title: Early multidisciplinary assessment was associated with longer periods of sick leave: a randomized controlled trial in a primary health care centre.
abstract: OBJECTIVE
  To study the effects on sick leave from an early multidisciplinary assessment at a primary health care centre.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Patients who saw GPs at a primary health care centre in mid-Sweden and asked for a sickness certificate for psychiatric or musculoskeletal diagnoses were invited to participate. Patients included were sick-listed for less than four weeks; 33 patients were randomized either to an assessment within a week by a physiotherapist, a psychotherapist, and an occupational therapist or to "standard care". The therapists used methods and tools they normally use in their clinical work.
  
  
  METHODS
  Proportion of patients still sick-listed three months after randomization, total and net days on sick leave, and proportion who were on part-time sick leave. Results. At follow-up after three months, in contrast to the pre-trial hypothesis, there was a trend toward a higher proportion of patients still sick-listed in the intervention group (7/18) as compared with the control group (3/15). The intervention group also had significantly longer sick-listing periods (mean 58 days) than the control group (mean 36 days) (p = 0.038). The proportion of patients who were part time sick-listed was significantly higher in the intervention group (10/18) than in the control group (2/15) (p = 0.027).
  
  
  CONCLUSIONS
  In this study an early multidisciplinary assessment was associated with longer periods on sick leave and more individuals on part-time sick leave.
authors.affiliation: Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Uppsala, Sweden. lars.carlsson@ltdalarna.se
authors.forename: Lars
authors.initials: L
authors.lastname: Carlsson
authors.forename: Lars
authors.initials: L
authors.lastname: Englund
authors.forename: Johan
authors.initials: J
authors.lastname: Hallqvist
authors.forename: Thorne
authors.initials: T
authors.lastname: Wallman
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D009140:Musculoskeletal Diseases; D009788:Occupational Therapy; D059825:Physical Therapists; D011320:Primary Health Care; D012046:Rehabilitation / Q000379:methods*; D018582:Sick Leave / Q000639:trends*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D016526:Workload
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