Original article

Scand J Work Environ Health Online-first -article    pdf

doi:10.5271/sjweh.3882

Inpatient multimodal occupational rehabilitation reduces sickness absence among individuals with musculoskeletal and common mental health disorders: a randomized clinical trial

by Gismervik SØ, Aasdahl L, Vasseljen O, Fors EA, Rise MB, Johnsen R, Hara K, Jacobsen HB, Pape K, Fleten N, Jensen C, Fimland MS

Objectives This study aimed to investigate whether inpatient multimodal occupational rehabilitation (I-MORE) reduces sickness absence (SA) more than outpatient acceptance and commitment therapy (O-ACT) among individuals with musculoskeletal and mental health disorders.

Methods Individuals on sick leave (2-12 months) due to musculoskeletal or common mental health disorders were randomized to I-MORE (N=86) or O-ACT (N=80). I-MORE lasted 3.5 weeks in which participants stayed at the rehabilitation center. I-MORE included ACT, physical exercise, work-related problem solving and creating a return to work plan. O-ACT consisted mainly of 6 weekly 2.5 hour group-ACT sessions. We assessed the primary outcome cumulative SA within 6 and 12 months with national registry-data. Secondary outcomes were time to sustainable return to work and self-reported health outcomes assessed by questionnaires.

Results SA did not differ between the interventions at 6 months, but after one year individuals in I-MORE had 32 fewer SA days compared to O-ACT (median 85 [interquartile range 33–149] versus 117 [interquartile range 59–189)], P=0.034). The hazard ratio for sustainable return to work was 1.9 (95% confidence interval 1.2–3.0) in favor of I-MORE. There were no clinically meaningful between-group differences in self-reported health outcomes.

Conclusions Among individuals on long-term SA due to musculoskeletal and common mental health disorders, a 3.5-week I-MORE program reduced SA compared with 6 weekly sessions of O-ACT in the year after inclusion. Studies with longer follow-up and economic evaluations should be performed.

This article refers to the following texts of the Journal: 2006;32(4):257-269  2012;38(2):93-104  [online first; 13 December 2019]