title: Pre-return-to-work medical consultation for low back pain workers. Good practice recommendations based on systematic review and expert consensus.
abstract: OBJECTIVE
  The pre-return-to-work medical consultation during sick leave for low back pain (LBP) aims at assessing the worker's ability to resume working without risk for his/her health, and anticipating any difficulties inherent to returning to work and job retention. This article summarizes the good practices guidelines proposed by the French Society of Occupational Medicine (SFMT) and the French National Health Authority (HAS), and published in October 2013.
  
  
  METHODS
  Good practices guidelines developed by a multidisciplinary and independent task force (24 experts) and peer review committee (50 experts) based on a literature review from 1990 to 2012, according to the HAS methodology.
  
  
  RESULTS
  According to the labour regulations, workers can request a medical consultation with their occupational physician at any time. The pre-return-to-work consultation precedes the effective return-to-work and can be requested by the employee regardless of their sick leave duration. It must be scheduled early enough to: (i) deliver reassuring information regarding risks to the lower back and managing LBP; (ii) evaluate prognostic factors of chronicity and prolonged disability in relations to LBP and its physical, social and occupational consequences in order to implement the necessary conditions for returning to work; (iii) support and promote staying at work by taking into account all medical, social and occupational aspects of the situation and ensure proper coordination between the different actors.
  
  
  CONCLUSIONS
  A better understanding of the pre-return-to-work consultation would improve collaboration and coordination of actions to facilitate resuming work and job retention for patients with LBP.
authors.affiliation: Laboratoire d'ergonomie et d'épidémiologie en santé et travail (LEEST), LUNAM, faculté de médecine d'Angers, université d'Angers, Angers, France; Centre de consultations de pathologie professionnelle, laboratoire d'épidémiologie et d'étude en santé au travail, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France. Electronic address: aupetit@chu-angers.fr.
authors.forename: A
authors.initials: A
authors.lastname: Petit
authors.affiliation: Service de rhumatologie, hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Rozenberg
authors.affiliation: Service de médecine et santé au travail, hospices civils de Lyon, UMRESTTE, université Claude-Bernard Lyon 1, Lyon, France.
authors.forename: J B
authors.initials: JB
authors.lastname: Fassier
authors.affiliation: Médecine et santé au travail, comité interentreprises d'hygiène du Loiret, Orléans, France.
authors.forename: S
authors.initials: S
authors.lastname: Rousseau
authors.affiliation: Service de santé au travail et éducation pour la santé, université de Liège, Liège, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Mairiaux
authors.affiliation: Laboratoire d'ergonomie et d'épidémiologie en santé et travail (LEEST), LUNAM, faculté de médecine d'Angers, université d'Angers, Angers, France; Centre de consultations de pathologie professionnelle, laboratoire d'épidémiologie et d'étude en santé au travail, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Roquelaure
mesh_terms: D032921:Consensus; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D062707:Return to Work; D014938:Work Capacity Evaluation
keywords: Chronic low back pain; Guidelines; Job retention; Pre-return-to-work medical consultation