Effectiveness and cost-effectiveness of an exposure-based return-to-work programme for patients on sick leave due to common mental disorders: design of a cluster-randomized controlled trial Coordinated and Tailored Work Rehabilitation: A Randomized Controlled Trial with Economic Evaluation Undertaken with Workers on Sick Leave Due to Musculoskeletal Disorders Promoting work ability in a structured national rehabilitation program in patients with musculoskeletal disorders: outcomes and predictors in a prospective cohort study Cost effectiveness of two rehabilitation programmes for neck and back pain patients: A seven year follow-up Costs of Inflammatory Bowel Disease in Germany Indirect medical costs in early rheumatoid arthritis: composition of and changes in indirect costs within the first three years of disease. Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial NICE guidance on long-term sickness and incapacity. Stay@Work: Participatory Ergonomics to prevent low back and neck pain among workers: design of a randomised controlled trial to evaluate the (cost-)effectiveness Can we enhance the ability to return to work among workers with stress-related disorders? Cost-effectiveness of a workplace intervention for sick-listed employees with common mental disorders: design of a randomized controlled trial A web-based intervention to promote applications for rehabilitation: a study protocol for a randomized controlled trial Health-related effects of early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial. Effectiveness of a multidisciplinary care program on recovery and return to work of patients after gynaecological surgery; design of a randomized controlled trial Economic Evaluation of a Multi-Stage Return to Work Program for Workers on Sick-Leave Due to Low Back Pain
Background To reduce the duration of sick leave and loss of productivity due to common mental disorders ( CMDs ) , we developed a return-to-work programme to be provided by occupational physicians ( OPs ) based on the principles of exposure in vivo ( RTW-E programme ) . This study evaluates this programme 's effectiveness and cost-effectiveness by comparing it with care as usual ( CAU ) . The three research questions we have are : 1 ) Is an RTW-E programme more effective in reducing the sick leave of employees with common mental disorders , compared with care as usual ? 2 ) Is an RTW-E programme more effective in reducing sick leave for employees with anxiety disorders compared with employees with other common mental disorders ? 3 ) From a societal perspective , is an RTW-E programme cost-effective compared with care as usual ? Methods / design This study was design ed as a pragmatic cluster-r and omized controlled trial with a one-year follow-up and r and omization on the level of OPs . We aim ed for 60 OPs in order to include 200 patients . Patients in the intervention group received the RTW-E programme .  Patients in the control group received care as usual .  Eligible patients had been on sick leave due to common mental disorders for at least two weeks and no longer than eight weeks . As primary outcome measures , we calculated the time until full return to work and the duration of sick leave . Secondary outcome measures were time until partial return to work , prevalence rate of sick leave at 3 , 6 , 9 , and 12 months ' follow-up , and scores of symptoms of distress , anxiety , depression , somatization , and fatigue ; work capacity ; perceived working conditions ; self-efficacy for return to work ; coping behaviour ; avoidance behaviour ; patient satisfaction ; and work adaptations . As process measures , we used indices of compliance with the intervention in the intervention group and employee-supervisor communication in both groups . Economic costs were calculated from a societal perspective . The total costs consisted of the costs of consuming health care , costs of production loss due to sick leave and reduced productivity , and out-of-pocket costs of patients for travelling to their OP . Discussion The results will be published in 2009 . The strengths and weaknesses of the study protocol are discussed . Trial registration IS RCT Introduction In Denmark , the magnitude and impact of work disability on the individual worker and society has prompted the development of a new “ coordinated and tailored work rehabilitation ” ( CTWR ) approach . The aim of this study was to compare the effects of CTWR with conventional case management ( CCM ) on return-to-work of workers on sick leave due to musculoskeletal disorders ( MSDs ) . Methods The study was a r and omized controlled trial with economic evaluation undertaken with workers on sick leave for 4–12 weeks due to MSDs . CTWR consists of a work disability screening by an interdisciplinary team followed by the collaborative development of a RTW plan . The primary outcome variable was registered cumulative sickness absence hours during 12 months follow-up . Secondary outcomes were work status as well as pain intensity and functional disability , measured at baseline , 3 and 12 months follow-up . The economic evaluation ( intervention costs , productivity loss , and health care utilization costs ) was based on administrative data derived from national registries . Results For the time intervals 0–6 months , 6–12 months , and the entire follow-up period , the number of sickness absence hours was significantly lower in the CTWR group as compared to the control group . The total costs saved in CTWR