title: Effect of Inpatient Multicomponent Occupational Rehabilitation Versus Less Comprehensive Outpatient Rehabilitation on Sickness Absence in Persons with Musculoskeletal- or Mental Health Disorders: A Randomized Clinical Trial.
abstract: Purpose To assess effects of an inpatient multicomponent occupational rehabilitation program compared to less comprehensive outpatient rehabilitation on sickness absence in persons with musculoskeletal- or mental health disorders. Methods Randomized clinical trial with parallel groups. Participants were individuals 18-60 years old on sick-leave for 2-12 months with a sick-leave diagnosis within the musculoskeletal, psychological or general and unspecified chapters of ICPC-2, identified in a national register. The inpatient program (4 + 4 days) consisted of Acceptance and Commitment Therapy (ACT), physical training and work-related problem-solving including creating a return to work plan and a workplace visit if considered relevant. The outpatient program consisted primarily of ACT (6 sessions during 6 weeks). Both programs were group based. Primary outcome was cumulated number of sickness absence days at 6 and 12 months follow-up. Secondary outcome was time until sustainable return to work. Results 168 individuals were randomized to the inpatient program (n = 92) or the outpatient program (n = 76). We found no statistically significant difference between the programs in median number of sickness absence days at 6 and 12 months follow-up. In the outpatient program 57% of the participants achieved sustainable return to work (median time 7 months), in the inpatient program 49% (log rank, p = 0.167). The hazard ratio for sustainable return to work was 0.74 (95% CI 0.48-1.32, p = 0.165), in favor of the outpatient program. Conclusions This study provided no support that the more comprehensive 4 + 4 days inpatient multicomponent occupational rehabilitation program reduced sickness absence compared to the outpatient rehabilitation program.
authors.affiliation: Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway. lene.aasdahl@ntnu.no.|Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. lene.aasdahl@ntnu.no.
authors.forename: Lene
authors.identifier: 0000-0003-4276-1345
authors.initials: L
authors.lastname: Aasdahl
authors.affiliation: Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
authors.forename: Kristine
authors.initials: K
authors.lastname: Pape
authors.affiliation: Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
authors.forename: Ottar
authors.initials: O
authors.lastname: Vasseljen
authors.affiliation: Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
authors.forename: Roar
authors.initials: R
authors.lastname: Johnsen
authors.affiliation: Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.|Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Sigmund
authors.initials: S
authors.lastname: Gismervik
authors.affiliation: Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.|Regional Center for health care improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Vidar
authors.initials: V
authors.lastname: Halsteinli
authors.affiliation: Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway.
authors.forename: Nils
authors.initials: N
authors.lastname: Fleten
authors.affiliation: Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Claus Vinther
authors.initials: CV
authors.lastname: Nielsen
authors.affiliation: Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.|Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.|Hysnes Rehabilitation Center, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Marius Steiro
authors.initials: MS
authors.lastname: Fimland
mesh_terms: D064869:Acceptance and Commitment Therapy / Q000379:methods*; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000523:psychology / Q000534:rehabilitation*; D062707:Return to Work; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Cognitive therapy; Mental health; Musculoskeletal diseases; Return to work; Sick leave