In a controlled trial training general practitioners and occupational physicians to collaborate did not influence sickleave of patients with low back pain.
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.
Faber
E
E
Netherlands Expert Centre for Workrelated Musculoskeletal Disorders, Erasmus MC, PO Box 2040, Rotterdam 3000 CA, The Netherlands. e.faber@erasmusmc.nl
Bierma-Zeinstra
S M A
SM
Burdorf
A
A
Nauta
A P
AP
Hulshof
C T J
CT
Overzier
P M
PM
Miedema
H S
HS
Koes
B W
BW
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