title: Sustainability of return to work in sick-listed employees with low-back pain. Two-year follow-up in a randomized clinical trial comparing multidisciplinary and brief intervention.
abstract: BACKGROUND
  Sick-listed employees with low back pain had similar return to work (RTW) rates at one-year follow-up in a randomized trial comparing two interventions, but the effects were modified by specific workplace related factors. The present study addressed the sustainability of the intervention effects by performing a two-year follow-up and by using different outcome measures.
  
  
  METHODS
  A total of 351 employees sick-listed for 3-16 weeks due to LBP were recruited from their general practitioners and were randomly allocated to a hospital-based brief or multidisciplinary intervention. Outcome measures were based on sick leave registered in a national database of social and health-related benefits. RTW rates, RTW status, sick leave weeks and sick leave relapse were studied.
  
  
  RESULTS
  During the two-year follow-up 80.0% and 77.3% had RTW for at least four weeks continuously, and the percentages with RTW at the 104th week were 61.1% and 58.0% in the brief and multidisciplinary intervention groups, respectively. At the 104th week 16.6% and 18.8% were on sick leave in the two groups, respectively, and about 12% were employed in modified jobs or participated in job training. The number of weeks on sick leave in the first year was significantly lower in the brief intervention group (median 14 weeks) than in the multidisciplinary intervention group (median 20 weeks), but during the second year the number of weeks on sick leave were not significantly different between intervention groups. Subgroups characterised by specific work related factors modified the effect of the intervention groups on RTW rates (p = 0.017). No difference in sick leave relapse was found between the intervention groups.
  
  
  CONCLUSIONS
  The effects of the brief and multidisciplinary interventions at the two-year follow-up were in general similar to the effects at one-year follow-up.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN18609003.
authors.affiliation: Department of Clinical Social Medicine, Public Health and Quality Management, Central Denmark Region and Section of Clinical Social Med, and Rehabilitation, School of Public Health, University of Aarhus, Aarhus, Denmark. chris.jensen@stab.rm.dk
authors.forename: Chris
authors.initials: C
authors.lastname: Jensen
authors.forename: Ole Kudsk
authors.initials: OK
authors.lastname: Jensen
authors.forename: Claus Vinther
authors.initials: CV
authors.lastname: Nielsen
mesh_terms: D000328:Adult; D003718:Denmark; D005260:Female; D058006:General Practice; D006801:Humans; D007318:Inservice Training; D033183:Interdisciplinary Communication; D007587:Job Description; D016015:Logistic Models; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010348:Patient Care Team; D016016:Proportional Hazards Models; D012008:Recurrence; D012042:Registries; D062707:Return to Work; D018582:Sick Leave; D013997:Time Factors; D016896:Treatment Outcome; D014478:Unemployment; D017132:Workplace