participants compared to controls were estimated at US $ 1,366 per person at 6 months follow-up and US $ 10,666 per person at 12 months follow-up . Conclusions Workers on sick leave for 4–12 weeks due to MSD who underwent “ CTWR ” by an interdisciplinary team had fewer sickness absence hours than controls . The economic evaluation showed that — in terms of productivity loss — CTWR seems to be cost saving for the society Background Musculoskeletal disorders ( MSDs ) are a major reason for impaired work productivity and sick leave . In 2009 , a national rehabilitation program was introduced in Sweden to promote work ability , and patients with MSDs were offered multimodal rehabilitation . The aim of this study was to analyse the effect of this program on health related quality of life , function , sick leave and work ability . Methods We conducted a prospect i ve , observational cohort study including 406 patients with MSDs attending multimodal rehabilitation .  Changes over time and differences between groups were analysed concerning function , health related quality of life , work ability and sick leave . Regression analyses were used to study the outcome variables health related quality of life ( measured with EQ-5D ) , and sick leave . Results Functional ability and health related quality of life improved after rehabilitation . Patients with no sick leave/disability pension the year before rehabilitation , improved health related quality of life more than patients with sick leave/disability pension the year before rehabilitation ( p = 0.044 ) . During a period of −/+ four months from rehabilitation start , patients with EQ-5D ≥ 0.5 at rehabilitation start , reduced their net sick leave days with 0.5 days and patients with EQ-5D < 0.5 at rehabilitation start , increased net sick leave days with 1.5 days ( p = 0.019 ) . Factors negatively associated with sick leave at follow-up were earlier episodes of sick leave/disability pension , problems with exercise tolerance functions and mobility after rehabilitation . Higher age was associated with not being on sick leave at follow-up and reaching an EQ-5D ≥ 0.5 at follow-up . Severe pain after rehabilitation , problems with exercise tolerance functions , born outside of Sweden and full-time sick leave/disability pension the year before rehabilitation were all associated with an EQ-5D level < 0.5 at follow-up . Conclusions Patients with MSDs participating in a national work promoting rehabilitation program  significantly improved their health related quality of life and functional ability , especially those with no sick leave . This shows that vocational rehabilitation programs in a primary health care setting are effective . The findings of this study can also be valuable for more appropriate patient selection for rehabilitation programs for MSDs ABSTRACT The cost effectiveness of work‐oriented rehabilitation for persons on long‐term sick leave needs to be assessed . This prospect i ve observational study presents a follow‐up seven years after rehabilitation using two different evidence ‐based work‐oriented regimens . Individuals on sick leave for neck and back pain were referred to two rehabilitation programmes in Sweden . The first programme was a relatively low‐intensity programme based on orthopaedic manual therapy and exercise programme ( OMTP ) . The second programme was a full‐time multidisciplinary programme ( MDP ) . The primary outcome was sickness absence seven years after intervention . Cost effectiveness was calculated on the basis of loss of production due to sickness absence . The results show that participants referred to MDP and with less than 60 sick days before rehabilitation have reduced sickness absence after intervention as compared to matched controls . This corresponds to a cost reduction of about 94,494 EUR per referred individual . Further , the results indicate that participants of the OMTP who have more than 60 sick days before rehabilitation have a statistically significant increased risk of disability pension . This means increased cost in terms of loss of production of 44,593 EUR per referred individual . The results of this study show that MPD but not OMTP achieves the goal of working life‐oriented rehabilitation . A direct comparison between the rehabilitation programmes strengthened the assumption that long‐term sickness absence prior to rehabilitation is associated with more days on sick leave after rehabilitation . This analysis also indicated the importance of participants  ’ pain self‐efficacy beliefs and recovery beliefs on rehabilitation outcome Abstract Introduction : Inflammatory bowel disease ( IBD ) is a chronic condition that afflicts young adults in their economically productive years . The goal of this study was to determine the costs of IBD in Germany from a societal perspective , using cost diaries . Methods : Members of the German Crohn ’s Disease and Ulcerative Colitis Association who had IBD were recruited by post , and those who agreed to participate documented their IBD-associated costs prospect ively in a diary over 4 weeks . They documented their use of healthcare facilities , medications , sick leave and out-of-pocket expenditures , as well as general demographic information , the status and history of their IBD , and long-term disability . Item costs were calculated according to national sources . Cost data were calculated using non-parametric bootstrapping and presented as mean costs ( year 2004 ) over 4 weeks . Results : The