title: In a controlled trial training general practitioners and occupational physicians to collaborate did not influence sickleave of patients with low back pain.
abstract: OBJECTIVE
  The objective of this study was to determine the effectiveness of a training to increase collaboration between general practitioners and occupational health physicians in the treatment of patients with low back pain (LBP) because more collaboration might improve a patient's recovery and shorten sick leave.
  
  
  METHODS
  In a controlled trial, the intervention in one region was compared with usual care in a control region. Participating physicians enrolled patients with LBP on sick leave for 3-12 weeks. Patients filled out three questionnaires: at inclusion, at 3 months, and at 6 months. Information on sick leave was gathered from occupational health services. All analyses were performed on an intention-to-treat basis.
  
  
  RESULTS
  Fifty-six patients with LBP were enrolled in each region. There was little collaboration between physicians during the project. Patients in the intervention region returned to work significantly later (P=.005) but were significantly more satisfied with their occupational health physician (P=.01). No differences were found between the intervention and control patients for pain, disability, quality of life, and medical consumption.
  
  
  CONCLUSIONS
  Our study does not show a positive effect of the training to increase collaboration between general practitioners and occupational health physicians. The training may not have improved collaboration enough to influence the prognosis of LBP.
authors.affiliation: Netherlands Expert Centre for Workrelated Musculoskeletal Disorders, Erasmus MC, PO Box 2040, Rotterdam 3000 CA, The Netherlands. e.faber@erasmusmc.nl
authors.forename: E
authors.initials: E
authors.lastname: Faber
authors.forename: S M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: A
authors.initials: A
authors.lastname: Burdorf
authors.forename: A P
authors.initials: AP
authors.lastname: Nauta
authors.forename: C T J
authors.initials: CT
authors.lastname: Hulshof
authors.forename: P M
authors.initials: PM
authors.lastname: Overzier
authors.forename: H S
authors.initials: HS
authors.lastname: Miedema
authors.forename: B W
authors.initials: BW
authors.lastname: Koes
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003299:Cooperative Behavior; D004185:Disability Evaluation; D004502:Education, Medical, Continuing / Q000379:methods*; D005194:Family Practice / Q000193:education*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007400:Interprofessional Relations; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009786:Occupational Health Services; D017060:Patient Satisfaction; D011788:Quality of Life; D018582:Sick Leave / Q000706:statistics & numerical data*; D016019:Survival Analysis