title: Feasibility trial of GP and case-managed support for workplace sickness absence.
abstract: Aim Our aim was to compare the return-to-work rates between individuals supported by their GP plus workplace health advisers (intervention group) and those supported by their GP alone.
  
  
  BACKGROUND
  Workplace sickness absence places a significant cost burden on individuals and the wider economy. Previous research shows better outcomes for individuals if they are supported while still in employment, or have been on sick leave for four weeks or less. Those helped back to work at an early stage are more likely to remain at work. A non-medicalised case-managed approach appears to have the best outcomes and can prevent or reduce the slide onto out-of-work benefits, but UK literature on its effectiveness is sparse.
  
  
  METHODS
  The design was a feasibility-controlled trial in which participants were sickness absentees, or presentees in employment with work-related health problems. Individuals completed health status measures (SF-36; EQ-5D) and a Job Content Questionnaire at baseline and again at four-month follow-up. Findings In the intervention group, 29/60 participants completed both phases of the trial. GP practices referred two control patients, and, despite various attempts by the research team, GPs failed to engage with the trial. This finding is of concern, although not unique in primary care research. In earlier studies, GPs reported a lack of knowledge and confidence in dealing with workplace health issues. Despite this, we report interesting findings from the case-managed group, the majority of whom returned to work within a month. Age and length of sickness absence at recruitment were better predictors of return-to-work rates than the number of case-managed contacts. The traditional randomised controlled trial approach was unsuitable for this study. GPs showed low interest in workplace sickness absence, despite their pivotal role in the process. This study informed a larger Department for Work and Pensions study of case-managed support.
authors.affiliation: 1Research Fellow,Department of Health Services Research,University of Liverpool,Liverpool,UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Rannard
authors.affiliation: 2Professor of General Practice & Head of Department of Health Services Research,University of Liverpool,Liverpool,UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Gabbay
authors.affiliation: 3Senior Lecturer,Department of Occupational Medicine,University of Manchester,Manchester,UK.
authors.forename: Dil
authors.initials: D
authors.lastname: Sen
authors.affiliation: 4Senior Lecturer,Department of Mathematics,University of Birmingham,Birmingham,UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Riley
authors.affiliation: 5Retired GP and lay research team member.
authors.forename: David
authors.initials: D
authors.lastname: Britt
mesh_terms: D000328:Adult; D019090:Case Management / Q000458:organization & administration / Q000706:statistics & numerical data*; D004739:England; D005240:Feasibility Studies; D005260:Female; D058006:General Practice / Q000379:methods / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000523:psychology*; D009786:Occupational Health Services / Q000379:methods / Q000458:organization & administration*; D011594:Psychometrics / Q000295:instrumentation; D011788:Quality of Life; D018582:Sick Leave / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D013997:Time Factors; D000078329:Workforce; D017132:Workplace; D055815:Young Adult