Sickness absence after carpal tunnel release: a multicentre prospective cohort study
Sickness absence after carpal tunnel release: a multicentre prospective cohort study
Objectives To describe when patients return to different types of work after elective carpal tunnel release (CTR) surgery and identify the factors associated with the duration of sickness absence.
Design Multicentre prospective observational cohort study.
Setting and participants Participants were recruited preoperatively from 16 UK centres and clinical, occupational and demographic information were collected. Participants completed a weekly diary and questionnaires at four and 12 weeks postoperatively.
Outcomes The main outcome was duration of work absence from date of surgery to date of first return to work.
Results 254 participants were enrolled in the study and 201 provided the follow-up data. Median duration of sickness absence was 20 days (range 1–99). Earlier return to work was associated with having surgery in primary care and a self-reported work role involving more than 4 hours of daily computer use. Being female and entitlement to more than a month of paid sick leave were both associated with longer work absences. The duration of work absence was strongly associated with the expected duration of leave, as reported by participants before surgery. Earlier return to work was not associated with poorer clinical outcomes reported 12 weeks after CTR.
Conclusions There was wide variation in the duration of work absence after CTR across all occupational categories. A combination of occupational, demographic and clinical factors was associated with the duration of work absence, illustrating the complexity of return to work decision making. However, preoperative expectations were strongly associated with the actual duration of leave. We found no evidence that earlier return to work was harmful. Clear, consistent advice from clinicians preoperatively setting expectations of a prompt return to work could reduce unnecessary sickness absence after CTR. To enable this, clinicians need evidence-informed guidance about appropriate timescales for the safe return to different types of work.
hand & wrist, occupational & industrial medicine, primary care
Newington, Lisa A
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Ntani, Georgia
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Warwick, David
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Adams, Joanna
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Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
10 February 2021
Newington, Lisa A
7dda4ec9-0bca-463e-9cb3-2a6573fde873
Ntani, Georgia
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Warwick, David
d23cacce-41eb-42bd-b8cc-da6a3b837a9f
Adams, Joanna
6e38b8bb-9467-4585-86e4-14062b02bcba
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Newington, Lisa A, Ntani, Georgia, Warwick, David, Adams, Joanna and Walker-Bone, Karen
(2021)
Sickness absence after carpal tunnel release: a multicentre prospective cohort study.
BMJ Open, 11 (2), [e041656].
(doi:10.1136/bmjopen-2020-041656).
Abstract
Objectives To describe when patients return to different types of work after elective carpal tunnel release (CTR) surgery and identify the factors associated with the duration of sickness absence.
Design Multicentre prospective observational cohort study.
Setting and participants Participants were recruited preoperatively from 16 UK centres and clinical, occupational and demographic information were collected. Participants completed a weekly diary and questionnaires at four and 12 weeks postoperatively.
Outcomes The main outcome was duration of work absence from date of surgery to date of first return to work.
Results 254 participants were enrolled in the study and 201 provided the follow-up data. Median duration of sickness absence was 20 days (range 1–99). Earlier return to work was associated with having surgery in primary care and a self-reported work role involving more than 4 hours of daily computer use. Being female and entitlement to more than a month of paid sick leave were both associated with longer work absences. The duration of work absence was strongly associated with the expected duration of leave, as reported by participants before surgery. Earlier return to work was not associated with poorer clinical outcomes reported 12 weeks after CTR.
Conclusions There was wide variation in the duration of work absence after CTR across all occupational categories. A combination of occupational, demographic and clinical factors was associated with the duration of work absence, illustrating the complexity of return to work decision making. However, preoperative expectations were strongly associated with the actual duration of leave. We found no evidence that earlier return to work was harmful. Clear, consistent advice from clinicians preoperatively setting expectations of a prompt return to work could reduce unnecessary sickness absence after CTR. To enable this, clinicians need evidence-informed guidance about appropriate timescales for the safe return to different types of work.
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Newington BMJ Open 2021
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Accepted/In Press date: 19 January 2021
e-pub ahead of print date: 10 February 2021
Published date: 10 February 2021
Additional Information:
Funding Information:
This research was supported by a patient advisory group consisting of six individuals who had previously undergone CTR at different UK sites. Study questionnaires were developed in collaboration with the patient advisors and these individuals also provided their feedback on the preliminary findings.
Funding Information:
Funding LN was supported by a National Institute for Health Research (NIHR) Doctoral Research Fellowship, grant number DRF-2015-08-056. GN was supported by funding from the MRC Versus Arthritis Centre for Musculoskeletal Health and Work, grant reference 22090.
Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
Keywords:
hand & wrist, occupational & industrial medicine, primary care
Identifiers
Local EPrints ID: 447069
URI: http://eprints.soton.ac.uk/id/eprint/447069
ISSN: 2044-6055
PURE UUID: f295b8ee-4adb-48d5-b315-2811aab607a3
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Date deposited: 02 Mar 2021 17:33
Last modified: 06 Jun 2024 01:38
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Author:
Lisa A Newington
Author:
David Warwick
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