Abstract
BACKGROUND: Within the working population there is a vulnerable group: workers without an employment contract and workers with a flexible labour market arrangement, e.g. temporary agency workers. In most cases, when sick-listed, these workers have no workplace/employer to return to. Also, for these workers access to occupational health care is limited or even absent in many countries. For this vulnerable working population there is a need for tailor-made occupational health care, including the presence of an actual return-to-work perspective. Therefore, a participatory return-to-work program has been developed based on a successful return-to-work intervention for workers, sick-listed due to low back pain.The objective of this paper is to describe the design of a randomised controlled trial to study the (cost-)effectiveness of this newly developed participatory return-to-work program adapted for temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders, compared to usual care.
METHODS/DESIGN: The design of this study is a randomised controlled trial with one year of follow-up. The study population consists of temporary agency workers and unemployed workers sick-listed between 2 and 8 weeks due to musculoskeletal disorders. The new return-to-work program is a stepwise program aimed at making a consensus-based return-to-work implementation plan with the possibility of a (therapeutic) workplace to return-to-work. Outcomes are measured at baseline, 3, 6, 9 and 12 months. The primary outcome measure is duration of the sickness benefit period after the first day of reporting sick. Secondary outcome measures are: time until first return-to-work, total number of days of sickness benefit during follow-up; functional status; intensity of musculoskeletal pain; pain coping; and attitude, social influence and self-efficacy determinants. Cost-benefit is evaluated from an insurer's perspective. A process evaluation is part of this study.
DISCUSSION: For sick-listed workers without an employment contract there can be gained a lot by improving occupational health care, including return-to-work guidance, and by minimising the 'labour market handicap' by creating a return-to-work perspective. In addition, reduction of sickness absence and work disability, i.e. a reduction of disability claims, may result in substantial benefits for the Dutch Social Security System.
TRIAL REGISTRATION:
TRIAL REGISTRATION NUMBER: NTR1047.
Original language | English |
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Pages (from-to) | 60 |
Number of pages | 14 |
Journal | BMC musculoskeletal disorders |
Volume | 11 |
DOIs | |
Publication status | Published - 28 Mar 2010 |
Keywords
- Adolescent
- Adult
- Clinical Trials as Topic/methods
- Cost of Illness
- Cost-Benefit Analysis/methods
- Disability Evaluation
- Disabled Persons/rehabilitation
- Health Care Costs
- Health Services Needs and Demand/economics
- Humans
- Insurance, Disability
- Middle Aged
- Musculoskeletal Diseases/economics
- National Health Programs/standards
- Netherlands
- Occupational Diseases/economics
- Occupational Health Services/economics
- Outcome Assessment, Health Care/economics
- Program Development/economics
- Program Evaluation/economics
- Rehabilitation, Vocational/economics
- Self Efficacy
- Sick Leave/legislation & jurisprudence
- Treatment Outcome
- Unemployment/statistics & numerical data
- Work Capacity Evaluation
- Workload/economics
- Young Adult