Effectiveness of very early workplace interventions to reduce sickness absence: a systematic review of the literature and meta-analysis.

Sergio Vargas-Prada,Kerry Freer,Evangelia Demou,Consol Serra,Maite Sampere,Ewan B Macdonald,Drushca Lalloo,Ione Avila-Palencia,Kaveh A Sanati

doi:10.5271/sjweh.3576

Sergio Vargas-Prada, Kerry Freer + Show 7 more

Open Access

https://doi.org/10.5271/sjweh.3576

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Abstract

The aim of this review was to investigate the effectiveness of workplace return-to-work (RTW) interventions delivered at very early stages (<15 days) of sickness absence (SA). A systematic literature search was conducted in PubMed, Health Management Information Consortium (HMIC), Cochrane library database, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychInfo and Embase. Using pre-established criteria, independent pairs of researchers carried out the study selection, quality appraisal and data extraction. Workplace interventions before day 15 of SA, were included. Primary outcome measures included rates of and time until RTW, productivity loss, and recurrences of SA. We found limited available evidence on the benefits of "very early" workplace interventions in terms of RTW after a SA episode compared to usual care. Only three randomized controlled trials classed as high or intermediate quality were identified. Early part-time sick leave together with appropriate job modifications led to a reduction in the duration and recurrence of SA. There is evidence of benefit of intervening during the first two weeks of SA for musculoskeletal disorders. Our review has identified a lack of evidence from the literature at this time point to support "very early" intervention compared to usual care. The methodological design of the studies, notably the extent and timing of usual care provided and variable compliance/crossover between groups could however explain the lack of demonstrated benefit. Consensus is required on the definition of "early" and "very early" interventions, and further research is recommended to improve understanding of the factors influencing when and how best to intervene for maximum gain.

Highlights

Police workers with mental health problems allocated to the guidelinebased care group did not return to work earlier, compared to the control group [25]
This systematic review found limited available evidence regarding the benefits of very early interventions at the workplace in terms of RTW after an episode of SA compared to usual care
Only three randomized controlled trials classified as high or intermediate quality were identified, it seems that the positive RTW impact in intervening during the first two weeks of SA is somewhat stronger for workers with musculoskeletal disorders and less for workers with mental health problems

Summary

Methods

This systematic review sought to answer whether very early interventions at the workplace are effective to reduce SA. To this end, we have considered all workplace interventions, defined as all interventions carried out in the workplace before day 15 of SA, implemented directly or indirectly by the employer, including the involvement and participation of a variety of professionals from internal (company/sector occupational health departments) or external occupational health services. Our search strategy was applied to all databases and combined four blocks of keywords or MEsH terms intended to cover all different aspects of our review: (i) setting: “workplace”, “employer”, “manager”, “management” and “nurse administrator”; (ii) early intervention: “early intervention”, “early stage”, “call handling”, “signposting”, “occupational health” and “case management”; (iii) outcome: “return-to-work”, “employment”, “unemployment”, “sick leave”, “work absence”, “sickness absence”, and “absenteeism”; (iv) type of study: “randomized controlled trials”, “clinical trial”, “random allocation”, “blind method” and “placebo”.

Results

Discussion

Conclusion