Effectiveness of guideline-based care by occupational physicians on the return-to-work of workers with common mental disorders: design of a cluster-randomised controlled trialReportar como inadecuado




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BMC Public Health

, 13:193

Health behavior, health promotion and society

Abstract

BackgroundSickness absence due to common mental disorders such as depression, anxiety disorder, adjustment disorder is a problem in many Western countries. Long-term sickness absence leads to substantial societal and financial costs. In workers with common mental disorders, sickness absence costs are much higher than medical costs. In the Netherlands, a practice guideline was developed that promotes an activating approach of the occupational physician to establish faster return-to-work by enhancing the problem-solving capacity of workers, especially in relation to their work environment. Studies on this guideline indicate a promising association between guideline adherence and a shortened sick leave duration, but also minimal adherence to the guideline by occupational physicians. Therefore, this study evaluates the effect of guideline-based care on the full return-to-work of workers who are sick listed due to common mental disorders.

Methods-designThis is a two-armed cluster-randomised controlled trial with randomisation at the occupational physician level. During one year, occupational physicians in the intervention group receive innovative training to improve their guideline-based care whereas occupational physicians in the control group provide care as usual. A total of 232 workers, sick listed due to common mental disorders and counselled by participating occupational physicians, will be included. Data are collected via the registration system of the occupational health service, and by questionnaires at baseline and at 3, 6 and 12 months. The primary outcome is time to full return-to-work. Secondary outcomes are partial return-to-work, total number of sick leave days, symptoms, and workability. Personal and work characteristics are the prognostic measures. Additional measures are coping, self-efficacy, remoralization, personal experiences, satisfaction with consultations with the occupational physician and with contact with the supervisor, experiences and behaviour of the supervisor, and the extent of guideline adherence.

DiscussionIf the results show that guideline-based care in fact leads to faster and sustainable return-to-work, this study will contribute to lowering personal, societal and financial costs.

Trial registrationISRCTN86605310

KeywordsCommon mental disorders Sick leave Return-to-work Occupational health service Occupational physicians Guideline adherence Guideline-based care AbbreviationsCMDCommon mental disorders

RTWReturn-to-work

OPOccupational physician

OHSOccupational health service

NVABThe Netherlands society of occupational medicine

CASDutch classification of diseases

4DSQFour dimensional symptoms questionnaire

UBOSUtrechtse burnout scale

WAIWork ability index

JCQJob content questionnaire

UCLUtrecht coping list

RTW-SEReturn-to-work self-efficacy scale

RS-1212-Item remoralization scale

PSOHPQPatient satisfaction with occupational health professionals questionnaire

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-13-193 contains supplementary material, which is available to authorized users.

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Autor: Karlijn M van Beurden - Evelien P M Brouwers - Margot C W Joosen - Berend Terluin - Jac J L van der Klink - Jaap van

Fuente: https://link.springer.com/







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