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The effect on work presenteeism of job retention vocational rehabilitation compared to a written self-help work advice pack for employed people with inflammatory arthritis: protocol for a multi-centre randomised controlled trial (the WORKWELL trial)

The effect on work presenteeism of job retention vocational rehabilitation compared to a written self-help work advice pack for employed people with inflammatory arthritis: protocol for a multi-centre randomised controlled trial (the WORKWELL trial)
The effect on work presenteeism of job retention vocational rehabilitation compared to a written self-help work advice pack for employed people with inflammatory arthritis: protocol for a multi-centre randomised controlled trial (the WORKWELL trial)

Background: Work problems are common in people with inflammatory arthritis. Up to 50% stop work within 10 years due to their condition and up to 67% report presenteeism (i.e. reduced work productivity), even amongst those with low disease activity. Job retention vocational rehabilitation (JRVR) may help prevent or postpone job loss and reduce presenteeism through work assessment, work-related rehabilitation and enabling job accommodations. This aims to create a better match between the person's abilities and their job demands. The objectives of the Workwell trial are to test the overall effectiveness and cost-effectiveness of JRVR (WORKWELL) provided by additionally trained National Health Service (NHS) occupational therapists compared to a control group who receive self-help information both in addition to usual care. Methods: Based on the learning from a feasibility trial (the WORK-IA trial: ISRCTN76777720), the WORKWELL trial is a multi-centre, pragmatic, individually-randomised parallel group superiority trial, including economic evaluation, contextual factors analysis and process evaluation. Two hundred forty employed adults with rheumatoid arthritis, undifferentiated inflammatory arthritis or psoriatic arthritis (in secondary care), aged 18 years or older with work instability will be randomised to one of two groups: a self-help written work advice pack plus usual care (control intervention); or WORKWELL JRVR plus a self-help written work advice pack and usual care. WORKWELL will be delivered by occupational therapists provided with additional JRVR training from the research team. The primary outcome is presenteeism as measured using the Work Limitations Questionnaire-25. A comprehensive range of secondary outcomes of work, health, contextual factors and health resource use are included. Outcomes are measured at 6- and 12- months (with 12-months as the primary end-point). A multi-perspective within-trial cost-effectiveness analyses will also be conducted. Discussion: This trial will contribute to the evidence base for provision of JRVR to people with inflammatory arthritis. If JRVR is found to be effective in enabling people to keep working, the findings will support decision-making about provision of JRVR by rheumatology teams, therapy services and healthcare commissioners, and providing evidence of the effectiveness of JRVR and the economic impact of its implementation. Trial registration: Clinical Trials.Gov: NCT03942783. Registered 08/05/2019 (https://clinicaltrials.gov/ct2/show/NCT03942783); ISRCTN Registry: ISRCTN61762297. Registered:13/05/2019 (http://www.isrctn.com/ISRCTN61762297). Retrospectively registered.

Absenteeism, Arthritis, Occupational therapy, Presenteeism, Randomised controlled trial, Vocational rehabilitation
1471-2474
1-20
Hammond, Alison
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Sutton, Chris
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Cotterill, Sarah
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Woodbridge, Sarah
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O’Brien, Rachel
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Radford, Kate
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Forshaw, Denise
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Verstappen, Suzanne M.M.
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Jones, Cheryl
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Marsden, Antonia
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Eden, Martin
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Prior, Yeliz
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Culley, June
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Holland, Paula
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Walker-Bone, Karen
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Hammond, Alison
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Sutton, Chris
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Cotterill, Sarah
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Woodbridge, Sarah
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O’Brien, Rachel
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Radford, Kate
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Forshaw, Denise
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Verstappen, Suzanne M.M.
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Jones, Cheryl
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Marsden, Antonia
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Eden, Martin
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Prior, Yeliz
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Culley, June
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Holland, Paula
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Walker-Bone, Karen
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Hammond, Alison, Sutton, Chris, Cotterill, Sarah, Woodbridge, Sarah, O’Brien, Rachel, Radford, Kate, Forshaw, Denise, Verstappen, Suzanne M.M., Jones, Cheryl, Marsden, Antonia, Eden, Martin, Prior, Yeliz, Culley, June, Holland, Paula and Walker-Bone, Karen (2020) The effect on work presenteeism of job retention vocational rehabilitation compared to a written self-help work advice pack for employed people with inflammatory arthritis: protocol for a multi-centre randomised controlled trial (the WORKWELL trial). BMC Musculoskeletal Disorders, 21 (1), 1-20, [607]. (doi:10.1186/s12891-020-03619-1).

