title: Long-term outcomes following vocational rehabilitation treatments in patients with prolonged fatigue.
abstract: BACKGROUND
  Multi-component vocational rehabilitation (VR) provides positive short-term outcomes in patients with prolonged fatigue.
  
  
  OBJECTIVE
  The purpose of this study is to evaluate the long-term outcomes of Dutch multi-component VR up to 18 months after treatment.
  
  
  METHODS
  In a pre-post-study, measurements were taken before treatment (t0), after treatment (t1) and in long-term follow-ups at 6 (t2), 12 (t3) and 18 months (t4) after treatment. Primary outcomes (fatigue, work participation and workability) and secondary outcomes [physical and social functioning, mental health and heart rate variability (HRV)] were assessed over time using linear mixed models analyses. Post hoc long-term outcomes were compared with t0 and t1.
  
  
  RESULTS
  Sixty patients with severe fatigue complaints participated. The primary outcomes significantly (p < 0.001) improved at follow-ups compared with t0 and showed no relapse compared with t1. Moreover, fatigue decreased (p < 0.002) whereas workability (p < 0.001) and work participation (p < 0.001) increased further after treatment (t1). The secondary outcomes, physical functioning, mental health, social functioning and HRV, improved significantly (p < 0.001, p < 0.001, p < 0.001 and p = 0.049, respectively) over the long term compared with t0. At 6-month follow-up (t2), mental health (p < 0.003) and social functioning (p = 0.003) further increased after the treatment was stopped.
  
  
  CONCLUSIONS
  Multi-component VR treatments seem to significantly and in a clinically relevant way decrease fatigue symptoms and improve individual functioning and work participation in patients with severe prolonged fatigue over the long term and without showing relapse.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands.
authors.forename: Margot C W
authors.initials: MC
authors.lastname: Joosen
authors.forename: Monique H W
authors.initials: MH
authors.lastname: Frings-Dresen
authors.forename: Judith K
authors.initials: JK
authors.lastname: Sluiter
mesh_terms: D000328:Adult; D004651:Employment; D005221:Fatigue / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012050:Rehabilitation, Vocational / Q000379:methods*; D062707:Return to Work; D016896:Treatment Outcome; D014937:Work