Evaluation of Self-Reported Work Ability and Usefulness of Interventions Among Sick-Listed Patients

Abstract

Methods A prospective cohort study was performed including 810 newly sick-listed patients (MSD 62% and MD 38%). The baseline questionnaire included sociodemographic characteristics and measures of work ability. The 3-month follow-up questionnaire included measures of work ability, type of intervention received, and judgment of usefulness.Results Twenty-five percent received medical intervention modalities (MI) only, 45% received a combination of medical and rehabilitative intervention modalities (CRI) and 31% received workrelated interventions combined with medical or rehabilitative intervention modalities (WI).Behavioural treatments were more common for patients with MD compared with MSD and exercise therapy were more common for patients with MSD. The most prevalent workplace interventions were adjustment of work tasks or the work environment. Among patients with MD, WI was found to be useful and improved work ability significantly more compared with only MI or CRI. For patients with MSD, no significant differences in improved work ability were found between interventions.Conclusions Patients with MD who received a combination of work-related and clinical interventions reported best usefulness and best improvement in work ability. There was no difference in improvements in work ability between rehabilitation methods in the MSD group.There seems to be a gap between scientific evidence and praxis behaviour in the rehabilitation process. Unimodal rehabilitation was widely applied in the early rehabilitation process, a multimodal treatment approach was rare and only one-third received work-related interventions.It remains a challenge to understand who needs what type of intervention.

Sickness certificates: what information do they provide about rehabilitation?

“…The finding that early rehabilitation interventions were only prescribed in approximately onefourth of sickness certificates is in agreement with a concurrent study conducted in the same county council, which included patients with MSD and MD who were certified sick leave by PHC or OHS [11]. Wåhlin et al observed that within three months, 45% of these patients reportedly have received a combination of medical and rehabilitative intervention modalities, and 31% had also received work-related interventions [11].…”

“…Wåhlin et al observed that within three months, 45% of these patients reportedly have received a combination of medical and rehabilitative intervention modalities, and 31% had also received work-related interventions [11]. When only MD and MSD were included in the current analysis, early rehabilitation was prescribed in 45% of the certificates issued for these two diagnostic groups.…”

“…Rehabilitation interventions suggested to improve RTW are often multifaceted including cooperation between different healthcare professionals and contact with the workplace [7][8][9][10]. The timing is also important, and some studies have shown that early rehabilitation interventions are effective in supporting RTW [7,10,11]. The time frames constituting "early" vary though in the studies.…”

“…The time frames constituting "early" vary though in the studies. When evaluating which rehabilitation interventions patients actually receive, differences based on patients' diagnoses, sex, and age are observed [11,12]. Rehabilitation interventions are primarily awarded to younger patients [12,13].…”

Costs of production loss and primary health care interventions for return-to-work of sick-listed workers in Sweden

“…Other caregivers were consulted in a few cases. Rehabilitative activities were healthcare advice, behavioural treatment (therapeutic conversation, cognitive therapy, body awareness), exercise therapy/physical activity, manual treatment (manual, acupuncture/TENS), ergonomic/ADL, equipment/orthosis and other [17]. The interventions included healthcare consultations with personal meetings as well as indirect contacts, i.e.…”