Cargando…

Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders

Purpose There is a lack of results on long-term effects of return to work interventions. We previously reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective in reducing sickness absence and facilitating return to work (RTW) at 12 months follow-up compa...

Descripción completa

Detalles Bibliográficos
Autores principales: Aasdahl, Lene, Vasseljen, Ottar, Gismervik, Sigmund Østgård, Johnsen, Roar, Fimland, Marius Steiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558177/
https://www.ncbi.nlm.nih.gov/pubmed/33765241
http://dx.doi.org/10.1007/s10926-021-09969-4
_version_ 1784592497783078912
author Aasdahl, Lene
Vasseljen, Ottar
Gismervik, Sigmund Østgård
Johnsen, Roar
Fimland, Marius Steiro
author_facet Aasdahl, Lene
Vasseljen, Ottar
Gismervik, Sigmund Østgård
Johnsen, Roar
Fimland, Marius Steiro
author_sort Aasdahl, Lene
collection PubMed
description Purpose There is a lack of results on long-term effects of return to work interventions. We previously reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective in reducing sickness absence and facilitating return to work (RTW) at 12 months follow-up compared to an outpatient program that consisted mainly of Acceptance and Commitment Therapy (O-ACT). We now report the 2-year outcome data. Methods A randomized clinical trial with parallel groups. Participants were 18–60 years old, sick listed with musculoskeletal, common mental or general/unspecified disorders. I-MORE lasted 3.5 weeks and consisted of ACT, physical training and work-related problem solving. O-ACT consisted mainly of 6 weekly sessions (2.5 h. each) of ACT in groups. Outcomes were cumulated number of days on medical benefits and time until sustainable RTW (1 month without medical benefits) during 2-years of follow-up, measured by registry data. Results For the 166 randomized participants, the median number of days on medical benefits was 159 (IQR 59–342) for I-MORE vs 249 days (IQR 103–379; Mann–Whitney U test, p = 0.07), for O-ACT. At 2 years, 40% in I-MORE received long-term benefits (work assessment allowance) vs 51% in O-ACT. The crude hazard ratio (HR) for sustainable RTW was 1.59 (95% CI 1.04–2.42, p = 0.03) and the adjusted HR 1.77 (95% CI 1.14–2.75, p = 0.01), in favor of I-MORE. Conclusions The 2-year outcomes show that I-MORE had long-term positive effects on increasing work participation for individuals sick listed with musculoskeletal and mental disorders. Further follow-up and economic evaluations should be performed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10926-021-09969-4.
format Online
Article
Text
id pubmed-8558177
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-85581772021-11-15 Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders Aasdahl, Lene Vasseljen, Ottar Gismervik, Sigmund Østgård Johnsen, Roar Fimland, Marius Steiro J Occup Rehabil Article Purpose There is a lack of results on long-term effects of return to work interventions. We previously reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective in reducing sickness absence and facilitating return to work (RTW) at 12 months follow-up compared to an outpatient program that consisted mainly of Acceptance and Commitment Therapy (O-ACT). We now report the 2-year outcome data. Methods A randomized clinical trial with parallel groups. Participants were 18–60 years old, sick listed with musculoskeletal, common mental or general/unspecified disorders. I-MORE lasted 3.5 weeks and consisted of ACT, physical training and work-related problem solving. O-ACT consisted mainly of 6 weekly sessions (2.5 h. each) of ACT in groups. Outcomes were cumulated number of days on medical benefits and time until sustainable RTW (1 month without medical benefits) during 2-years of follow-up, measured by registry data. Results For the 166 randomized participants, the median number of days on medical benefits was 159 (IQR 59–342) for I-MORE vs 249 days (IQR 103–379; Mann–Whitney U test, p = 0.07), for O-ACT. At 2 years, 40% in I-MORE received long-term benefits (work assessment allowance) vs 51% in O-ACT. The crude hazard ratio (HR) for sustainable RTW was 1.59 (95% CI 1.04–2.42, p = 0.03) and the adjusted HR 1.77 (95% CI 1.14–2.75, p = 0.01), in favor of I-MORE. Conclusions The 2-year outcomes show that I-MORE had long-term positive effects on increasing work participation for individuals sick listed with musculoskeletal and mental disorders. Further follow-up and economic evaluations should be performed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10926-021-09969-4. Springer US 2021-03-25 2021 /pmc/articles/PMC8558177/ /pubmed/33765241 http://dx.doi.org/10.1007/s10926-021-09969-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Aasdahl, Lene
Vasseljen, Ottar
Gismervik, Sigmund Østgård
Johnsen, Roar
Fimland, Marius Steiro
Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders
title Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders
title_full Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders
title_fullStr Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders
title_full_unstemmed Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders
title_short Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders
title_sort two-year follow-up of a randomized clinical trial of inpatient multimodal occupational rehabilitation vs outpatient acceptance and commitment therapy for sick listed workers with musculoskeletal or common mental disorders
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558177/
https://www.ncbi.nlm.nih.gov/pubmed/33765241
http://dx.doi.org/10.1007/s10926-021-09969-4
work_keys_str_mv AT aasdahllene twoyearfollowupofarandomizedclinicaltrialofinpatientmultimodaloccupationalrehabilitationvsoutpatientacceptanceandcommitmenttherapyforsicklistedworkerswithmusculoskeletalorcommonmentaldisorders
AT vasseljenottar twoyearfollowupofarandomizedclinicaltrialofinpatientmultimodaloccupationalrehabilitationvsoutpatientacceptanceandcommitmenttherapyforsicklistedworkerswithmusculoskeletalorcommonmentaldisorders
AT gismerviksigmundøstgard twoyearfollowupofarandomizedclinicaltrialofinpatientmultimodaloccupationalrehabilitationvsoutpatientacceptanceandcommitmenttherapyforsicklistedworkerswithmusculoskeletalorcommonmentaldisorders
AT johnsenroar twoyearfollowupofarandomizedclinicaltrialofinpatientmultimodaloccupationalrehabilitationvsoutpatientacceptanceandcommitmenttherapyforsicklistedworkerswithmusculoskeletalorcommonmentaldisorders
AT fimlandmariussteiro twoyearfollowupofarandomizedclinicaltrialofinpatientmultimodaloccupationalrehabilitationvsoutpatientacceptanceandcommitmenttherapyforsicklistedworkerswithmusculoskeletalorcommonmentaldisorders