Interventions regarding physicians' sickness certification practice - a systematic literature review with...

Area of Science:

• Occupational Medicine
• Health Services Research
• Evidence-Based Practice

Background:

• Physician sickness certification practices significantly influence patient sickness absence (SA) and return to work (RTW).
• Many interventions exist to modify these practices, but few are rigorously evaluated.
• A systematic review is needed to synthesize current evidence on intervention effectiveness.

Purpose of the Study:

• To systematically review and synthesize the effects of interventions on physicians' sickness certification practices.
• To evaluate the impact of these interventions on patient sickness absence (SA) and return to work (RTW).

Main Methods:

• Systematic literature search of PubMed and Web of Science up to June 2020.
• Inclusion of peer-reviewed studies on controlled interventions targeting physician sickness certification.
• Meta-analysis using random-effect models to assess effects on SA/RTW.

Main Results:

• Twelve studies, representing 9 unique interventions, were included; most originated from the Netherlands.
• Interventions primarily involved physician training, with some incorporating IT support.
• Meta-analyses revealed no statistically significant effect of interventions on any form of return to work (RTW) or sickness absence (SA).

Conclusions:

• Current evidence suggests interventions do not significantly alter physician sickness certification practices concerning patient SA/RTW.
• High heterogeneity in intervention content and outcome measures limits definitive conclusions.
• Further research with standardized methodologies is required to develop effective interventions.