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Independent medical evaluation of general practitioners’ follow-up of sick-listed patients: a cross-sectional study in Norway

OBJECTIVES: The study was designed to examine the sufficiency of general practitioners’ (GPs) follow-up of patients on sick leave, assessed by independent medical evaluators. DESIGN: Cross-sectional study SETTING: Primary health care in the Western part of Norway. The study reuses data from a random...

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Autores principales: Øyeflaten, Irene, Maeland, Silje, Haukenes, Inger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202711/
https://www.ncbi.nlm.nih.gov/pubmed/32193258
http://dx.doi.org/10.1136/bmjopen-2019-032776
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author Øyeflaten, Irene
Maeland, Silje
Haukenes, Inger
author_facet Øyeflaten, Irene
Maeland, Silje
Haukenes, Inger
author_sort Øyeflaten, Irene
collection PubMed
description OBJECTIVES: The study was designed to examine the sufficiency of general practitioners’ (GPs) follow-up of patients on sick leave, assessed by independent medical evaluators. DESIGN: Cross-sectional study SETTING: Primary health care in the Western part of Norway. The study reuses data from a randomised controlled trial—the Norwegian independent medical evaluation trial (NIME trial). PARTICIPANTS: The intervention group in the NIME trial: Sick-listed workers having undergone an independent medical evaluation by an experienced GP at 6 months of unremitting sick leave (n=937; 57% women). In the current study, the participants were distributed into six exposure groups defined by gender and main sick leave diagnoses (women/musculoskeletal, men/musculoskeletal, women/mental, men/mental, women/all other diagnoses and men/all other diagnoses). OUTCOME MEASURE: The independent medical evaluators assessment (yes/no) of the sufficiency of the regular GPs follow-up of their sick-listed patients. RESULTS: Estimates from generalised linear models demonstrate a robust association between men with mental sick leave diagnoses and insufficient follow-up by their regular GP first 6 months of sick leave (adjusted relative risk (RR)=1.8, 95% CI=1.15–1.68). Compared with the reference group, women with musculoskeletal sick leave diagnoses, this was the only significant finding. Men with musculoskeletal diagnoses (adjusted RR=1.4, 95% CI=0.92–2.09); men with other diagnoses (adjusted RR=1.0, 95% CI=0.58–1.73); women with mental diagnoses (adjusted RR=1.2, 95% CI=0.75–1.77) and women with other diagnoses (adjusted RR=1.3, 95% CI=0.58–1.73). CONCLUSIONS: Assessment by an independent medical evaluator showed that men with mental sick leave diagnoses may be at risk of insufficient follow-up by their GP. Efforts should be made to clarify unmet needs to initiate relevant actions in healthcare and work life. Avoiding marginalisation in work life is of the utmost importance. TRIAL REGISTRATION NUMBER: NCT02524392; Post-results.
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spelling pubmed-72027112020-05-13 Independent medical evaluation of general practitioners’ follow-up of sick-listed patients: a cross-sectional study in Norway Øyeflaten, Irene Maeland, Silje Haukenes, Inger BMJ Open General practice / Family practice OBJECTIVES: The study was designed to examine the sufficiency of general practitioners’ (GPs) follow-up of patients on sick leave, assessed by independent medical evaluators. DESIGN: Cross-sectional study SETTING: Primary health care in the Western part of Norway. The study reuses data from a randomised controlled trial—the Norwegian independent medical evaluation trial (NIME trial). PARTICIPANTS: The intervention group in the NIME trial: Sick-listed workers having undergone an independent medical evaluation by an experienced GP at 6 months of unremitting sick leave (n=937; 57% women). In the current study, the participants were distributed into six exposure groups defined by gender and main sick leave diagnoses (women/musculoskeletal, men/musculoskeletal, women/mental, men/mental, women/all other diagnoses and men/all other diagnoses). OUTCOME MEASURE: The independent medical evaluators assessment (yes/no) of the sufficiency of the regular GPs follow-up of their sick-listed patients. RESULTS: Estimates from generalised linear models demonstrate a robust association between men with mental sick leave diagnoses and insufficient follow-up by their regular GP first 6 months of sick leave (adjusted relative risk (RR)=1.8, 95% CI=1.15–1.68). Compared with the reference group, women with musculoskeletal sick leave diagnoses, this was the only significant finding. Men with musculoskeletal diagnoses (adjusted RR=1.4, 95% CI=0.92–2.09); men with other diagnoses (adjusted RR=1.0, 95% CI=0.58–1.73); women with mental diagnoses (adjusted RR=1.2, 95% CI=0.75–1.77) and women with other diagnoses (adjusted RR=1.3, 95% CI=0.58–1.73). CONCLUSIONS: Assessment by an independent medical evaluator showed that men with mental sick leave diagnoses may be at risk of insufficient follow-up by their GP. Efforts should be made to clarify unmet needs to initiate relevant actions in healthcare and work life. Avoiding marginalisation in work life is of the utmost importance. TRIAL REGISTRATION NUMBER: NCT02524392; Post-results. BMJ Publishing Group 2020-03-17 /pmc/articles/PMC7202711/ /pubmed/32193258 http://dx.doi.org/10.1136/bmjopen-2019-032776 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://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/.
spellingShingle General practice / Family practice
Øyeflaten, Irene
Maeland, Silje
Haukenes, Inger
Independent medical evaluation of general practitioners’ follow-up of sick-listed patients: a cross-sectional study in Norway
title Independent medical evaluation of general practitioners’ follow-up of sick-listed patients: a cross-sectional study in Norway
title_full Independent medical evaluation of general practitioners’ follow-up of sick-listed patients: a cross-sectional study in Norway
title_fullStr Independent medical evaluation of general practitioners’ follow-up of sick-listed patients: a cross-sectional study in Norway
title_full_unstemmed Independent medical evaluation of general practitioners’ follow-up of sick-listed patients: a cross-sectional study in Norway
title_short Independent medical evaluation of general practitioners’ follow-up of sick-listed patients: a cross-sectional study in Norway
title_sort independent medical evaluation of general practitioners’ follow-up of sick-listed patients: a cross-sectional study in norway
topic General practice / Family practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202711/
https://www.ncbi.nlm.nih.gov/pubmed/32193258
http://dx.doi.org/10.1136/bmjopen-2019-032776
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