Department of Clinical Social Medicine, Public Health and Quality Management, Central Denmark Region and Section of Clinical Social Med, and Rehabilitation, School of Public Health, University of Aarhus, Aarhus, Denmark.
BMC Musculoskelet Disord. 2012 Aug 25;13:156. doi: 10.1186/1471-2474-13-156.
Sick-listed employees with low back pain had similar return to work (RTW) rates at one-year follow-up in a randomized trial comparing two interventions, but the effects were modified by specific workplace related factors. The present study addressed the sustainability of the intervention effects by performing a two-year follow-up and by using different outcome measures.
A total of 351 employees sick-listed for 3-16 weeks due to LBP were recruited from their general practitioners and were randomly allocated to a hospital-based brief or multidisciplinary intervention. Outcome measures were based on sick leave registered in a national database of social and health-related benefits. RTW rates, RTW status, sick leave weeks and sick leave relapse were studied.
During the two-year follow-up 80.0% and 77.3% had RTW for at least four weeks continuously, and the percentages with RTW at the 104th week were 61.1% and 58.0% in the brief and multidisciplinary intervention groups, respectively. At the 104th week 16.6% and 18.8% were on sick leave in the two groups, respectively, and about 12% were employed in modified jobs or participated in job training. The number of weeks on sick leave in the first year was significantly lower in the brief intervention group (median 14 weeks) than in the multidisciplinary intervention group (median 20 weeks), but during the second year the number of weeks on sick leave were not significantly different between intervention groups. Subgroups characterised by specific work related factors modified the effect of the intervention groups on RTW rates (p = 0.017). No difference in sick leave relapse was found between the intervention groups.
The effects of the brief and multidisciplinary interventions at the two-year follow-up were in general similar to the effects at one-year follow-up.
Current Controlled Trials ISRCTN18609003.
在一项比较两种干预措施的随机试验中，患有下背痛且请病假的员工在一年随访时的重返工作岗位（RTW）率相似，但这些效果受到特定工作场所相关因素的影响。本研究通过进行为期两年的随访，并使用不同的结果测量方法，来研究干预效果的可持续性。
总共招募了 351 名因 LBP 请病假 3-16 周的员工，他们从他们的全科医生那里招募，并随机分配到基于医院的简短或多学科干预组。结果测量基于在社会和健康相关福利的国家数据库中登记的病假。研究了 RTW 率、RTW 状态、病假周数和病假复发。
在两年随访期间，80.0%和 77.3%的患者至少连续四周 RTW，在第 104 周时，简短干预组和多学科干预组的 RTW 百分比分别为 61.1%和 58.0%。在第 104 周时，两组分别有 16.6%和 18.8%的人请病假，约 12%的人从事修改后的工作或参加工作培训。在第一年，简短干预组的病假周数（中位数 14 周）明显低于多学科干预组（中位数 20 周），但在第二年，干预组之间的病假周数没有显著差异。以特定工作相关因素为特征的亚组改变了干预组对 RTW 率的影响（p=0.017）。在干预组之间未发现病假复发的差异。
在两年随访时，简短和多学科干预的效果一般与一年随访时的效果相似。
当前对照试验 ISRCTN82512777。
