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The Relationship of the Amount of Physical Therapy to Time Lost From Work and Costs in the Workers’ Compensation System
Physical therapy (PT) is perceived as a cost driver in the US workers' compensation system. We conducted a 5-year (2013 to 2017) retrospective analysis utilizing 192,197 claims from a large Texas based workers' compensation insurance company to describe the relationship between the amount of physical therapy delivered and workers' compensation costs and lost-time. Closed, indemnity claims with 15 or more PT visits were six times more likely (95% confidence interval [CI]: 5.50, 86.58) to result in high medical costs (>$7000, excluding PT costs) and were four times more likely (95...
The effectiveness of vocational rehabilitation on work participation
A propensity score matched analysis using nationwide register data Objective: Research on the effectiveness of vocational rehabilitation has focused on small and selected groups, lacked proper controls, or not captured dynamic changes in work participation. Using rich nationwide data on vocational rehabilitees and matched controls, long-term changes in work participation before and after vocational rehabilitation were examined to assess its effectiveness. Methods: Representative Finnish register data were used to examine 3199 recently employed individuals aged 30-55 years with histories of musculoskeletal...
Interventions Developed with the Intervention Mapping Protocol in Work Disability Prevention
A Systematic Review of the Literature Purposes Intervention mapping (IM) is a protocol for developing effective behavior change interventions. It has been used for 10 years to develop work disability prevention (WDP) interventions, but it is not known to what extent and with what success. The main objective of this study was to review the effectiveness of these interventions. Secondary objectives were to review their fidelity to the IM protocol, their theoretical frameworks and their content. Methods A search strategy was conducted in MEDLINE, Web of Science, PsycINFO, Pascal, Francis, and BDSP...
Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions
An Update of the Evidence and Messages for Practitioners Purpose: The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods: We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results: Seven electronic...
Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions
An Update of the Evidence and Messages for Practitioners Purpose: The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods: We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results: Seven electronic...
Effectiveness of Occupational Therapy Interventions for Lower-Extremity Musculoskeletal Disorders
A Systematic Review Lower-extremity (LE) musculoskeletal disorders (MSDs) can have a major impact on the ability to carry out daily activities. The effectiveness of interventions must be examined to enable occupational therapy practitioners to deliver the most appropriate services. This systematic review examined the literature published between 1995 and July 2014 that investigated the effectiveness of occupational therapy interventions for LE MSDs. Forty-three articles met the criteria and were reviewed. Occupational therapy interventions varied on the basis of population subgroup: hip fracture...
Factors Associated With Success in an Occupational Rehabilitation Program for Work-Related Musculoskeletal Disorders
Work-related musculoskeletal disorders are a significant burden; however, no consensus has been reached on how to maximize occupational rehabilitation programs for people with these disorders, and the impact of simulating work tasks as a mode of intervention has not been well examined. In this retrospective cohort study, the authors used logistic regression to identify client and program factors predicting success for 95 clients in a general occupational rehabilitation program and 71 clients in a comprehensive occupational rehabilitation program. The final predictive model for general rehabilitation...
Effects of a randomized controlled intervention trial on return to work and health care utilization after long-term sickness absence
BACKGROUND: The aim of the RCT study was to investigate if the effect of a multidisciplinary intervention on return to work (RTW) and health care utilization differed by participants' self-reported health status at baseline, defined by a) level of somatic symptoms, b) health anxiety and c) self-reported general health. METHODS: A total of 443 individuals were randomized to the intervention (n = 301) or the control group (n = 142) and responded to a questionnaire measuring health status at baseline. Participants were followed in registries measuring RTW and health care utilization. Relative...
Effectiveness of multifaceted implementation strategies for the implementation of back and neck pain guidelines in health care
A systematic review For the optimal use of clinical guidelines in daily practice, mere distribution of guidelines and materials is not enough, and active implementation is needed. This review investigated the effectiveness of multifaceted implementation strategies compared to minimal, single, or no implementation strategy for the implementation of non-specific low back and/or neck pain guidelines in health care. Source: Suman, A., Dikkers, M. F., Schaafsma, F. G., van Tulder, M. W., & Anema, J. R. (2016). Implementation Science, 11 (1), 126. https://dx.doi.org/10.1186%2Fs13012-016-0482-7
Web-Based Interventions for Chronic Back Pain: A Systematic Review
Background: Chronic low back pain is one of the most common presenting complaints to a physician's office. Treatment is often challenging and recovery depends on various factors, often resulting in significant investments of time and resources. Objective: The aim of this review is to determine which Web-based interventions aimed at chronic low back pain are of benefit to patients. Methods: Randomized controlled trials (RCTs) studying Web-based interventions directed at adults with chronic low back pain were included. Retrospective studies, narrative reviews, nonrandomized trials, and observational...
