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Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss: a systematic review

Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss: a systematic review
Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss: a systematic review
OBJECTIVES: To assess the effectiveness of community- and workplace-based interventions to reduce sickness absence and job loss in workers with musculoskeletal disorders(MSDs).

METHODS: We identified relevant randomised controlled trials (RCTs) and cohort studies, published since 1990, by screening citations from 35 earlier systematic reviews and by searching Medline and Embase to April 2010. We estimated effects by type of intervention and other features, including study quality.

RESULTS: Among 42 finally included studies, 27 assessed return to work (RTW), 21 duration of sickness absence, and five job loss. Interventions included prescribed exercises, behavioural change techniques, workplace modifications and provision of extra services. Studies tended to be small (median sample 107 (IQR 77 – 148) and of limited quality. Most interventions appeared beneficial: the median RR for RTW was 1.21 (IQR 1.00–1.60) and that for avoiding MSD-related job loss, 1.25 (IQR 1.06–1.71); the median reduction in sickness absence was 1.11 (IQR 0.32–3.20) days/month. Effects were smaller, however, in larger better quality studies, suggesting potential publication bias. No intervention type was clearly superior to others, although effort-intensive interventions were less effective than simple ones. No study established statistically significant net economic benefits.

CONCLUSIONS: Benefits are generally small and of uncertain cost-effectiveness. Expensive interventions should be implemented only with careful cost-benefit evaluation planned from the start. Future research should focus on the cost-effectiveness of simple low cost interventions, and impacts on job retention.
Palmer, K.
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Coggon, D.
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Linekar, C.
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Harris, E.C.
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Barker, M.
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Lawrence, W.
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Cooper, C.
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Palmer, K.
0cfe63f0-1d33-40ff-ae8c-6c33601df850
Coggon, D.
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Linekar, C.
b4d68f14-60dd-41ba-979d-2e6d4f0c0408
Harris, E.C.
3e4bd946-3f09-45a1-8725-d35e80dd7971
Barker, M.
374310ad-d308-44af-b6da-515bf5d2d6d2
Lawrence, W.
e9babc0a-02c9-41df-a289-7b18f17bf7d8
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6

Palmer, K., Coggon, D., Linekar, C., Harris, E.C., Barker, M., Lawrence, W. and Cooper, C. (2011) Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss: a systematic review. 22nd International Conference on Epidemiology in Occupational Health, Oxford, United Kingdom. 06 - 10 Sep 2011. (doi:10.1136/oemed-2011-100382.201).

Record type: Conference or Workshop Item (Other)

Abstract

OBJECTIVES: To assess the effectiveness of community- and workplace-based interventions to reduce sickness absence and job loss in workers with musculoskeletal disorders(MSDs).

METHODS: We identified relevant randomised controlled trials (RCTs) and cohort studies, published since 1990, by screening citations from 35 earlier systematic reviews and by searching Medline and Embase to April 2010. We estimated effects by type of intervention and other features, including study quality.

RESULTS: Among 42 finally included studies, 27 assessed return to work (RTW), 21 duration of sickness absence, and five job loss. Interventions included prescribed exercises, behavioural change techniques, workplace modifications and provision of extra services. Studies tended to be small (median sample 107 (IQR 77 – 148) and of limited quality. Most interventions appeared beneficial: the median RR for RTW was 1.21 (IQR 1.00–1.60) and that for avoiding MSD-related job loss, 1.25 (IQR 1.06–1.71); the median reduction in sickness absence was 1.11 (IQR 0.32–3.20) days/month. Effects were smaller, however, in larger better quality studies, suggesting potential publication bias. No intervention type was clearly superior to others, although effort-intensive interventions were less effective than simple ones. No study established statistically significant net economic benefits.

CONCLUSIONS: Benefits are generally small and of uncertain cost-effectiveness. Expensive interventions should be implemented only with careful cost-benefit evaluation planned from the start. Future research should focus on the cost-effectiveness of simple low cost interventions, and impacts on job retention.

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More information

Published date: 9 September 2011
Venue - Dates: 22nd International Conference on Epidemiology in Occupational Health, Oxford, United Kingdom, 2011-09-06 - 2011-09-10
Organisations: Faculty of Medicine

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Local EPrints ID: 356137
URI: http://eprints.soton.ac.uk/id/eprint/356137
PURE UUID: eef70998-8291-4ee2-95c5-f95af097d518
ORCID for D. Coggon: ORCID iD orcid.org/0000-0003-1930-3987
ORCID for E.C. Harris: ORCID iD orcid.org/0000-0001-8037-566X
ORCID for M. Barker: ORCID iD orcid.org/0000-0003-2976-0217
ORCID for W. Lawrence: ORCID iD orcid.org/0000-0003-1264-0438
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 17 Sep 2013 14:08
Last modified: 18 Feb 2021 16:57

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Contributors

Author: K. Palmer
Author: D. Coggon ORCID iD
Author: C. Linekar
Author: E.C. Harris ORCID iD
Author: M. Barker ORCID iD
Author: W. Lawrence ORCID iD
Author: C. Cooper ORCID iD

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