Effects of a randomized controlled intervention trial on return to work and health care utilization after long-term sickness absence.
The aim of the RCT study was to investigate if the effect of a multidisciplinary intervention on return to work (RTW) and health care utilization differed by participants' self-reported health status at baseline, defined by a) level of somatic symptoms, b) health anxiety and c) self-reported general health.



A total of 443 individuals were randomized to the intervention (n = 301) or the control group (n = 142) and responded to a questionnaire measuring health status at baseline. Participants were followed in registries measuring RTW and health care utilization. Relative risk (RR) and odds ratio (OR) were used as measures of associations. Results were adjusted for gender, age, educational level, work ability and previous sick leave.



Among all responders we found no effect of the intervention on RTW. Among participants with low health anxiety, the one-year probability of RTW was lower in the intervention than in the control group (RR = 0.79 95 % CI 0.68-0.93), but for those with high health anxiety there was no difference between the groups (RR = 1.15 95 % CI 0.84-1.57). Neither general health nor somatic symptoms modified the effect of the intervention on RTW. The intervention had no effect on health care utilization.



The multidisciplinary intervention did not facilitate RTW or decrease health care utilization compared to ordinary case management in subgroups with multiple somatic symptoms, health anxiety or low self-rated health. However, the intervention resulted in a reduced chance of RTW among participants with low health anxiety levels.



ISRCTN43004323 , and ISRCTN51445682.
DEFACTUM - Social & Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark. anne-mette.momsen@stab.rm.dk.|MarselisborgCentret, P.P. Oerums Gade 11, 1B, 8000, Aarhus C, Denmark. anne-mette.momsen@stab.rm.dk.
Anne-Mette H
AH
Momsen
DEFACTUM - Social & Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark.
Christina Malmose
CM
Stapelfeldt
Section of Clinical Social Medicine and Rehabilitation, Institute of Public Health, Aarhus University, Aarhus, Denmark.
Claus Vinther
CV
Nielsen
COWI A/S, Lyngby, Denmark.|The National Research Centre for the Working Environment, Copenhagen, Denmark.
Maj Britt D
MB
Nielsen
The National Research Centre for the Working Environment, Copenhagen, Denmark.
Birgit
B
Aust
The National Research Centre for the Working Environment, Copenhagen, Denmark.|Department of Public Health, University of Copenhagen, Copenhagen, Denmark.|Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Reiner
R
Rugulies
National Centre for Occupational Rehabilitation, Rauland, Norway.|Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
Chris
C
Jensen
D000328:Adult; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D001521:Behavior Therapy / Q000379:methods*; D003718:Denmark; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000523:psychology / Q000628:therapy*; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012042:Registries; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data*; D012306:Risk; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014938:Work Capacity Evaluation
Effect evaluation; Health anxiety; Health care utilization; Interdisciplinary intervention; Randomized controlled trial; Rehabilitation; Return-to-work; Sickness absence; Somatic symptoms