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Effect of the Danish return-to-work program on long-term sickness absence
Results from a randomized controlled trial in three municipalities Objectives : The aim of this study was to evaluate the effect of the Danish return-to-work (RTW) program on long-term sickness absence in a randomized controlled trial in three municipalities. Methods : The intervention group comprised 1948 participants while the control group comprised 1157 participant receiving ordinary sickness benefit management (OSM). Study participants were working-age adults receiving long-term (≥8 weeks or more) benefits, included regardless of reason for sickness absence or employment status. Each beneficiary...
The Danish national return-to-work program
The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management...
A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain
Low back pain (LBP) is a common and disabling disorder in western society. The management of LBP comprises a range of different intervention strategies including surgery, drug therapy, and non-medical interventions. The objective of the present study is to determine the effectiveness of physical and rehabilitation interventions (i.e. exercise therapy, back school, transcutaneous electrical nerve stimulation (TENS), low level laser therapy, education, massage, behavioural treatment, traction, multidisciplinary treatment, lumbar supports, and heat/cold therapy) for chronic LBP. The primary search...
Daily functioning and self-management in patients with chronic low back pain after an intensive cognitive behavioral programme for pain management
Chronic low back pain (CLBP) is associated with persistent or recurrent disability which results in high costs for society. Cognitive behavioral treatments produce clinically relevant benefits for patients with CLBP. Nevertheless, no clear evidence for the most appropriate intervention is yet available. The purpose of this study is to evaluate the mid-term effects of treatment in a cohort of patients with CLBP participating in an intensive pain management programme. The programme provided by RealHealth-Netherlands is based on cognitive behavioral principles and executed in collaboration with orthopedic...
The COPE LBP trial: Cognitive Patient Education for Low Back Pain - a cluster randomized controlled trial in primary care
Non-specific low back pain (LBP) is usually self-limiting within 4-6 weeks. Longstanding pain and disability are not predictable from clinical signs or pathoanatomical findings. Pain cognition and physical performance have been shown to improve patients with chronic LBP following neurophysiological education. The primary aim of this study is to evaluate whether a specific cognitive based education programme for patients with LBP in primary care is more effective than normal care in terms of increased function. The secondary aims of the study are to evaluate whether this intervention also results...
The COPE LBP trial: Cognitive Patient Education for Low Back Pain - a cluster randomized controlled trial in primary care
Non-specific low back pain (LBP) is usually self-limiting within 4-6 weeks. Longstanding pain and disability are not predictable from clinical signs or pathoanatomical findings. Pain cognition and physical performance have been shown to improve patients with chronic LBP following neurophysiological education. The primary aim of this study is to evaluate whether a specific cognitive based education programme for patients with LBP in primary care is more effective than normal care in terms of increased function. The secondary aims of the study are to evaluate whether this intervention also results...
The COPE LBP trial: Cognitive Patient Education for Low Back Pain - a cluster randomized controlled trial in primary care
Non-specific low back pain (LBP) is usually self-limiting within 4-6 weeks. Longstanding pain and disability are not predictable from clinical signs or pathoanatomical findings. Pain cognition and physical performance have been shown to improve patients with chronic LBP following neurophysiological education. The primary aim of this study is to evaluate whether a specific cognitive based education programme for patients with LBP in primary care is more effective than normal care in terms of increased function. The secondary aims of the study are to evaluate whether this intervention also results...
The Economic Impact of a Disability Prevention Program
We evaluated the effect of an employer- and clinic-based intervention on indemnity, medical, and workers compensation costs. The intervention was designed to improve communication and coordination of employer and physician efforts to help employees with work-related injuries to return-to-work. The research design was a quasi-experimental comparison of expenditures in treatment and control employers and clinics, controlling for differences in baseline expenditures and other characteristics of the subjects. We estimated that the employer and clinic interventions produced combined savings of $490...
Effectiveness of a Targeted Occupational Health Intervention in Workers with High Risk of Sickness Absence: Baseline Characteristics and Adherence as Effect Modifying Factors in a Randomized Controlled Trial
In a recently published randomized controlled trial (RCT), a targeted occupational health (OH) intervention was found effective in an intention-to-treat analysis in controlling sickness absence among workers with high risk of sickness absence, compared to usual care. We performed an exploratory subgroup analysis in order to detect possible effect modifiers and mediators. Methods Age, gender, working status, severity of physical impairment, depression score, self-rated working ability, co-morbidity, and sickness absence characteristics in the previous 12 months were identified as potential effect...
Adjusting Rehabilitation Costs and Benefits for Health Capital: The Case of Low Back Occupational Injuries
Introduction Case-mix adjustments for treatment/rehabilitation costs and benefits of non-traumatic injuries, such as occupational back pain, are much more difficult than adjustments for traumatic injuries. We present a new method for adjusting for severity differences in the costs and benefits of treating occupational low back injuries. Methods Using initial post-injury differences in the health capital of prospective sample of 1,831 occupational related back pain patients, we combine survey data with workers' compensation claim files and medical billing information to adjust the costs and...
Cost effectiveness of two rehabilitation programmes for neck and back pain patients: A seven year follow-up
The cost effectiveness of work-oriented rehabilitation for persons on long-term sick leave needs to be assessed. This prospective observational study presents a follow-up seven years after rehabilitation using two different evidence-based work-oriented regimens. Individuals on sick leave for neck and back pain were referred to two rehabilitation programmes in Sweden. The first programme was a relatively low-intensity programme based on orthopaedic manual therapy and exercise programme (OMTP). The second programme was a full-time multidisciplinary programme (MDP). The primary outcome was sickness...

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