Interventions to Promote Work‐Focused Care by Healthcare Providers for Individuals with Musculoskeletal Conditions a Scoping Review

Xie, Yanfei; Hutting, Nathan; Bartys, Serena; Johnston, Venerina

doi:10.1007/s10926-021-09971-w

Cited by 11 publications

(6 citation statements)

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“…These interventions had a specific focus on work, while in our meta-analyses only 37% (n=15 of 41) had a 'vocational or work-related support' feature in clinical settings or combined settings (clinical and workplace). 10 As the number of workplace interventions in our meta-analyses was very low (n=4), this precluded any firm conclusions regarding their effect. A previous meta-analysis on workplace interventions in various diseases including among which eight RCTs in people with RMDs found improvements in sick leave, but half of the studies included back pain or work-related Treatments Treatments Treatments musculoskeletal disorders (which were outside the scope of our review).…”

Section: Discussionmentioning

confidence: 93%

“…Previous reviews of nonpharmacological interventions focused on a specific type of non-pharmacological intervention or a specific RMD, such as inflammatory arthritis, and did not address all domains of work participation (presenteeism, sick leave and work status). [10][11][12] A summary of the effectiveness of all types of non-pharmacological interventions, across the whole spectrum of RMDs and for all work outcome domains, could be worthwhile. Subgroup analyses would allow quantifying effectiveness of non-pharmacological interventions by type of RMDs, intervention characteristics and outcomes.…”

Section: What This Study Addsmentioning

confidence: 99%

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Non-pharmacological interventions to promote work participation in people with rheumatic and musculoskeletal diseases: a systematic review and meta-analysis from the EULAR taskforce on healthy and sustainable work participation

et al. 2023

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ObjectiveTo summarise the evidence on effectiveness of non-pharmacological (ie, non-drug, non-surgical) interventions on work participation (sick leave, work status and presenteeism) in people with rheumatic and musculoskeletal diseases (RMDs).MethodsA systematic review of randomised controlled trials (RCTs) and longitudinal observational studies (LOS) was performed. Qualitative (RCTs/LOS) and quantitative (RCTs) evidence syntheses were conducted. Mixed-effects restricted maximum likelihood models were used to combine effect estimates, using standardised mean differences (SMDs) as the summary measure for each outcome domain separately, with a negative SMD favouring the intervention over comparator. Subgroup analyses were performed for type of RMD, risk status at baseline regarding adverse work outcomes and intervention characteristics.ResultsOf 10 153 records, 64 studies (37 RCTs and 27 LOS; corresponding tok=71 treatment comparisons) were included. Interventions were mostly conducted in clinical settings (44 of 71, 62%). Qualitative synthesis suggested clear beneficial effects of 7 of 64 (11%) interventions for sick leave, 1 of 18 (6%) for work status and 1 of 17 (6%) for presenteeism. Quantitative synthesis (37 RCTs;k=43 treatment comparisons) suggested statistically significant but only small clinical effects on each outcome (SMDsick leave(95% CI)=−0.23 (−0.33 to −0.13;k=42); SMDwork status=−0.38 (−0.63 to −0.12;k=9); SMDpresenteeism=−0.25 (−0.39 to −0.12;k=13)).ConclusionIn people with RMDs, empirical evidence shows that non-pharmacological interventions have small effects on work participation. Effectiveness depends on contextual factors such as disease, population risk status, intervention characteristics and outcome of interest, highlighting the importance of tailoring interventions.

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Section: Discussionmentioning

confidence: 93%

Section: What This Study Addsmentioning

confidence: 99%

Non-pharmacological interventions to promote work participation in people with rheumatic and musculoskeletal diseases: a systematic review and meta-analysis from the EULAR taskforce on healthy and sustainable work participation

et al. 2023

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“…A recently published review on interventions to promote work-focused care (ie, work interventions within healthcare) presented positive results concerning work-related outcomes overall. 49 However, they highlighted the issue with a heterogeneity and variability in categorizing the work-focused interventions and concluded that the effectiveness of components could not be clarified. A common shared description of the content of work focused care would facilitate interpretation of results and comparison between studies.…”

Section: Strength and Limitationsmentioning

confidence: 99%

“…Xie et al presented six categories or elements of work-focused care: vocational advice/coaching or education, work-related assessment, involvement of the workplace stakeholders, regular communication with multidisciplinary team members, restoration of fitness for work, and training of work-related skills. 49 The four categories of work interventions in our study – ie, ergonomic intervention, RTW plan, stakeholder reconciliation meeting, and workplace visit – can be found in the description of one or several of the categories devised by Xie et al Although categories are not well defined and there may be an overlap, the strength of our categories is that they were identified by clinicians in the national SQRP network to fit what is actually offered to the patients within IPRPs in Sweden.…”

