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Randomized Controlled Trial
. 2022 Jun;36(6):753-766.
doi: 10.1177/02692155221076826. Epub 2022 Feb 22.

The Effectiveness of Case-management Rehabilitation Intervention in Facilitating Return to Work and Maintenance of Employment After Myocardial Infarction: Results of a Randomized Controlled Trial

Oren Zack  1 , Samuel Melamed  1 , Haim Silber  2 , Tali Cinamon  3 , Doron Levy  4 , Shlomo Moshe  1   4
Affiliations
Randomized Controlled Trial

The Effectiveness of Case-management Rehabilitation Intervention in Facilitating Return to Work and Maintenance of Employment After Myocardial Infarction: Results of a Randomized Controlled Trial

Oren Zack et al. Clin Rehabil. 2022 Jun.

Abstract

Objective: To study the long-term effectiveness of case-management rehabilitation intervention on vocational reintegration of patients after myocardial infarction (MI).

Design: Blinded simple randomization was used to construct an intervention and control groups that were followed up for two years.

Subjects and setting: 151 patients, aged 50.3 ± 5.9 years, who experienced uncomplicated MI and were enrolled in a cardiac rehabilitation program were recruited.

Interventions: included an early referral to an occupational physician, tailoring an occupational rehabilitation program, based on individual patient needs, coordination with relevant parties, psychosocial intervention, intensive follow-up sessions during a two-year follow-up.

Main measures: Return to work within six months of hospitalization and maintenance of employment at one and two years of follow-up.

Results: Return-to-work (RTW) rate in the intervention group was 89% and nearly all maintained employment at one year of follow-up (92%) and two years of follow-up (87%). Moreover, almost all of them returned to and maintained their previous jobs. The corresponding figures were: 98%, 94% and 98%, respectively. The figures for the RTW and employment maintenance for the control group were: 74%, 75%, and 72%, respectively. Only about 75%, in this group kept their previous job. The case-management intervention was associated with increased odds of maintaining employment at follow-up of one year (OR = 5.89, 95% CI 1.42-24.30) and two years (OR = 3.12, 95% CI 1.01-10.03).

Conclusions: The extended case-management rehabilitation intervention had a substantial positive impact on both the RTW of MI patients and their maintenance of employment at one and two years of follow-up.

Trial registration: This trial is registered at US National Institutes of Health #NCT04934735.

Keywords: Myocardial infarction; case-management; randomized controlled trial; rehabilitation; return to work.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of The study design.
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