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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

OBJECTIVE: To 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). METHODS: A systematic review of randomised controlled...

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Autores principales: Butink, Maarten H P, Webers, Casper, Verstappen, Suzanne M M, Falzon, Louise, Betteridge, Neil, Wiek, Dieter, Woolf, Anthony D, Stamm, Tanja A, Burmester, Gerd R, Bijlsma, Johannes W J, Christensen, Robin, Boonen, Annelies
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10098260/
https://www.ncbi.nlm.nih.gov/pubmed/36596655
http://dx.doi.org/10.1136/rmdopen-2022-002903
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author Butink, Maarten H P
Webers, Casper
Verstappen, Suzanne M M
Falzon, Louise
Betteridge, Neil
Wiek, Dieter
Woolf, Anthony D
Stamm, Tanja A
Burmester, Gerd R
Bijlsma, Johannes W J
Christensen, Robin
Boonen, Annelies
author_facet Butink, Maarten H P
Webers, Casper
Verstappen, Suzanne M M
Falzon, Louise
Betteridge, Neil
Wiek, Dieter
Woolf, Anthony D
Stamm, Tanja A
Burmester, Gerd R
Bijlsma, Johannes W J
Christensen, Robin
Boonen, Annelies
author_sort Butink, Maarten H P
collection PubMed
description OBJECTIVE: To 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). METHODS: A 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. RESULTS: Of 10 153 records, 64 studies (37 RCTs and 27 LOS; corresponding to k=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 (SMD(sick leave) (95% CI)=−0.23 (−0.33 to −0.13; k=42); SMD(work status)=−0.38 (−0.63 to −0.12; k=9); SMD(presenteeism)=−0.25 (−0.39 to −0.12; k=13)). CONCLUSION: In 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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spelling pubmed-100982602023-04-14 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 Butink, Maarten H P Webers, Casper Verstappen, Suzanne M M Falzon, Louise Betteridge, Neil Wiek, Dieter Woolf, Anthony D Stamm, Tanja A Burmester, Gerd R Bijlsma, Johannes W J Christensen, Robin Boonen, Annelies RMD Open Treatments OBJECTIVE: To 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). METHODS: A 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. RESULTS: Of 10 153 records, 64 studies (37 RCTs and 27 LOS; corresponding to k=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 (SMD(sick leave) (95% CI)=−0.23 (−0.33 to −0.13; k=42); SMD(work status)=−0.38 (−0.63 to −0.12; k=9); SMD(presenteeism)=−0.25 (−0.39 to −0.12; k=13)). CONCLUSION: In 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. BMJ Publishing Group 2023-01-03 /pmc/articles/PMC10098260/ /pubmed/36596655 http://dx.doi.org/10.1136/rmdopen-2022-002903 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Treatments
Butink, Maarten H P
Webers, Casper
Verstappen, Suzanne M M
Falzon, Louise
Betteridge, Neil
Wiek, Dieter
Woolf, Anthony D
Stamm, Tanja A
Burmester, Gerd R
Bijlsma, Johannes W J
Christensen, Robin
Boonen, Annelies
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Treatments
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10098260/
https://www.ncbi.nlm.nih.gov/pubmed/36596655
http://dx.doi.org/10.1136/rmdopen-2022-002903
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