cost diaries were returned by 483 subjects ( Crohn ’s disease : n = 241 , ulcerative colitis : n = 242 ) with a mean age of 42 years and an average disease duration of 13 years ( SD ± 8.09 ) . The cost diaries were regarded as ‘ easy to complete ’ by 89 % of participants . The mean 4-week costs per subject were € 1425 ( 95 % CI 1201 , 1689 ) for Crohn ’s disease and € 1015 ( 95 % CI 832 , 1258 ) for ulcerative colitis . Of the total costs for Crohn ’s disease , 64 % were due to indirect costs such as early retirement or sick leave and 32 % were due to direct medical costs . In contrast , of the total costs for ulcerative colitis , 41 % were due to direct medical costs and 54 % to indirect costs . Conclusions : This is the first comprehensive cost study for Crohn ’s disease and ulcerative colitis in Germany . The most important economic factors that influenced the cost profiles of both diseases were the long-term productivity losses due to an ongoing inability to work and the cost of medications . Results indicate significant cost differences between Crohn ’s disease and ulcerative colitis . This data provides initial cost estimates that can be analysed further with respect to cost determinants and disease-specific costs in the future OBJECTIVE To investigate 1 ) the magnitude of indirect costs , 2 ) changes in cost components , and 3 ) correlations between changes in cost and social , clinical , and occupational variables within the first 3 years of rheumatoid arthritis ( RA ) . METHODS We evaluated the indirect costs  per person-year in 133 consecutive gainfully employed out- patients with early RA , in a prospect i ve multicenter followup study . Costs due to RA-related sick leave , work disability , and other work loss were assessed using the human capital approach . Variables associated with reduction in lost productivity were tested by multivariate logistic regression analysis . RESULTS Mean + /- SEM annual indirect costs were $ 11,750 + /- 1,120 per person . During the 3-year period of observation , a marked reduction in the costs associated with sick leave was seen , which exceeded the increase in costs due to work disability and other work loss . This phenomenon result ed in an overall reduction in indirect costs of 21 % . The final logistic regression model of reduced loss of productivity included 3 variables : no problems with st and ing ( odds ratio [ OR ] 7.1 ) , no problems with working speed ( OR 4.1 ) , and no problems with outdoor work ( OR 3.1 ) . CONCLUSION High indirect costs in early RA were demonstrated . An overall decrease of costs can be seen in the first 3 years , due to the reduction in sick leave . Since the absence of problems due to strenuous working conditions was found to be associated with a reduction in indirect costs , it is assumed that early intensified vocational rehabilitation , apart from controlling disease activity by adequate treatment , might help to reduce indirect costs Background Working women of childbearing age are a vital part of the population . Following childbirth , this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work . Currently , there is little known about cost-effective post-partum interventions to prevent work disability . The purpose of the study was to evaluate whether supervisor telephone contact ( STC ) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality -adjusted life years ( QALYs ) compared to common practice ( CP ) . Methods We conducted an economic evaluation alongside a r and omized controlled trial . QALYs were measured by the EuroQol 5-D , and sick leave and presenteeism by the Health and work Performance Question naire . Re source use was collected by question naires . Data were analysed according to intention-to-treat . Missing data were imputed via multiple imputation . Uncertainty was estimated by 95 % confidence intervals , cost-utility planes and curves , and sensitivity analyses . Results 541 working women from 15 companies participated . Response rates were above 85 % at each measurement moment . At the end of the follow-up , no statistically significant between-group differences in QALYs , mean hours of sick leave or presenteeism or costs were observed . STC was found to be less effective and more costly . For willingness-to-pay levels from € 0 through € 50,000 , the probability that STC was cost-effective compared to CP was 0.2 . Overall re source use was low . Mean total costs were € 3678 ( 95 % CI : 3386 ; 3951 ) . Productivity loss costs represented 37 % of the total costs and of these costs , 48 % was attributable to sick leave and 52 % to work presenteeism . The cost analysis from a company 's perspective indicated that there was a net cost associated with the STC intervention . Conclusions STC was not cost-effective compared to common practice for a healthy population of working mothers ; therefore , implementation is not indicated . The cost-utility of STC for working mothers with more severe post-partum health problems , however , needs to be investigated . Work presenteeism accounted for half of the total productivity loss and warrants attention in future studies .Trial registration numberIS RCT N : IS RCT Long-term  sickness absence and incapacity benefits ( disability pension ) rates have increased across industrialised countries . Effective measures are needed to support return to work . The recommendations of this guidance were informed by the most appropriate available evidence of effectiveness and cost-effectiveness . Public health evidence was provided by research using a variety of study design s that attempted to determine the outcome of a particular intervention by evaluating status before and after the intervention had been effected , and was not limited to r and omised control trials . Where the evidence base was depleted or underdeveloped , expert witnesses were called to give their opinion on the best available evidence and emerging interventions . The process enabled challenge and contestability from stakeholder groups at different points as the guidance was developed . Forty-five heterogeneous studies were included in the review of interventions to reduce long-term sickness absence and transitions from short-term to long-term absence ( mainly covering the former and also mainly examining musculoskeletal conditions ) . The analysis of evidence was restricted to descriptive synthesis . Three general themes emerged from an analysis of the studies that were more likely to report positive results : early interventions ; multidisciplinary approaches ; and interventions with a workplace component . Two further review s were undertaken , one on interventions to reduce the re-occurrence of sickness absence , which identified seven studies on lower back pain , and concluded that early intervention and direct workplace input are important factors . The final evidence review focused on six studies of interventions for those in receipt of incapacity benefit . The evidence was that work-focused interviews coupled with access to tailored support are effective and cost-effective interventions . Practitioners should consider the impact of interventions and management options on work ability for patients of working age . Work ability should be considered a key outcome for future intervention studies Background Low back pain ( LBP ) and neck pain ( NP ) are a major public health problem with considerable costs for individuals , companies and society . Therefore , prevention is imperative . The Stay@Work study investigates the (cost-)effectiveness of Participatory Ergonomics ( PE ) to prevent LBP and NP among workers . Methods In a r and omised controlled trial ( RCT ) , a total of 5,759 workers working at 36 departments of four companies is expected to participate in the study at baseline . The departments consisting of about 150 workers are pre-stratified and r and omised . The control departments receive usual practice and the intervention departments receive PE . Within each intervention department a working group is formed including eight workers , a representative of the management , and an occupational health and safety coordinator . During a one day meeting , the working group follows the steps of PE in which the most important risk factors for LBP and NP , and the most adequate ergonomic measures are identified on the basis of group consensus . The implementation of ergonomic measures at the department is performed by the working group . To improve the implementation process , so-called ' ergocoaches ' are trained . The primary outcome measure is an episode of LBP and NP . Secondary outcome measures are actual use of ergonomic measures , physical workload , psychosocial workload , intensity of pain , general health status , sick leave , and work productivity . The cost-effectiveness analysis is performed from the societal and company perspective . Outcome measures are assessed using question naires at baseline and after 6 and 12 months . Data on the primary outcome as well as on intensity of pain , sick leave , work productivity , and health care costs are collected every 3 months . Discussion Prevention of LBP and NP is beneficial for workers , employers , and society . If the intervention is proven (cost-)effective , the intervention can have a major impact on LBP and NP prevention and , thereby , on work disability prevention . Results are expected in 2010.Trial registration IS RCT Background Stress-related disorders are widespread and responsible for high societal costs e.g. sick leave payment and reduced productivity . The aim of this study was to evaluate the effect of an intervention program on return to work or labour market . Methods In a controlled interventional study design we compared 72 emotionally distressed patients , who received support during 2006 , with 89 control individuals who had also been sick listed for emotional distress .  Intervention was provided by trained psychologists and social workers who were in continuous dialog with the patients , providing counselling e.g. on decisions concerning resumption of work , support to families , participation in meetings with the workplace . Basically , the controls and the intervention group share the same access to welfare benefits . The main outcome was time to return to labour market ( TTR ) . Results The baseline characteristics were similar in the two groups . There were no differences in the rate of resuming work between the two groups . About 80 % in both groups had returned to the labour market after one year . Conclusion An intervention program with psychological stress management and case management did not improve work capability compared to usual care . Work resumption as a single outcome probably is an insensitive parameter of intervention management quality , and should be supplemented by other data on different aspects of treatment Background Considering the high costs of sick leave and the consequences of sick leave for employees , an early return-to-work