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Efficacy of a work disability prevention program for people with rheumatic and musculoskeletal conditions
A single‐blind parallel‐arm randomized controlled trial
Keysor, J. J., LaValley, M. P., Brown, C., Felson, D. T., AlHeresh, R. A., Vaughan, M. W., Yood, R., Reed, J. I., & Allaire, S. J. (2018). Efficacy of a work disability prevention program for people with rheumatic and musculoskeletal conditions: A single‐blind parallel‐arm randomized controlled trial. Arthritis care and research : the official journal of the Arthritis Health Professions Association, 70(7), 1022-1029. https://doi.org/10.1002/acr.23423
Work disability rates are high among people with rheumatic and musculoskeletal conditions. Effective disability preventive programs are needed. We examined the efficacy of a modified vocational rehabilitation approach delivered by trained occupational therapists and physical therapists on work limitation and work loss over 2 years among people with rheumatic and musculoskeletal conditions.
Methods
Eligibility criteria for this single‐blind, parallel‐arm randomized trial included ages 21–65 years, 15 or more hours/week employment, a self‐reported doctor‐diagnosed rheumatic or musculoskeletal condition, and concern about staying employed. The intervention consisted of a 1.5‐hour meeting, an action plan, written materials on employment supports, and telephone calls at 3 weeks and 3 months. Control group participants received the written materials. The primary outcome was the Work Limitations Questionnaire (WLQ) output job demand subscale. The secondary outcome was work loss. Intent‐to‐treat analyses were performed.
Results
Between October 2011 and January 2014, 652 individuals were assessed for eligibility. A total of 287 participants were randomized: 143 intervention and 144 control participants. In total, 264 participants (92%) completed 2‐year data collection. There was no difference in the mean ± SD WLQ change scores from baseline to 2‐year followup (−8.6 ± 1.9 intervention versus −8.3 ± 2.2 control; P = 0.93). Of the 36 participants who experienced permanent work loss at 2 years, 11 (8%) were intervention participants and 25 (18%) control participants (P = 0.03).
Conclusion
The intervention did not have an effect on work limitations but reduced work loss. The intervention can be delivered by trained rehabilitation therapists.