title: A multisite randomized controlled trial on time to self-support among sickness absence beneficiaries. The Danish national return-to-work programme.
abstract: BACKGROUND
  In 2010, the Danish Government launched the Danish national return-to-work (RTW) programme to reduce sickness absence and promote labour market attainment. Multidisciplinary teams delivered the RTW programme, which comprised a coordinated, tailored and multidisciplinary effort (CTM) for sickness absence beneficiaries at high risk for exclusion from the labour market. The aim of this article was to evaluate the effectiveness of the RTW programme on self-support.
  
  
  METHODS
  Beneficiaries from three municipalities (denoted M1, M2 and M3) participated in a randomized controlled trial. We randomly assigned beneficiaries to CTM (M1: n = 598; M2: n = 459; M3: n = 331) or to ordinary sickness absence management (OSM) (M1: n = 393; M2: n = 324; M3: n = 95). We used the Cox proportional hazards model to estimate hazard ratios (HR) comparing rates of becoming self-supporting between beneficiaries receiving CTM and OSM.
  
  
  RESULTS
  In M2, beneficiaries from employment receiving CTM became self-supporting faster compared with beneficiaries receiving OSM (HR = 1.32, 95% CI: 1.08-1.61). In M3, beneficiaries receiving CTM became self-supporting slower than beneficiaries receiving OSM (HR = 0.72, 95% CI: 0.54-0.95). In M1, we found no difference between the two groups (HR = 0.99, 95% CI: 0.84-1.17).
  
  
  CONCLUSIONS
  The effect of the CTM programme on return to self-support differed substantially across the three participating municipalities. Thus, generalizing the study results to other Danish municipalities is not warranted.
  
  
  BACKGROUND
  ISRCTN43004323.
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark 2 Oxford Research, Copenhagen, Denmark mdn@oxfordresearch.dk.
authors.forename: Maj Britt D
authors.initials: MB
authors.lastname: Nielsen
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Vinsløv Hansen
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: Birgit
authors.initials: B
authors.lastname: Aust
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark 3 Department for Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.
authors.forename: Torill
authors.initials: T
authors.lastname: Tverborgvik
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: Birthe L
authors.initials: BL
authors.lastname: Thomsen
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark 4 Department of Public Health, University of Copenhagen, Copenhagen, Denmark 5 QualityMetric, Lincoln, RI, USA.
authors.forename: Jakob
authors.initials: J
authors.lastname: Bue Bjorner
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark 6 Department of Occupational Medicine, Køge Hospital, Køge, Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: Steen Mortensen
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark 4 Department of Public Health, University of Copenhagen, Copenhagen, Denmark 7 Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Reiner
authors.initials: R
authors.lastname: Rugulies
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: Glen
authors.initials: G
authors.lastname: Winzor
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark 8 Danish Working Environment Authority, Copenhagen, Denmark.
authors.forename: Palle
authors.initials: P
authors.lastname: Ørbæk
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: Trine
authors.initials: T
authors.lastname: Helverskov
authors.affiliation: 9 KORA, Danish Institute for Local and Regional Governmental Research, Copenhagen, Denmark.
authors.forename: Nicolai
authors.initials: N
authors.lastname: Kristensen
authors.affiliation: 1 The National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: Otto
authors.initials: O
authors.lastname: Melchior Poulsen
mesh_terms: D000328:Adult; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D062707:Return to Work / Q000706:statistics & numerical data*; D012648:Self Care / Q000706:statistics & numerical data*; D018582:Sick Leave