Structured functional assessments in general practice increased the use of part-time sick leave: a cluster randomised controlled trial

Abstract

Aim: A method for structured functional assessments of persons with long-term sick leave was implemented in a cluster randomised controlled trial in general practice. The aim was to analyse intervention effects on general practitioner (GP) sick-listing practice and patient sick leave.

Methods: 57 GPs were randomly assigned to an intervention or a control group. The intervention group GPs learned the method at a 1-day workshop including teamwork and role-playing. The control group GPs were requested to assess functional ability as usual during the 8 months intervention period in 2005. Outcome measures included duration of patient sick leave episodes, GP prescription of part-time sick leave, active sick leave, and vocational rehabilitation. This data was extracted from a national register.

Results: The GPs in the intervention group prescribed part-time sick leave more often (p < 0.01) and active sick leave less often (p = 0.04) than the control group GPs during the intervention period. There was no intervention effect on duration of patient sick leave episodes or on GP prescription of vocational rehabilitation.

Conclusions: Implementing structured functional assessments in general practice made the GPs capable to assess functional ability of persons with long-term sick leave in a standardised and explicit manner. The intervention GPs' sick-listing practice was changed as they prescribed more part-time and less active sick leave compared to the control group GPs. As a result, more intervention GP patients returned to part-time work compared to control GP patients. No intervention effect was seen on duration of patient sick leave episodes or on prescription of vocational rehabilitation.