association of Occupational Safety and Health (NOROSH) |
| record_format | Article |
| series | Scandinavian Journal of Work, Environment & Health |
| spelling | doaj.art-fc9b5db54ef040ba9718047d633f71232022-12-21T22:44:45ZengNordic Association of Occupational Safety and Health (NOROSH)Scandinavian Journal of Work, Environment & Health0355-31401795-990X2013-03-0139214415410.5271/sjweh.33203320Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trialErik Noordik0Jac J van der KlinkRonald B GeskusMichiel R de BoerFrank JH van DijkKaren NieuwenhuijsenCoronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands.OBJECTIVES: In case of long-term sick leave, gradually increasing workload appears to be an effective component of work-directed interventions to reduce sick leave due to common mental disorders (CMD). CMD are defined as stress-related, adjustment, anxiety, or depressive disorders. We developed an exposure-based return-to-work (RTW-E) intervention and evaluated the effect on time-to-full return to work (RTW) among workers who were on sick leave due to CMD in comparison to those treated with care-as-usual (CAU). CAU is guideline-directed and consists of problem-solving strategies and graded activities. METHODS: Using a two-armed cluster-randomized trial, we randomized 56 occupational physicians (OP). Of these, 35 OP treated 160 workers at the start of their sick leave; 75 workers received RTW-E and 85 workers received CAU. These workers were followed over a 12-month follow-up period. The time-to-full RTW lasting ≥28 days without recurrence was the primary outcome measure. To evaluate differences between groups, we used intention-to-treat and multilevel Cox’s regression analysis. RESULTS: The median time-to-full RTW differed significantly between groups [hazard ratio (HR) 0.55; 95% confidence interval (95% CI) 0.33–0.89]. The workers receiving RTW-E (209 days; 95% CI 62–256) had a prolonged time-to-full RTW compared to workers receiving CAU (153 days; 95% CI 128–178). CONCLUSIONS: Workers on sick leave due to CMD treated with RTW-E showed a prolonged time-to-full RTW compared to those treated with CAU. We recommend that OP do not apply RTW-E but continue counseling workers on sick leave due to CMD according to CAU. https://www.sjweh.fi/show_abstract.php?abstract_id=3320 occupational healthabsenteeismsickness absencereturn to workrandomized controlled trialoccupational healthrtwcommon mental disorderreturn-to-work programexposure |
| spellingShingle | Erik Noordik Jac J van der Klink Ronald B Geskus Michiel R de Boer Frank JH van Dijk Karen Nieuwenhuijsen Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trial Scandinavian Journal of Work, Environment & Health occupational health absenteeism sickness absence return to work randomized controlled trial occupational health rtw common mental disorder return-to-work program exposure |
| title | Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trial |
| title_full | Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trial |
| title_fullStr | Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trial |
| title_full_unstemmed | Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trial |
| title_short | Effectiveness of an exposure-based return-to-work program for workers on sick leave due to common mental disorders: a cluster-randomized controlled trial |
| title_sort | effectiveness of an exposure based return to work program for workers on sick leave due to common mental disorders a cluster randomized controlled trial |
| topic | occupational health absenteeism sickness absence return to work randomized controlled trial occupational health rtw common mental disorder return-to-work program exposure |
| url |
https://www.sjweh.fi/show_abstract.php?abstract_id=3320
|
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