Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions

An Update of the Evidence and Messages for Practitioners

K. L. Cullen, Allison E Irvin, A. Collie, F. Clay, U. Gensby, P. A. Jennings, Sheilah Hogg-Johnson, Vicki Kristman, M. Laberge, D. McKenzie, S. Newnam, A. Palagyi, R. Ruseckaite, D. M. Sheppard, S. Shourie, I A Steenstra, Dwayne Van Eerd, Benjamin C Amick III

Research output: Contribution to journalArticleResearchpeer-review

55 Citations (Scopus)

Abstract

Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.

Original languageEnglish
Pages (from-to)1-15
Number of pages15
JournalJournal of Occupational Rehabilitation
Volume28
Issue number1
DOIs
Publication statusPublished - Mar 2018

Keywords

  • Mental health
  • Musculoskeletal pain
  • Program effectiveness
  • Return to work
  • Systematic review
  • Workplace

Cite this

Cullen, K. L. ; Irvin, Allison E ; Collie, A. ; Clay, F. ; Gensby, U. ; Jennings, P. A. ; Hogg-Johnson, Sheilah ; Kristman, Vicki ; Laberge, M. ; McKenzie, D. ; Newnam, S. ; Palagyi, A. ; Ruseckaite, R. ; Sheppard, D. M. ; Shourie, S. ; Steenstra, I A ; Van Eerd, Dwayne ; Amick III, Benjamin C. / Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions : An Update of the Evidence and Messages for Practitioners. In: Journal of Occupational Rehabilitation. 2018 ; Vol. 28, No. 1. pp. 1-15.
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abstract = "Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.",
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Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions : An Update of the Evidence and Messages for Practitioners. / Cullen, K. L.; Irvin, Allison E; Collie, A.; Clay, F.; Gensby, U.; Jennings, P. A.; Hogg-Johnson, Sheilah; Kristman, Vicki; Laberge, M.; McKenzie, D.; Newnam, S.; Palagyi, A.; Ruseckaite, R.; Sheppard, D. M.; Shourie, S.; Steenstra, I A; Van Eerd, Dwayne; Amick III, Benjamin C.

In: Journal of Occupational Rehabilitation, Vol. 28, No. 1, 03.2018, p. 1-15.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Collie, A.

AU - Clay, F.

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AU - Jennings, P. A.

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AU - Laberge, M.

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N2 - Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.

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