Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs Gata 22B, SE-413 19, Gothenburg, Sweden.
School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
BMC Prim Care. 2023 Sep 20;24(1):195. doi: 10.1186/s12875-023-02151-0.
Stress-related disorders have become a major challenge for society and are associated with rising levels of sick leave. The provision of support to facilitate the return to work (RTW) for this patient group is of great importance. The aim of the present study was to evaluate whether a new systematic procedure with collaboration between general practitioners (GPs), rehabilitation coordinators (RCs) and employers could reduce sick leave days for this patient group.
Employed patients with stress-related diagnoses seeking care at primary health care centres (PHCCs) were included in either the intervention group (n = 54), following the systematic intervention procedure, or the control group (n = 58), receiving treatment as usual (TAU). The intervention included a) a training day for participant GPs and RCs, b) a standardised procedure for GPs and RCs to follow after training, c) the opportunity to receive clinical advice from specialist physicians in the research group. Outcome measures for RTW were sick leave days.
The median number of registered gross sick leave days was lower for the control group at six, 12 and 24 months after inclusion, but the difference was not statistically significant. The control group had significantly fewer net sick leave days at three months (p = 0.03) at six months (p = 0.00) and at 12-months follow-up (p = 0.01). At 24 months, this difference was no longer significant.
The PRIMA intervention, which applied a standardized procedure for employer involvement in the rehabilitation process for patients with stress-related disorders, actually increased time to RTW compared to TAU. However, at 24 months, the benefit of TAU could no longer be confirmed. The study was registered on 16/01/2017 (ClinicalTrials.gov, NCT03022760).
与日俱增的病假与压力相关障碍共同成为了社会的一大挑战。为这一患者群体提供重返工作岗位（RTW）的支持十分重要。本研究旨在评估普通科医生（GP）、康复协调员（RC）和雇主之间开展新的系统合作程序是否能减少该患者群体的病假天数。
在初级保健中心（PHCC）就诊、患有压力相关疾病的在职患者纳入干预组（n=54），按系统干预程序进行；或纳入对照组（n=58），接受常规治疗（TAU）。干预措施包括：a）为参与的 GP 和 RC 举办培训日，b）GP 和 RC 在培训后遵循的标准化程序，c）为研究组的专科医生提供临床咨询机会。RTW 的结果测量指标是病假天数。
在纳入后 6、12 和 24 个月，对照组的注册总病假天数中位数较低，但差异无统计学意义。对照组在 3 个月（p=0.03）、6 个月（p=0.00）和 12 个月随访（p=0.01）时的净病假天数显著较少。在 24 个月时，这一差异不再显著。
PRIMA 干预措施采用了标准化程序，让雇主参与压力相关障碍患者的康复过程，与 TAU 相比，实际增加了 RTW 的时间。然而，在 24 个月时，无法再确认 TAU 的获益。该研究于 2017 年 1 月 16 日在 ClinicalTrials.gov（NCT03022760）注册。
