Details

Autor(en) / Beteiligte

• Noordik, Erik
• van der Klink, Jac J
• Geskus, Ronald B
• de Boer, Michiel R
• van Dijk, Frank J H
• Nieuwenhuijsen, Karen

Titel

Effectiveness of an Exposure-Based Return-to-Work Program for Workers on Sick Leave due to Common Mental Disorders: A Cluster-Randomized Controlled Trial

Ist Teil von

• Scandinavian Journal of Work, Environment ＆ Health, 2013-03, Vol.39 (2), p.144-154

Ort / Verlag

Helsinki: Scandinavian Journal of Work, Environment ＆ Health

Erscheinungsjahr

2013

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• 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 primary outcome measure was time-to-full RTW lasting ≥28 days without recurrence. 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.