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Workplace interventions for preventing work disability.

Abstract

BACKGROUND

Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders.

OBJECTIVES

To determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions.

SEARCH STRATEGY

We searched the Cochrane Occupational Health Field Trials Register, CENTRAL, MEDLINE and EMBASE (EMBASE.com), and PsycINFO databases (to November 2007).

SELECTION CRITERIA

We included randomized controlled trials of workplace interventions aimed at return to work for workers where absence from work because of sickness was reported as a continuous outcome.

DATA COLLECTION AND ANALYSIS

Two authors independently extracted data and assessed risk of bias of the studies. Meta-analysis and qualitative analysis (using GRADE levels of evidence) were performed.

MAIN RESULTS

We included six randomized controlled trials (749 workers): three on low back pain, one on upper-extremity disorders, one on musculoskeletal disorders, and one on adjustment disorders. Five studies were rated as having low risk of bias for the sickness absence outcome. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. The lack of studies made it impossible to investigate the effectiveness of workplace interventions among workers with mental health problems and other health conditions. A comparison of a workplace intervention with a clinical intervention, in one study only, yielded similar results for sickness absence and symptoms for workers with mental health problems.

AUTHORS' CONCLUSIONS

As a result of the few available studies, no convincing conclusions can be formulated about the effectiveness of workplace interventions on work-related outcomes and health outcomes regardless of the type of work disability. The pooled data for the musculoskeletal disorders subgroup indicated that workplace interventions are effective in the reduction of sickness absence, but they are not effective in improving health outcomes. The evidence from the subgroup analysis on musculoskeletal disorders was rated as moderate-quality evidence. Unfortunately, conclusions cannot be drawn on the effectiveness of these interventions for mental health problems and other health conditions due to a lack of studies.

Authors+Show Affiliations

Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, Netherlands, 1081 BT.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

19370664

Citation

van Oostrom, Sandra H., et al. "Workplace Interventions for Preventing Work Disability." The Cochrane Database of Systematic Reviews, 2009, p. CD006955.
van Oostrom SH, Driessen MT, de Vet HC, et al. Workplace interventions for preventing work disability. Cochrane Database Syst Rev. 2009.
van Oostrom, S. H., Driessen, M. T., de Vet, H. C., Franche, R. L., Schonstein, E., Loisel, P., van Mechelen, W., & Anema, J. R. (2009). Workplace interventions for preventing work disability. The Cochrane Database of Systematic Reviews, (2), CD006955. https://doi.org/10.1002/14651858.CD006955.pub2
van Oostrom SH, et al. Workplace Interventions for Preventing Work Disability. Cochrane Database Syst Rev. 2009 Apr 15;(2)CD006955. PubMed PMID: 19370664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Workplace interventions for preventing work disability. AU - van Oostrom,Sandra H, AU - Driessen,Maurice T, AU - de Vet,Henrica C W, AU - Franche,Renée-Louise, AU - Schonstein,Eva, AU - Loisel,Patrick, AU - van Mechelen,Willem, AU - Anema,Johannes R, Y1 - 2009/04/15/ PY - 2009/4/17/entrez PY - 2009/4/17/pubmed PY - 2009/6/24/medline SP - CD006955 EP - CD006955 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 2 N2 - BACKGROUND: Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders. OBJECTIVES: To determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions. SEARCH STRATEGY: We searched the Cochrane Occupational Health Field Trials Register, CENTRAL, MEDLINE and EMBASE (EMBASE.com), and PsycINFO databases (to November 2007). SELECTION CRITERIA: We included randomized controlled trials of workplace interventions aimed at return to work for workers where absence from work because of sickness was reported as a continuous outcome. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed risk of bias of the studies. Meta-analysis and qualitative analysis (using GRADE levels of evidence) were performed. MAIN RESULTS: We included six randomized controlled trials (749 workers): three on low back pain, one on upper-extremity disorders, one on musculoskeletal disorders, and one on adjustment disorders. Five studies were rated as having low risk of bias for the sickness absence outcome. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. The lack of studies made it impossible to investigate the effectiveness of workplace interventions among workers with mental health problems and other health conditions. A comparison of a workplace intervention with a clinical intervention, in one study only, yielded similar results for sickness absence and symptoms for workers with mental health problems. AUTHORS' CONCLUSIONS: As a result of the few available studies, no convincing conclusions can be formulated about the effectiveness of workplace interventions on work-related outcomes and health outcomes regardless of the type of work disability. The pooled data for the musculoskeletal disorders subgroup indicated that workplace interventions are effective in the reduction of sickness absence, but they are not effective in improving health outcomes. The evidence from the subgroup analysis on musculoskeletal disorders was rated as moderate-quality evidence. Unfortunately, conclusions cannot be drawn on the effectiveness of these interventions for mental health problems and other health conditions due to a lack of studies. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/19370664/Workplace_interventions_for_preventing_work_disability_ L2 - https://doi.org/10.1002/14651858.CD006955.pub2 DB - PRIME DP - Unbound Medicine ER -