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Return to work coordination programmes for work disability: a meta-analysis of randomised controlled trials.

Stefan Schandelmaier¹, Shanil Ebrahim, Susan C A Burkhardt

¹Academy of Swiss Insurance Medicine, University Hospital Basel, Basel, Switzerland. sschandelmaier@uhbs.ch

|November 28, 2012

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Return to work (RTW) coordination programs help more employees with long-term disability return to work. These programs show small but important absolute benefits in work participation, function, and pain reduction.

Area of Science:

Occupational health
Social insurance policy
Rehabilitation medicine

Background:

Rising chronic illness and disability claims strain social security systems.
Return to work (RTW) coordination programs are increasingly adopted but their effectiveness is uncertain.
This review assesses the long-term impact of RTW coordination versus usual care for disability risk.

Purpose of the Study:

To systematically review the long-term effectiveness of RTW coordination programs.
To compare RTW coordination with usual practice in patients at risk for long-term disability.

Main Methods:

Systematic review of 9 randomized controlled trials from 7 countries.
Included employees absent from work for at least 4 weeks.
Assessed outcomes including return to work rates, overall and functional status, and pain.

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Main Results:

Moderate quality evidence indicates RTW coordination increases the proportion of individuals returning to work (RR 1.08).
Small but significant improvements were observed in overall function (MD 5.2), physical function (MD 5.3), and mental function (MD 3.1).
RTW coordination also led to a reduction in pain (MD 6.1).

Conclusions:

RTW coordination offers small relative but important absolute benefits for return to work.
Associated improvements in function and pain are likely significant for patients.
Further research is needed on long-term persistence of effects and cost-effectiveness.