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Randomized Controlled Trial
. 2018 Aug;159(8):1456-1464.
doi: 10.1097/j.pain.0000000000001216.

Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up-WorkUp, a randomised controlled trial in primary care

Charlotte P Sennehed  1   2   3 , Sara Holmberg  3   4 , Iben Axén  5 , Kjerstin Stigmar  2   6 , Malin Forsbrand  1   2   7 , Ingemar F Petersson  1   8 , Birgitta Grahn  1   2   3
Affiliations
Randomized Controlled Trial

Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up-WorkUp, a randomised controlled trial in primary care

Charlotte P Sennehed et al. Pain. 2018 Aug.

Abstract

Workplace involvement in rehabilitation for patients with musculoskeletal pain may improve work ability. Convergence Dialogue Meeting (CDM) is a model aimed at helping the patient, the care giver, and the employer to support work ability and return-to-work. Our aim was to study the effect on work ability when adding a workplace dialogue according to CDM in physiotherapy practice for patients with pain in ordinary primary care. We conducted a prospective pairwise cluster randomised controlled trial (ClinicalTrials.gov ID: NCT02609750) in primary care involving 20 primary care rehabilitation units with 1-year follow-up. Adult patients with acute/subacute neck and back pain, worked ≥4 weeks past year and not currently on sick leave or no more than 60 days of sick leave and considered at-risk of sick leave were included (n = 352). All patients received structured physiotherapy and the intervention was the addition of CDM, delivered by the treating physiotherapist. The main confirmatory outcome, work ability (defined as working at least 4 consecutive weeks at follow-up), was assessed by a weekly short text message question on number of sick leave days past week. Work ability was reached by significantly more patients in the intervention group (108/127, 85%) compared with the reference group (127/171, 74%) (P = 0.02). The intervention increased the odds of having work ability at 1-year follow-up, also after adjustment for baseline health-related quality of life (odds ratio 1.85, confidence interval 1.01-3.38). We conclude that an early workplace dialogue in addition to structured physiotherapy improved work ability significantly.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
Flowchart of inclusion and follow-up of primary care rehabilitation units. The proportion of patients who reported days on sick leave past week, by answering the text message.
Figure 2.
Figure 2.
Proportion of text message answers per week after baseline, during 52 weeks, intervention n = 146 and reference n = 206.
Figure 3.
Figure 3.
Self-reported sick leave days per week, collected using weekly text messages, intervention n = 146, and reference n = 206.
Figure 4.
Figure 4.
Proportion with work ability (no sick leave days) at baseline and 4 consecutive weeks month 3 (week 9-12), month 6 (week 23-26), month 9 (week 36-39), and month 12 (week 49-52) after baseline, intervention n = 146, reference n = 206. BL, baseline.
See this image and copyright information in PMC

Comment in

References

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