Efficacy of a Work Disability Prevention Program for People with Rheumatic and Musculoskeletal Conditions: The Work It Study Trial
OBJECTIVE: 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 two years among people with rheumatic and musculoskeletal conditions.
METHODS: Eligibility criteria for this single-blind parallel-arm randomized trial included 21-65 years of age, 15 or more hours/week employment, 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. This study is registered with ClinicalTrials. gov number NCT01387100.
RESULTS: Between October 2011 and January 2014, 652 individuals were assessed for eligibility. 287 participants were randomized: 143 intervention and 144 control participants. 264 participants (92%) completed two-year data collection. There was no difference in the mean WLQ change scores from baseline to two year follow-up (-8.6 ± 1.9 intervention vs. -8.3 ± 2.2 control (p=.93)). Of the 36 participants who experienced permanent work loss at two years: 11 (8%) were intervention participants and 25 (18%) control participants (p=.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. This article is protected by copyright. All rights reserved.