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Rehabilitation cooperation and person-centred dialogue meeting for patients sick-listed for common mental disorders: 12 months follow-up of sick leave days, symptoms of depression, anxiety, stress and work ability - a pragmatic cluster randomised controlled trial from the CO-WORK-CARE project.

Authors :
Björkelund C
Saxvik A
Svenningsson I
Petersson EL
Wiegner L
Larsson M
Törnbom K
Wikberg C
Ariai N
Nejati S
Hensing G
Hange D
Source :
BMJ open [BMJ Open] 2023 Jun 09; Vol. 13 (6), pp. e074137. Date of Electronic Publication: 2023 Jun 09.
Publication Year :
2023

Abstract

Objectives: To study whether early and enhanced cooperation within the primary care centres (PCC) combined with workplace cooperation via a person-centred employer dialogue meeting can reduce days on sick leave compared with usual care manager contact for patients on sick leave because of common mental disorders (CMD). Secondary aim: to study lapse of CMD symptoms, perceived Work Ability Index (WAI) and quality of life (QoL) during 12 months.<br />Design: Pragmatic cluster randomised controlled trial, randomisation at PCC level.<br />Setting: 28 PCCs in Region Västra Götaland, Sweden, with care manager organisation.<br />Participants: 30 PCCs were invited, 28 (93%) accepted invitation (14 intervention, 14 control) and recruited 341 patients newly sick-listed because of CMD (n=185 at intervention, n=156 at control PCCs).<br />Intervention: Complex intervention consisting of (1) early cooperation among general practitioner (GP), care manager and a rehabilitation coordinator, plus (2) a person-centred dialogue meeting between patient and employer within 3 months.<br />Control Group: regular contact with care manager.<br />Main Outcome Measures: 12 months net and gross number of sick leave days at group level.<br />Secondary Outcomes: 12 months depression, anxiety, stress symptoms, perceived WAI and QoL (EuroQoL-5 Dimensional, EQ-5D).<br />Results: No significant differences were found between intervention and control groups concerning days of sick leave (intervention net days of sick leave mean 102.48 (SE 13.76) vs control 96.29 (SE 12.38) p=0.73), return to work (HR 0.881, 95% CI 0.688 to 1.128), or CMD symptoms, WAI or EQ-5D after 12 months.<br />Conclusions: It is not possible to speed up CMD patients' return to work or to reduce sick leave time by early and enhanced coordination among GP, care manager and a rehabilitation coordinator, combined with early workplace contact over and above what 'usual' care manager contact during 3 months provides.<br />Trial Registration Number: NCT03250026.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Details

Language :
English
ISSN :
2044-6055
Volume :
13
Issue :
6
Database :
MEDLINE
Journal :
BMJ open
Publication Type :
Academic Journal
Accession number :
37295824
Full Text :
https://doi.org/10.1136/bmjopen-2023-074137