of employees with mental disorders is very important . Therefore , a workplace intervention is developed based on a successful return-to-work intervention for employees with low back pain . The objective of this paper is to present the design of a r and omized controlled trial evaluating the cost-effectiveness of the workplace intervention compared with usual care for sick-listed employees with common mental disorders . Methods The study is design ed as a r and omized controlled trial with a follow-up of one year . Employees eligible for this study are on sick leave for 2 to 8 weeks with common mental disorders . The workplace intervention will be compared with usual care . The workplace intervention is a stepwise approach that aims to reach consensus about a return-to-work plan by active participation and strong commitment of both the sick-listed employee and the supervisor . Outcomes will be assessed at baseline , 3 , 6 , 9 and 12 months . The primary outcome of this study is lasting return-to-work , which will be acquired from continuous registration systems of the companies after the follow-up . Secondary outcomes are total number of days of sick leave during the follow-up , severity of common mental disorders , coping style , job content , and attitude , social influence , and self-efficacy determinants . Cost-effectiveness will be evaluated from the societal perspective . A process evaluation will also be conducted . Discussion Return-to-work is difficult to discuss in the workplace for sick-listed employees with mental disorders and their supervisors . Therefore , this intervention offers a unique opportunity for the sick-listed employee and the supervisor to discuss barriers for return-to-work . Results of this study will possibly contribute to improvement of disability management for sick-listed employees with common mental disorders . Results will become available in 2009.Trial registration IS RCT Background The German welfare system follows the principle “ rehabilitation rather than pension , ” but more than the half of all disability pensioners did not utilize medical rehabilitation before their early retirement . A major barrier is the application procedure . Lack of information about the opportunity to utilize rehabilitation services restricts the chance to improve work ability and to prevent health-related early retirement by rehabilitation programs . The establishment of new access paths to medical rehabilitation services was , therefore , identified as a major challenge for rehabilitation research in a recent expertise . Thus , a web-based information guide was developed to support the application for a medical rehabilitation program . Methods / Design For this study , the development of a web-based information guide was based on the health action process approach . Four modules were established . Three modules support forming an intention by strengthening risk perception ( module 1 ) , positive outcome expectancies ( module 2 ) and self-efficacy ( module 3 ) . A fourth module aims at the realization of actual behavior by offering instructions on how to plan and to push the application process . The study on the effectiveness of the web-based information guide will be performed as a r and omized controlled trial . Persons aged 40 to 59 years with prior sick leave benefits during the preceding year will be included . A sample of 16,000 persons will be r and omly drawn from the registers of 3 pension insurance agencies . These persons will receive a question naire to determine baseline characteristics . Respondents of this first survey will be r and omly allocated either to the intervention or the control group . Both study groups will then receive letters with general information about rehabilitation . The intervention group will additionally receive a link to the web-based information guide . After 1 year , a second survey will be conducted . Additionally , administrative data will be used to determine if participants apply for rehabilitation and finally start a rehabilitation program . The primary outcomes are the proportion of applied and utilized medical rehabilitation services . Secondary outcomes are cognitions on rehabilitation , self-rated work ability , health-related quality of life and perceived disability , as well as days with sick leave benefits and days of regular employment . Discussion The r and omized controlled trial will provide highest ranked evidence to clarify whether theory-driven web-based information supports access to rehabilitation services for people with prior sickness benefits .Trial registration German Clinical Trials Register ( Identifier : DRKS00005658 , 16 January 2014 ) OBJECTIVE Previously we reported that early part-time sick leave enhances return to work ( RTW ) among employees with musculoskeletal disorders ( MSD ) . This paper assesses the health-related effects of this intervention . METHODS Patients aged 18 - 60 years who were unable to perform their regular work due to MSD were r and omized to part- or full-time sick leave groups . In the former , workload was reduced by halving working time . Using vali date d question naires , we assessed pain intensity and interference with work and sleep , region-specific disability due to MSD , self-rated general health , health-related quality of life ( measured via EuroQol ) , productivity loss , depression , and sleep disturbance at baseline , 1 , 3 , 8 , 12 , and 52 weeks . We analyzed the repeated measures data ( 171 - 