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Cited by 94Medical Practices and RehabilitationWorkplace Health and Well-beingMusculoskeletal pain and rehabilitation

Return to Work Coordination Programmes for Work Disability: A Meta-Analysis of Randomised Controlled Trials

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Schandelmaier, Stefan, Ebrahim, Shanil, Burkhardt, Susan C. A., de Boer, Wout E. L., Zumbrunn, Thomas, Guyatt, Gordon H., Busse, Jason W., Kunz, Regina·2012·PLoS ONE
DOI 10.1371/journal.pone.0049760PMC PMC3501468
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Abstract

BACKGROUND: The dramatic rise in chronically ill patients on permanent disability benefits threatens the sustainability of social security in high-income countries. Social insurance organizations have started to invest in promising, but costly return to work (RTW) coordination programmes. The benefit, however, remains uncertain. We conducted a systematic review to determine the long-term effectiveness of RTW coordination compared to usual practice in patients at risk for long-term disability. METHODS AND FINDINGS: Eligible trials enrolled employees on work absence for at least 4 weeks and randomly assigned them to RTW coordination or to usual practice. We searched 5 databases (to April 2, 2012). Two investigators performed standardised eligibility assessment, study appraisal and data extraction independently and in duplicate. The GRADE framework guided our assessment of confidence in the meta-analytic estimates. We identified 9 trials from 7 countries, 8 focusing on musculoskeletal, and 1 on mental complaints. Most trials followed participants for 12 months or less. No trial assessed permanent disability. Moderate quality evidence suggests a benefit of RTW coordination on proportion at work at end of follow-up (risk ratio = 1.08, 95% CI = 1.03 to 1.13; absolute effect = 5 in 100 additional individuals returning to work, 95% CI = 2 to 8), overall function (mean difference [MD] on a 0 to 100 scale = 5.2, 95% CI = 2.4 to 8.0; minimal important difference [MID] = 10), physical function (MD = 5.3, 95% CI = 1.4 to 9.1; MID = 8.4), mental function (MD = 3.1, 95% CI = 0.7 to 5.6; MID = 7.3) and pain (MD = 6.1, 95% CI = 3.1 to 9.2; MID = 10). CONCLUSIONS: Moderate quality evidence suggests that RTW coordination results in small relative, but likely important absolute benefits in the likelihood of disabled or sick-listed patients returning to work, and associated small improvements in function and pain. Future research should explore whether the limited effects persist, and whether the programmes are cost effective in the long term.

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  • Most occupational rehabilitation programs described in the scientific literature are directed towards specific diagnostic groups, mainly musculoskeletal disorders.

    “Most occupational rehabilitation programs described in the scientific literature are directed towards specific diagnostic groups, mainly musculoskeletal disorders [3, 4].”

    From Effects of Inpatient Multicomponent Occupational Rehabilitation versus Less Comprehensive Outpatient Rehabilitation on Somatic and Mental Health: Secondary Outcomes of a Randomized Clinical Trial. (2017) · cites this paper as [3]

    The Discussion’s “Applicability of Findings” section says all but two studies in this meta-analysis focused on claimants with musculoskeletal complaints. That supports the claim’s emphasis on musculoskeletal conditions, but the review covers randomised trials of return-to-work coordination programmes, not most occupational rehabilitation programmes described across the scientific literature. No page number is provided in our copy. (LLM, conf=0.84)

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Research works printed but not linked: 1

  1. [25]The Nordic Cochrane Centre, The Cochrane Collaboration (2011) Review Manager (RevMan). Copenhagen. p.

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Authors
Schandelmaier, S., Ebrahim, S., Burkhardt, S. C. A., de Boer, W. E. L., Zumbrunn, T., Guyatt, G. H., Busse, J. W., & Kunz, R.
Affiliations
  • University Hospital of Basel (CH)
  • McMaster University (CA)
Corresponding author
Schandelmaier, Stefan
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2012-11-19
Volume
7
Issue
11
Pages
e49760
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0049760
PMC
PMC3501468
OpenAlex
W2056867380
Cited by
94
References
59
Citations by year
2026: 2 · 2025: 2 · 2024: 7 · 2023: 3 · 2022: 7 · 2021: 5 · 2020: 9 · 2019: 8 · 2018: 9 · 2017: 17 · 2016: 5 · 2015: 13 · 2014: 6 · 2013: 1
FWCI
0.70
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • edoc (University of Basel) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
Canadian Institutes of Health Research
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
return to work, work disability, long-term disability, sick leave, musculoskeletal disorders, absenteeism, physical function, pain, social security, disability benefits
MeSH terms
Chronic Disease, Cost-Benefit Analysis, Persons with Disabilities, Humans, Social Security, Randomized Controlled Trials as Topic, Developed Countries, Return to Work

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