Structured functional assessments in general practice increased the use of part-time sick leave: a cluster randomised controlled trial.
OBJECTIVE
A method for structured functional assessments of persons with long-term sick leave was implemented in a cluster randomised controlled trial in general practice. The aim was to analyse intervention effects on general practitioner (GP) sick-listing practice and patient sick leave.


METHODS
57 GPs were randomly assigned to an intervention or a control group. The intervention group GPs learned the method at a 1-day workshop including teamwork and role-playing. The control group GPs were requested to assess functional ability as usual during the 8 months intervention period in 2005. Outcome measures included duration of patient sick leave episodes, GP prescription of part-time sick leave, active sick leave, and vocational rehabilitation. This data was extracted from a national register.


RESULTS
The GPs in the intervention group prescribed part-time sick leave more often (p < 0.01) and active sick leave less often (p = 0.04) than the control group GPs during the intervention period. There was no intervention effect on duration of patient sick leave episodes or on GP prescription of vocational rehabilitation.


CONCLUSIONS
Implementing structured functional assessments in general practice made the GPs capable to assess functional ability of persons with long-term sick leave in a standardised and explicit manner. The intervention GPs' sick-listing practice was changed as they prescribed more part-time and less active sick leave compared to the control group GPs. As a result, more intervention GP patients returned to part-time work compared to control GP patients. No intervention effect was seen on duration of patient sick leave episodes or on prescription of vocational rehabilitation.
Osterås
Nina
N
Section for Social Medicine, Institute of General Practice and Community Health, Faculty of Medicine, University of Oslo, Norway. nina.osteras@medisin.uio.no
Gulbrandsen
Pål
P
Kann
Inger Cathrine
IC
Brage
Søren
S
D000328:Adult; D005194:Family Practice; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians'; D012042:Registries; D012050:Rehabilitation, Vocational; D012381:Role Playing; D018582:Sick Leave; D013997:Time Factors; D014938:Work Capacity Evaluation