School of Health Sciences, University of Nottingham, Medical School, Queens Medical Centre, Nottingham, NG7 2UH, UK.
Royal College of Occupational Therapists, 106-114 Borough High Street, London, SE1 1LB, UK.
BMC Fam Pract. 2020 Dec 13;21(1):268. doi: 10.1186/s12875-020-01340-5.
GPs are under considerable pressure providing routine care. However, they may not be the most appropriate professionals to manage getting patients back to work, and keeping them there.
To test the feasibility of delivering occupational therapy-led vocational clinics (OTVoc) to provide return to work advice and support for people with musculoskeletal conditions and mental health problems, in primary care.
Prospective mixed methods study in two primary care centres (eight GP surgeries). We collected anonymised service level data on all patients receiving OTVoc. Next, patient participants who met inclusion criteria and consented, undertook baseline and 3-month follow-up assessments. Interviews were also conducted to explore stakeholders' views- GPs, Nurse Practitioners, Front Desk Staff, Occupational Therapists, patients and their employers about OTVoc- and included study eligibility, referral, experiences and attitudes to return to work. Data were analysed using descriptive statistics and thematic analysis.
The majority of standardized measures showed some improvement over the study period: the sickness absence rate dropped from 71 to 15% and use of GP 'fit' notes reduced from 76 to 6%. Interview data indicated positive attitudes to OTVoc, the use of the fit note and the Allied Health Professions Health and Work Reports (AHP H&WRs). GPs felt that OTVoc reduced their workload.
Further research is feasible and warranted. OTVoc was positively received and stakeholders believed it was effective in getting patients back to work or preparing for their return. There was enthusiasm for extending service eligibility criteria, suggesting potential for further development and evaluation.
全科医生在提供常规护理方面承受着相当大的压力。然而，他们可能不是管理患者重返工作岗位并保持工作状态的最合适的专业人员。
测试在初级保健中提供由职业治疗师主导的职业诊所（OTVoc）为患有肌肉骨骼疾病和心理健康问题的患者提供重返工作岗位建议和支持的可行性。
在两个初级保健中心（8 个全科医生手术）进行前瞻性混合方法研究。我们收集了所有接受 OTVoc 的患者的匿名服务水平数据。接下来，符合纳入标准并同意的患者参与者进行基线和 3 个月随访评估。还进行了访谈，以探讨利益相关者对 OTVoc 的看法，包括全科医生、护士从业者、前台工作人员、职业治疗师、患者及其雇主，内容涉及 OTVoc 的资格、转诊、经验和对重返工作岗位的态度。使用描述性统计和主题分析对数据进行分析。
大多数标准化措施在研究期间显示出一些改善：病假率从 71%降至 15%，使用全科医生“适合”说明的比例从 76%降至 6%。访谈数据表明对 OTVoc、使用适合说明和联合健康专业人员健康和工作报告（AHP H&WRs）的积极态度。全科医生认为 OTVoc 减轻了他们的工作量。
进一步的研究是可行和必要的。OTVoc 受到了积极的评价，利益相关者认为它在让患者重返工作岗位或为他们的回归做准备方面是有效的。扩大服务资格标准的热情很高，这表明有进一步发展和评估的潜力。
