Interventions for enhancing return to work in individuals with a common mental illness: systematic review and meta-analysis of randomized controlled trials.
Common mental disorders (CMDs) are highly prevalent in the working population, and are associated with long-term sickness absence and disability. Workers on sick leave with CMDs would benefit from interventions that enable them to successfully return to work (RTW). However, the effectiveness of RTW interventions for workers with a CMD is not well studied. The objective of this review is to assess the effectiveness of existing workplace and clinical interventions that were aimed at enhancing RTW. A systematic review of studies of interventions for improving RTW in workers with a CMD was conducted. The main outcomes were proportion of RTW and sick-leave duration until RTW. Randomized controlled trials (RCTs) were identified from Medline/PubMed, PsycINFO, EMBASE, SocINDEX, and Human resource and management databases from January 1995 to 2016. Two authors independently selected studies, assessed risk of bias and extracted data. We pooled studies that we deemed sufficiently homogeneous in different comparison groups and assessed the overall quality of the evidence. We reviewed 2347 abstracts from which 136 full-text articles were reviewed and 16 RCTs were included in the analysis. Combined results from these studies suggested that the available interventions did not lead to improved RTW rates over the control group [pooled risk ratio 1.05, 95% confidence interval (CI) 0.97-1.12], but reduced the number of sick-leave days in the intervention group compared to the control group, with a mean difference of -13.38 days (95% CI -24.07 to -2.69).
Department of Psychiatry,Cumming School of Medicine,University of Calgary,Alberta,Canada.
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YT
Nigatu
Department of Psychiatry,Cumming School of Medicine,University of Calgary,Alberta,Canada.
Y
Y
Liu
Department of Psychiatry,Cumming School of Medicine,University of Calgary,Alberta,Canada.
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M
Uppal
Department of Psychiatry,Cumming School of Medicine,University of Calgary,Alberta,Canada.
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S
McKinney
Department of Psychiatry,Faculty of Medicine,University of Ottawa,Ontario,Canada.
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S
Rao
Department of Psychiatry,Faculty of Medicine,University of Ottawa,Ontario,Canada.
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K
Gillis
Department of Psychiatry,Cumming School of Medicine,University of Calgary,Alberta,Canada.
J
J
Wang
D000223:Adaptation, Psychological; D015928:Cognitive Behavioral Therapy; D006801:Humans; D007171:Implosive Therapy; D001523:Mental Disorders / Q000534:rehabilitation*; D009788:Occupational Therapy; D010353:Patient Education as Topic; D011340:Problem Solving; D016032:Randomized Controlled Trials as Topic; D012017:Referral and Consultation; D062707:Return to Work; D018582:Sick Leave; D013997:Time Factors
Clinical trial; intervention; mental illness; meta-analysis; return to work