title: Effectiveness of an early cognitive-behavioral treatment in patients with work disability due to musculoskeletal disorders.
abstract: OBJECTIVE
  To evaluate whether an early cognitive-behavioral treatment complementary to a rheumatologic care program, for patients with recent-onset temporary work disability caused by musculoskeletal disorders (MSDs) is effective.
  
  
  METHODS
  Patients with an MSD-related temporary work disability episode from 3-8 weeks' duration who were in a rheumatologic care program were randomized into a control group (rheumatologic care program) or an intervention group (rheumatologic care program plus cognitive-behavioral treatment). Enrollment lasted 24 months and followup lasted 6-24 months. Efficacy variables included duration of temporary work disability episodes, total number of work days saved, relative efficacy, and relative rate to return to work. An economic evaluation was also performed.
  
  
  RESULTS
  One hundred eighty-one patients were included (66 control and 115 intervention patients), generating 222 episodes of MSD-related temporary work disability. Episodes tended to be shorter in the intervention group than in the control group (mean 98 versus 127 days; P = 0.053), with a relative efficacy of 22.9%. There were no differences in duration of the first episode between groups (mean 105 versus 110 days; P = 0.79), but relapse episodes were significantly shorter in the intervention group (mean 63 days versus 197 days; P = 0.0002). Costs were also lower in the intervention group. To save 1 day of temporary work disability, $13.50 had to be invested in the program. Each dollar invested generated a benefit of $4.08. The program had a net benefit of $172,607.
  
  
  CONCLUSIONS
  Early cognitive-behavioral treatment complementary to a rheumatologic care program is cost-effective, adds >20% efficacy to the rheumatologic care program, and reduces the duration of relapses.
authors: Hospital Clinico San Carlos, Madrid, Spain.
authors: Leticia
authors: L
authors: Leon
authors: Juan A
authors: JA
authors: Jover
authors: Gloria
authors: G
authors: Candelas
authors: Cristina
authors: C
authors: Lajas
authors: Cristina
authors: C
authors: Vadillo
authors: Margarita
authors: M
authors: Blanco
authors: Estibaliz
authors: E
authors: Loza
authors: Miguel Angel
authors: MA
authors: Perez
authors: Marta
authors: M
authors: Redondo
authors: Lydia
authors: L
authors: Abasolo
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D004185:Disability Evaluation; D005260:Female; D006281:Health Occupations; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000523:psychology / Q000628:therapy*; D012008:Recurrence; D016896:Treatment Outcome; D017132:Workplace