Record type: Article

Abstract

Background: Work problems are common in people with inflammatory arthritis. Up to 50% stop work within 10 years due to their condition and up to 67% report presenteeism (i.e. reduced work productivity), even amongst those with low disease activity. Job retention vocational rehabilitation (JRVR) may help prevent or postpone job loss and reduce presenteeism through work assessment, work-related rehabilitation and enabling job accommodations. This aims to create a better match between the person's abilities and their job demands. The objectives of the Workwell trial are to test the overall effectiveness and cost-effectiveness of JRVR (WORKWELL) provided by additionally trained National Health Service (NHS) occupational therapists compared to a control group who receive self-help information both in addition to usual care. Methods: Based on the learning from a feasibility trial (the WORK-IA trial: ISRCTN76777720), the WORKWELL trial is a multi-centre, pragmatic, individually-randomised parallel group superiority trial, including economic evaluation, contextual factors analysis and process evaluation. Two hundred forty employed adults with rheumatoid arthritis, undifferentiated inflammatory arthritis or psoriatic arthritis (in secondary care), aged 18 years or older with work instability will be randomised to one of two groups: a self-help written work advice pack plus usual care (control intervention); or WORKWELL JRVR plus a self-help written work advice pack and usual care. WORKWELL will be delivered by occupational therapists provided with additional JRVR training from the research team. The primary outcome is presenteeism as measured using the Work Limitations Questionnaire-25. A comprehensive range of secondary outcomes of work, health, contextual factors and health resource use are included. Outcomes are measured at 6- and 12- months (with 12-months as the primary end-point). A multi-perspective within-trial cost-effectiveness analyses will also be conducted. Discussion: This trial will contribute to the evidence base for provision of JRVR to people with inflammatory arthritis. If JRVR is found to be effective in enabling people to keep working, the findings will support decision-making about provision of JRVR by rheumatology teams, therapy services and healthcare commissioners, and providing evidence of the effectiveness of JRVR and the economic impact of its implementation. Trial registration: Clinical Trials.Gov: NCT03942783. Registered 08/05/2019 (https://clinicaltrials.gov/ct2/show/NCT03942783); ISRCTN Registry: ISRCTN61762297. Registered:13/05/2019 (http://www.isrctn.com/ISRCTN61762297). Retrospectively registered.

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WORKWELL Trial protocol article Hammond et al 28.7.20 - Accepted Manuscript
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Accepted/In Press date: 31 August 2020
e-pub ahead of print date: 10 September 2020
Published date: 10 September 2020
Additional Information: Publisher Copyright: © 2020 The Author(s).
Keywords: Absenteeism, Arthritis, Occupational therapy, Presenteeism, Randomised controlled trial, Vocational rehabilitation

Identifiers

Local EPrints ID: 444243
URI: http://eprints.soton.ac.uk/id/eprint/444243
ISSN: 1471-2474
PURE UUID: 7f1f8e4e-d58c-4718-88a9-b5bbe7126904
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459

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Date deposited: 02 Oct 2020 16:37
Last modified: 09 Nov 2022 02:36

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Contributors

Author: Alison Hammond
Author: Chris Sutton
Author: Sarah Cotterill
Author: Sarah Woodbridge
Author: Rachel O’Brien
Author: Kate Radford
Author: Denise Forshaw
Author: Suzanne M.M. Verstappen
Author: Cheryl Jones
Author: Antonia Marsden
Author: Martin Eden
Author: Yeliz Prior
Author: June Culley
Author: Paula Holland

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