Effectiveness of a return-to-work program for workers without an employment contract, sick-listed due to common mental disorders
A participatory supportive return-to-work (RTW) program did not result in a significant shorter duration until sustainable RTW of workers without an employment contract, sick-listed due to a common mental disorder, compared to usual occupational healthcare. Further research is needed to consider how vocational needs of these vulnerable workers could be better addressed. Source: Lammerts L, Schaafsma FG, Bonefaas-Groenewoud K, van Mechelen W, Anema JR. Scand J Work Environ Health , 2016. http://dx.doi.org/10.5271/sjweh.3588
Effectiveness of very early workplace interventions to reduce sickness absence
A systematic review of the literature and meta-analysis This systematic review identified a lack of evidence to support the effectiveness of "very early" (less than 15 days after the start of sickness absence) workplace intervention to reduce sick leave compared to usual care. Lack of consensus on definition of "very early/early" interventions, methodological design of studies, the extent, and timing of usual care provided and variable compliance between groups might explain the absence of demonstrated benefit. Source: Vargas-Prada S, Demou E, Lalloo D, Avila-Palencia I, Sanati...
Effectiveness of Occupation- and Activity-Based Interventions to Improve Everyday Activities and Social Participation for People With Traumatic Brain Injury
A Systematic Review This systematic review presents research on the effectiveness of occupation- and activity-based interventions to improve everyday activities and areas of occupation and social participation for people with traumatic brain injury (TBI). Nineteen studies identified through a comprehensive database search were reviewed and synthesized into five themes: (1) multidisciplinary and interdisciplinary treatment approaches, (2) community-based rehabilitation programs, (3) treatment approaches using client-centered goals and relevant contexts, (4) social skills training and peer mentoring...
Cross-cultural adaptation and validation of the Danish version of the 19-item return-to-work self-efficacy (RTWSE-19) questionnaire
A Danish version of the 19-item return-to-work self-efficacy (RTWSE-19) questionnaire was developed. The performance of a questionnaire may differ between populations and in various cultures. In order to use the RTWSE-19 in a Danish context, translation was necessary, and cross-cultural and conceptual adaptation needed to preserve the original purpose of the instrument. Source: Hedeager Momsen A-M, Rosbjerg R, Stapelfeldt CM, Lund T, Jensen C, Johansen T, Nielsen CV, Labriola M. Scand J Work Environ Health , 2016. http://dx.doi.org/10.5271/sjweh.3568
Is Early Prescribing of Opioid and Psychotropic Medications Associated With Delayed Return to Work and Increased Final Workers’ Compensation Cost?
Objective: To explore the association between the initial 60 days of prescriptions for psychotropic medications and final workers' compensation claim outcomes. Methods: A cohort of 11,394 claimants involved in lost time injuries between 1999 and 2002 were followed through December 31, 2009. Logistic regressions and Cox Proportional Hazard Models were used in the analysis. Results: The initial 60 days of prescriptions for psychotropic medications were significantly associated with a final claim cost at least $100,000. Odds ratios were 1.88 for short-acting opioids, 2.14 for hypnotics, antianxiety...
Programme de prise de décision entre l'ergothérapeute et le travailleur ayant une incapacité due à un trouble musculosquelettique persistant
Les travailleurs et les autres acteurs qui prennent des décisions en matière d'interventions de retour au travail ont souvent des intérêts et des buts différents. Le processus de prise de décision partagée (PDP) est une approche centrée sur la personne qui permet d'agir sur les écarts entre les travailleurs et les autres acteurs par rapport au but et au plan d'action à mettre de l'avant. À notre connaissance, un programme de PDP n'avait jamais été spécifiquement contextualisé...
