PMID- 21415023
OWN - NLM
STAT- MEDLINE
DCOM- 20120313
LR  - 20211020
IS  - 1462-0332 (Electronic)
IS  - 1462-0324 (Print)
IS  - 1462-0324 (Linking)
VI  - 51
IP  - 2
DP  - 2012 Feb
TI  - Effectiveness of community- and workplace-based interventions to manage 
      musculoskeletal-related sickness absence and job loss: a systematic review.
PG  - 230-42
LID - 10.1093/rheumatology/ker086 [doi]
AB  - OBJECTIVE: To assess the effectiveness of interventions in community and 
      workplace settings to reduce sickness absence and job loss in workers with 
      musculoskeletal disorders (MSDs). METHODS: Relevant randomized controlled trials 
      (RCTs) and cohort studies, published since 1990, were identified by screening 
      citations from 35 earlier systematic reviews and by searching MEDLINE and Embase 
      until April 2010. Effects were estimated by intervention category and other 
      features, including study quality. RESULTS: Among 42 studies (including 34 RCTs), 
      27 assessed return to work (RTW), 21 duration of sickness absence and 5 job loss. 
      Interventions included exercise therapy, behavioural change techniques, workplace 
      adaptations and provision of additional services. Studies were typically small 
      median sample 107 [inter-quartile range (IQR) 77-148] and limited in quality. 
      Most interventions appeared beneficial: the median relative risk (RR) for RTW was 
      1.21 (IQR 1.00-1.60) and that for avoiding MSD-related job loss was 1.25 (IQR 
      1.06-1.71); the median reduction in sickness absence was 1.11 (IQR 0.32-3.20) 
      days/month. However, effects were smaller in larger and better-quality studies, 
      suggesting publication bias. No intervention was clearly superior, although 
      effort-intensive interventions were less effective than simple ones. No 
      cost-benefit analyses established statistically significant net economic 
      benefits. CONCLUSION: As benefits are small and of doubtful cost-effectiveness, 
      employers' practice should be guided by their value judgements about the 
      uncertainties. Expensive interventions should be implemented only with rigorous 
      cost-benefit evaluation planned from the outset. Future research should focus on 
      the cost-effectiveness of simple, low-cost interventions, and further explore 
      impacts on job retention.
FAU - Palmer, Keith T
AU  - Palmer KT
AD  - MRC Epidemiology Lifecourse Unit, Southampton General Hospital, Southampton, 
      Hants SO16 6YD, UK. ktp@mrc.soton.ac.uk
FAU - Harris, Elizabeth C
AU  - Harris EC
FAU - Linaker, Cathy
AU  - Linaker C
FAU - Barker, Mary
AU  - Barker M
FAU - Lawrence, Wendy
AU  - Lawrence W
FAU - Cooper, Cyrus
AU  - Cooper C
FAU - Coggon, David
AU  - Coggon D
LA  - eng
GR  - COMMISSIONED SERVICES REF 2500.9/ARC_/Arthritis Research UK/United Kingdom
GR  - MC_UP_A620_1014/MRC_/Medical Research Council/United Kingdom
GR  - MC_UP_A620_1018/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20110316
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
SB  - IM
MH  - *Absenteeism
MH  - Disability Evaluation
MH  - *Health Promotion
MH  - Humans
MH  - Musculoskeletal Diseases/*rehabilitation
MH  - Residence Characteristics
MH  - *Sick Leave
MH  - Treatment Outcome
MH  - Workplace
PMC - PMC3276837
MID - UKMS40470
OID - NLM: UKMS40470
EDAT- 2011/03/19 06:00
MHDA- 2012/03/14 06:00
PMCR- 2012/08/01
CRDT- 2011/03/19 06:00
PHST- 2011/03/19 06:00 [entrez]
PHST- 2011/03/19 06:00 [pubmed]
PHST- 2012/03/14 06:00 [medline]
PHST- 2012/08/01 00:00 [pmc-release]
AID - ker086 [pii]
AID - 10.1093/rheumatology/ker086 [doi]
PST - ppublish
SO  - Rheumatology (Oxford). 2012 Feb;51(2):230-42. doi: 10.1093/rheumatology/ker086. 
      Epub 2011 Mar 16.