Predictors of return-to-work in patients with chronic musculoskeletal pain: A randomized clinical trial
Randi Brendbekken, Arild Vaktskjold, Anette Harris, Tone Tangen
Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, NO-2312 Ottestad, Norway. E-mail: email@example.com
Objective: To assess the predictive effect of a multidisciplinary intervention programme, pain, work-related factors and health, including anxiety/depression and beliefs, on return-to-work for patients sick-listed due to musculoskeletal pain.
Design: A randomized clinical study.
Methods: A total of 284 patients were randomized to either a multidisciplinary intervention programme (n = 141) or to a less resource-demanding brief intervention (n = 143). Work participation was estimated monthly from register data for 12 months. Return-to-work was defined as increased work participation in 3 consecutive months.
Results: In the adjusted model, return-to-work by 3 months was associated with a multidisciplinary intervention programme (odds ratio (OR) = 2.7, 95% confidence interval (95% CI) = 1.1–6.9), the factor “belief that work was cause of the pain” (OR = 2.2, 95% CI = 1.1–4.3), anxiety and depression (OR = 0.5, 95% CI = 0.2–0.98), and by an interaction between the multidisciplinary intervention and perceived support at work (OR = 0.3, 95% CI = 0.1–0.9). At 12 months, only duration of sick leave was associated with return-to-work (OR = 0.6, 95% CI = 0.5–0.8).
Conclusion: Multidisciplinary intervention may hasten return-to-work and benefit those who perceive low support at work, but at 12 months only duration of sick leave at baseline was associated with return-to-work.
A novel, clinical intervention hastened the return-to-work (RTW) process in patients sick-leaved with chronic musculoskeletal pain. In this study we compared the effects on RTW of a novel, comprehensive treatment involving a physician, a social worker and a physiotherapist with the effects of a less resource demanding treatment involving a physician and a physiotherapist. The new approach had a particular focus at psychosocial factors and the work situation and applied a visual, educational communication tool. The new intervention was superior to the control intervention in promoting RTW at 3 months follow-up but not at 12 months. The new intervention is more costly, so further studies are needed before we can conclude if this approach should be recommended before the control intervention.
Do you want to comment on this paper? The comments will show up here and if appropriate the comments will also separately be forwarded to the authors.
You need to login/create an account to comment on articles. Click here to login/create an account