title: Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions: An Update of the Evidence and Messages for Practitioners.
abstract: Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.
authors.affiliation: Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada. kcullen@iwh.on.ca.
authors.forename: K L
authors.initials: KL
authors.lastname: Cullen
authors.affiliation: Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Irvin
authors.affiliation: Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.|School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Collie
authors.affiliation: Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.
authors.forename: F
authors.initials: F
authors.lastname: Clay
authors.affiliation: National Centre for Occupational Rehabilitation, Rauland, Norway.|Team WorkingLife ApS, Copenhagen, Denmark.
authors.forename: U
authors.initials: U
authors.lastname: Gensby
authors.affiliation: Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, VIC, Australia.
authors.forename: P A
authors.initials: PA
authors.lastname: Jennings
authors.affiliation: Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Hogg-Johnson
authors.affiliation: Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada.|Lakehead University, Thunder Bay, ON, Canada.
authors.forename: V
authors.initials: V
authors.lastname: Kristman
authors.affiliation: University of Montreal and CHU Ste-Justine Research Centre, Montreal, QC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Laberge
authors.affiliation: Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.
authors.forename: D
authors.initials: D
authors.lastname: McKenzie
authors.affiliation: Accident Research Centre, Monash University, Melbourne, VIC, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Newnam
authors.affiliation: Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Palagyi
authors.affiliation: Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Ruseckaite
authors.affiliation: Accident Research Centre, Monash University, Melbourne, VIC, Australia.
authors.forename: D M
authors.initials: DM
authors.lastname: Sheppard
authors.affiliation: Accident Research Centre, Monash University, Melbourne, VIC, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Shourie
authors.affiliation: Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada.|Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Steenstra
authors.affiliation: Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada.|School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Van Eerd
authors.affiliation: Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada.|Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
authors.forename: B C
authors.initials: BC
authors.lastname: Amick
mesh_terms: D000041:Absenteeism; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015331:Cohort Studies; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation*; D059352:Musculoskeletal Pain / Q000534:rehabilitation*; D009784:Occupational Diseases / Q000191:economics / Q000534:rehabilitation; D060051:Occupational Injuries / Q000191:economics / Q000534:rehabilitation; D016032:Randomized Controlled Trials as Topic; D062707:Return to Work
keywords: Mental health; Musculoskeletal pain; Program effectiveness; Return to work; Systematic review; Workplace