丹麦Ibbis对患有常见精神障碍的病缺人员的试验:一项第4阶段前性研究,比较随机试验和现实世界的数据
Andreas Hoff1, Anders Bo Bojesen1, Lene Falgaard Eplov1
1Copenhagen Research Unit for Recovery, Mental Health Services, Capital Region Denmark, Copenhagen University Hospital, Hans Bogbinders Allé3, 3. sal, 2300 København S, Denmark.
International journal of integrated care
|July 29, 2024
概括
这项研究发现,综合性职业康复和精神卫生保健干预 (INT) 在现实环境中效果不如疾病缺勤者的随机试验. 现实世界中的小组显示出明显较差的职业成果,包括较低的返回就业率.
科学领域:
- 职业健康 职业健康 职业健康
- 心理健康服务研究 心理健康服务研究
- 康复医学 康复医学 康复医学
背景情况:
- 综合性职业康复和精神卫生保健干预措施旨在改善因病缺席的人的职业成果.
- 以前的随机对照试验 (RCT) 对新型干预 (INT) 显示出混合的结果,一些诊断组的结果更差.
- 这项第四阶段研究评估了丹麦市政府INT的现实有效性.
研究的目的:
- 检查综合干预 (INT) 在现实环境中对患有抑郁,焦虑或适应障碍的病缺人员的有效性.
- 为了比较在现实环境中接受INT的个人的职业成果,与在之前的RCT中接受INT的人相比.
- 评估12个月内返回工作的首要结果.
主要方法:
- 在现实环境中采用了前性干预研究设计.
- 被诊断为患有抑郁症,焦虑症或适应障碍的成年病缺人员被分配给接受INT.
- 职业成果与先前的INTRCT匹配组进行了比较,主要结果是12个月后恢复工作.
主要成果:
- 现实世界组 (n=151) 与RCT组 (n=302) 相比,表现出明显较差的职业成果.
- 在12个月内返回工作的现实世界组 (48.3%) 与RCT组 (64.6%) 相比较低,赔率比率为0.54 (p=0.001).
- 在大多数职业指标中,观察到统计学上显著的较差结果,包括工作周减少和12个月就业比例较低.
结论:
- 与其在随机对照试验中的表现相比,综合干预 (INT) 在现实环境中效果较差.
- 在不太结构化的现实环境中,实施挑战可能更大,这可能解释了效率的下降.
- 这些发现表明,在RCT中观察到的一些组的不太有利的结果可能会在现实世界实践中加剧.
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