Abstract
BackgroundSickness absence due to common mental disorders (such as depression, anxiety disorder, adjustment disorder) is a problem in many Western countries. Long-term sickness absence leads to substantial societal and financial costs. In workers with common mental disorders, sickness absence costs are much higher than medical costs. In the Netherlands, a practice guideline was developed that promotes an activating approach of the occupational physician to establish faster return-to-work by enhancing the problem-solving capacity of workers, especially in relation to their work environment. Studies on this guideline indicate a promising association between guideline adherence and a shortened sick leave duration, but also minimal adherence to the guideline by occupational physicians. Therefore, this study evaluates the effect of guideline-based care on the full return-to-work of workers who are sick listed due to common mental disorders.Methods/designThis is a two-armed cluster-randomised controlled trial with randomisation at the occupational physician level. During one year, occupational physicians in the intervention group receive innovative training to improve their guideline-based care whereas occupational physicians in the control group provide care as usual. A total of 232 workers, sick listed due to common mental disorders and counselled by participating occupational physicians, will be included. Data are collected via the registration system of the occupational health service, and by questionnaires at baseline and at 3, 6 and 12 months. The primary outcome is time to full return-to-work. Secondary outcomes are partial return-to-work, total number of sick leave days, symptoms, and workability. Personal and work characteristics are the prognostic measures. Additional measures are coping, self-efficacy, remoralization, personal experiences, satisfaction with consultations with the occupational physician and with contact with the supervisor, experiences and behaviour of the supervisor, and the extent of guideline adherence.DiscussionIf the results show that guideline-based care in fact leads to faster and sustainable return-to-work, this study will contribute to lowering personal, societal and financial costs.Trial registrationISRCTN86605310
Highlights
Sickness absence due to common mental disorders is a problem in many Western countries
If the results show that guideline-based care leads to faster and sustainable return-to-work, this study will contribute to lowering personal, societal and financial costs
In workers with common mental disorders (CMD), sickness absence costs are reported to be much higher than the medical costs, mainly due to the long duration of a sick leave period [5,6]
Summary
Sickness absence due to common mental disorders (such as depression, anxiety disorder, adjustment disorder) is a problem in many Western countries. Long-term sickness absence leads to substantial societal and financial costs. This study evaluates the effect of guideline-based care on the full return-to-work of workers who are sick listed due to common mental disorders. Sickness absence due to common mental disorders (CMD), such as depression, anxiety disorder and adjustment disorder, is a problem in many Western countries, including Sweden, Germany, the UK and the Netherlands [1]. CMD have negative consequences for the worker They affect functioning in private life and can lead to long-term absenteeism, which is associated with individual suffering, reduced probability of eventual return-to-work (RTW), a weakened financial position, social isolation, and exclusion from the labour market [2,3]. The annual costs of sickness absence due to CMD are estimated at 2.7–7.5 billion euros [6,9]
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