Section: Strength and Limitationsmentioning

confidence: 99%

Work Interventions Within Interdisciplinary Pain Rehabilitation Programs (IPRP) – Frequency, Patient Characteristics, and Association with Self-Rated Work Ability

Svanholm¹,

Björk²,

Löfgren³

et al. 2023

JPR

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Background Interdisciplinary pain rehabilitation programs (IPRPs) help people with chronic pain improve their health and manage their work; however, the way IPRPs address sick leave could be improved. Although work interventions can be a part of IPRP, it is not well known how and to what extent. Aim This study explores the frequency of work interventions and the characteristics of patients who participate in work interventions as part of IPRP at specialist pain rehabilitation departments in Sweden. In addition, this study explores the association between participation in work interventions and change in patients’ self-rated work ability after IPRP. Methods Data from the Swedish quality registry for pain rehabilitation (SQRP), which includes 3809 patients between 2016 and 2018, were analysed with descriptive statistics and regression analyses. Results The results indicate a high participation rate in work interventions (90%). Some differences were evident concerning characteristics of patients who participated in different work interventions. The return-to-work (RTW) plan, the most frequently used work intervention, had the strongest association with change in self-rated work ability after IPRP. However, the effect sizes were small, and the initial score best explained the change. Furthermore, there were differences between employed and unemployed patients and employment had a positive association with change in self-rated work ability. Conclusion More research is needed to understand IPRP’s mechanisms and work interventions to support patients with chronic pain, reduce sick leave, and manage work. Employment status needs to be considered and interventions should be tailored to match the individual needs.

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“…"Where the healthcare professional acknowledges the importance of work by identifying and addressing obstacles to work participation in the clinical encounter and collaborates with other stakeholders" (Xie et al 2021).…”

Section: Introductionmentioning

confidence: 99%

Empathy is key: addressing obstacles to policy progress of ‘work-focused healthcare’

Bartys

Martin

Parker

et al. 2022

Evidence &Amp; Policy

Self Cite

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Background: In 2019, Public Health England commissioned the authors of this paper to conduct research examining healthcare professionals’ conversations about work with their patients to inform policy aimed at reducing work loss due to ill health.Aims and objectives: The purpose of this paper is to show how the commission provided a unique opportunity for the authors to collaborate with the funders to address obstacles to policy progress.Methods: A steering group was established to revise the original remit of research. In outlining that process here, qualitative data collected from a wide range of healthcare professionals as part of the commission are presented for the first time. We are able to further illuminate and expand on the previously published report findings and policy recommendations, revealing novel insights on researcher-policy engagement.Findings: Robust implementation of ‘work-focused healthcare’ policy has been limited, resulting in an overwhelming lack of empirical data and misguided directives. However, the existing evidence did provide important information about obstacles to policy progress and how to overcome them. The qualitative data were instrumental in this respect, with healthcare professionals revealing various interpretations of, and discourse on the policy.Discussion and conclusions: This paper adds to the expanding literature which suggests that long term, mutualistic, collaborative working is central to addressing barriers to improving evidence use and mobilising health policy into practice. It was shown that tacit, generous, open, empathic and ongoing knowledge exchange, advocacy, and alliances are needed.<br />Key messages<br /><ul><li>This paper builds on the literature which reports relationship- and skills-building with policymakers to be the most important factors in influencing the use of evidence and mobilising health policy into practice.</li><br /><li>A unique opportunity to participate in a continuous, informal, and timely exchange of information with decision makers to address obstacles to policy progress is described.</li><br /><li>Novel insights are revealed into the alliances needed between academic, policy, and healthcare professionals to implement ‘work-focused healthcare’.</li></ul>

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Interventions to Promote Work‐Focused Care by Healthcare Providers for Individuals with Musculoskeletal Conditions a Scoping Review

Abstract: ManuscriptClick here to access/download;Manuscript;Scoping review manuscript_R2_1.3.21.docx Click here to view linked References

Cited by 11 publications

References 43 publications

Non-pharmacological interventions to promote work participation in people with rheumatic and musculoskeletal diseases: a systematic review and meta-analysis from the EULAR taskforce on healthy and sustainable work participation

Non-pharmacological interventions to promote work participation in people with rheumatic and musculoskeletal diseases: a systematic review and meta-analysis from the EULAR taskforce on healthy and sustainable work participation

Work Interventions Within Interdisciplinary Pain Rehabilitation Programs (IPRP) – Frequency, Patient Characteristics, and Association with Self-Rated Work Ability

Empathy is key: addressing obstacles to policy progress of ‘work-focused healthcare’

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