Nordic approaches to disability prevention
Different approaches to disability prevention, including work modifications, work schedule redesign and national legislative changes were the topics at the Disability prevention seminar, held in Helsinki, Finland, by the Finnish Institute of Occupational Health (FIOH) on November 26. Source: http://www.ttl.fi/en/news/Pages/Nordic_approach_to_disability_prevention_presentations.aspx
Economic Evaluation of a New Organizational RTW Intervention to Improve Cooperation Between Sick-Listed Employees and Their Supervisors: A Field Study
A Field Study Objective: The purpose of this study is to assess the cost-effectiveness, -utility, and -benefit of a new organizational return-to-work intervention to improve COoperation between Sick-listed employees and their Supervisors (COSS). Methods: A field study with 6 months follow-up comparing COSS with common practice randomized participants aged 18 to 60, working at least 12?hours/week and absent for at least 2 weeks. Outcomes were initial return-to-work, quality-adjusted life years, and productivity gains. Results: After 6 months, COSS generated less costs when compared with common practice...
Implementation of the Danish return-to-work program
Process evaluation of a trial in 21 Danish municipalities Objectives: The aim of this study was to evaluate the implementation of the Danish national return-to-work (RTW) program in 21 Danish municipalities. Methods: We conducted a structured process evaluation on (i) reach and recruitment, (ii) fidelity, (iii) dose-delivered, (iv) dose-received, and (v) context by formulating 29 implementation criteria and analyzing qualitative and quantitative data from administrative records, interviews, field notes, and questionnaires. Results: All municipalities integrated the basic features of the RTW program...
Barriers and facilitators for implementation of a return-to-work intervention for sickness absence beneficiaries with mental health problems
Results from three Danish municipalities AIMS: Evidence for the effectiveness of return-to-work (RTW) interventions aimed at sickness absence beneficiaries with mental health problems (MHPs) is still relatively sparse and mostly inconclusive. This may in part reflect the varying settings and inconsistent implementations associated with the interventions. The aim of this paper is to identify barriers and facilitators for the implementation of a coordinated and tailored RTW-intervention implemented at three different sites. METHODS: We used qualitative and quantitative data to assess the implementation...
Results of a feasibility study: barriers and facilitators in implementing the Sherbrooke model in France
Objectives: Return-to-work interventions associated with the workplace environment are often more effective than conventional care. The Sherbrooke model is an integrated intervention that has proved successful in preventing work disability due to low-back pain. Implementation, however, runs up against many obstacles, and failure has been reported in many countries. The present study sought to identify barriers to and facilitators of the implementation of the Sherbrooke model within the French health system. Methods: A multiple case study with nested levels of analysis was performed in two regions...
The EASY (Early Access to Support for You) sickness absence service
A four-year evaluation of the impact on absenteeism Objectives In May 2008, the National Health Service (NHS) Lanarkshire (NHSL) implemented a unique telephone-based sickness absence management service entitled “EASY” (Early Access to Support for You). The EASY service supplements existing absence policies and enables telephone communication between the absentee, their line manager, and the EASY service from the first day of absence and referral to occupational health services at day ten. The aim of this study was to determine if the EASY service was effective between May 2008 and May...
Log in and breathe out: internet-based recovery training for sleepless employees with work-related strain
Results of a randomized controlled trial Objectives: The primary purpose of this randomized controlled trial (RCT) was to evaluate the efficacy of a guided internet-based recovery training for employees who suffer from both work-related strain and sleep problems (GET.ON Recovery). The recovery training consisted of six lessons, employing well-established methods from cognitive behavioral therapy for insomnia (CBT-I) such as sleep restriction, stimulus control, and hygiene interventions as well as techniques targeted at reducing rumination and promoting recreational activities. Methods: In a two...
How can a brief intervention contribute to coping with back pain?
A focus group study about participants' expériences Background: Our aim was to explore how individuals who had participated in a brief back and neck pain intervention perceived connections between the intervention and their subsequent coping. Methods: Three focus group discussions were conducted with a sample of ten employees aged 20–67 years, who had participated in a brief intervention for back and neck pain, perceived the intervention as helpful and had returned or remained at work subsequent to the intervention. Participants were invited to share stories of how the intervention...
Evaluation of Functional Restoration Outcomes for Chronic Disabling Occupational Cervical Disorders
Objective: To systematically evaluate the effectiveness of an interdisciplinary functional restoration program (FRP) for treating chronic cervical disorders. Methods: Consecutive chronic occupational lumbar disorder patients (n = 898) and chronic occupational cervical disorder patients (n = 215) were admitted to an FRP from 2001 to 2011. Patients were compared on demographics, work-related and psychosocial factors, and socioeconomic outcomes 1 year after discharge. Results: Compared with lumbar patients, cervical patients were more likely to be female, have preadmission surgery, perform white-collar...
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