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. 2018 Mar;28(1):1-15.
doi: 10.1007/s10926-016-9690-x.

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

K L Cullen  1 , E Irvin  2 , A Collie  3   4 , F Clay  3 , U Gensby  5   6 , P A Jennings  7 , S Hogg-Johnson  2 , V Kristman  2   8 , M Laberge  9 , D McKenzie  3 , S Newnam  10 , A Palagyi  3 , R Ruseckaite  3 , D M Sheppard  10 , S Shourie  10 , I Steenstra  2   11 , D Van Eerd  2   12 , B C Amick 3rd  2   13
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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

K L Cullen et al. J Occup Rehabil. 2018 Mar.

Abstract

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 databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.

Keywords: Mental health; Musculoskeletal pain; Program effectiveness; Return to work; Systematic review; Workplace.

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Conflict of interest statement

All authors declare that (1) no financial or other support was received for the submitted work; (2) they have no relationships with companies that might have an interest in the submitted work in the previous 3 years; (3) their spouses, partners, or children have no financial relationships that may be relevant to the submitted work; and (4) they have no non-financial interests that may be relevant to the submitted work. This article does not contain any studies with human participants or animals performed by any of the authors. This study was funded in part by the Institute for Safety, Compensation and Recovery Research (ISCRR).

Figures

Fig. 1
Fig. 1
Flowchart of study identification, selection and synthesis
See this image and copyright information in PMC

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