356 observations ) with the generalized estimating equation approach . RESULTS The intervention ( part-time sick leave ) and control ( full-time sick leave ) groups did not differ with regard to pain intensity , pain interference with work and sleep , region-specific disability , productivity loss , depression , or sleep disturbance . The intervention group reported better self-rated general health ( adjusted P=0.07 ) and health-related quality of life ( adjusted P=0.02 ) than the control group . In subgroup analyses , the intervention was more effective among the patients whose current problem began occurring < 6 weeks before baseline and those with ≤30 % productivity loss at baseline . CONCLUSIONS Our findings showed that part-time sick leave did not exacerbate pain-related symptoms and functional disability , but improved self-rated general health and health-related quality of life in the early stage of work disability due to MSD Background Return to work after gynaecological surgery takes much longer than expected , irrespective of the level of invasiveness . In order to empower patients in recovery and return to work , a multidisciplinary care program consisting of an e-health intervention and integrated care management including participatory workplace intervention was developed . Methods / Design We design ed a r and omized controlled trial to assess the effect of the multidisciplinary care program on full sustainable return to work in patients after gynaecological surgery , compared to usual clinical care . Two hundred twelve women ( 18 - 65 years old ) undergoing hysterectomy and /or laparoscopic adnexal surgery on benign indication in one of the 7 participating ( university ) hospitals in the Netherl and s are expected to take part in this study at baseline . The primary outcome measure is sick leave duration until full sustainable return to work and is measured by a monthly calendar of sickness absence during 26 weeks after surgery . Secondary outcome measures are the effect of the care program on general recovery , quality of life , pain intensity and complications , and are assessed using question naires at baseline , 2 , 6 , 12 and 26 weeks after surgery . Discussion The discrepancy between expected physical recovery and actual return to work after gynaecological surgery contributes to the relevance of this study . There is strong evidence that long periods of sick leave can result in work disability , poorer general health and increased risk of mental health problems . We expect that this multidisciplinary care program will improve peri-operative care , contribute to a faster return to work of patients after gynaecological surgery and , as a consequence , will reduce societal costs considerably . Trial registration Netherl and s Trial Register ( NTR ) : Objective : To evaluate the cost-effectiveness and cost-utility of a return to work ( RTW ) program for workers on sick-leave due to low back pain ( LBP ) , comparing a workplace intervention implemented between 2 to 8 weeks of sick-leave with usual care , and a clinical intervention after 8 weeks of sick-leave with usual care . Design : Economic evaluation alongside a r and omised controlled trial ( RCT ) . Study population : Workers sick-listed for a period of 2 to 6 weeks due to LBP . Interventions : 1 . workplace assessment , work modifications and case management ) . 2 . physiotherapy based on operant behavioural principles . 3 . usual care : provided by an occupational physician . Outcomes : The primary outcome was return to work ( RTW ) . Other outcomes were pain intensity , functional status , quality of life and general health . The economic evaluation was conducted from a societal perspective . Outcomes were assessed at baseline ( after 2–6 weeks on sick-leave ) , and 12 weeks , 26 weeks , and 52 weeks after the first day of sick-leave . Results : The workplace intervention group returned to work 30.0 days ( 95 % CI=[3.1 , 51.3 ] ) earlier on average than the usual care group at slightly higher direct costs ( ratio of 1 day : € 19 ) . Workers in the clinical intervention group that had received usual care in the first 8 weeks returned to work 21.3 days ( 95 % CI= [ −74.1 , 29.2 ] ) later on average . The group that had received the workplace intervention in the first 8 weeks and the clinical intervention after 8 weeks returned to work 50.9 days ( 95 % CI=[−89.4 , −2.7 ] ) later on average . A workplace intervention was more effective than usual care in RTW at slightly higher costs and was equally effective as usual care at equal costs on other outcomes . A clinical intervention was less effective than usual care and associated with higher costs . Conclusion : The workplace intervention results in a safe and faster RTW than usual care at reasonable costs for workers on sick-leave for two to six weeks due to LBP
The majority of the studies reported a high burden of work-related outcomes among inflammatory bowel disease patients regardless of the methodology used .
Inflammatory bowel disease patients experience a high burden in work-related outcomes .
BACKGROUND & AIMS Inflammatory bowel disease has considerable effects on work-related outcomes and leads to high societal costs due to sick leave and disability pension .
The aims of this study were to systematic ally review evidence on work-related outcomes that are relevant to productivity losses and to evaluate whether medical or surgical interventions have a positive impact on patients ' work ability .