Effect of Cognitive Behavioural Stress Management on Return-to-Work Amongst Sick-Listed Employees.

Abstract

Background: The literature provides contradictory information on the effect of cognitive behavioural therapy (CBT) interventions on return to work (RTW) for patients on sick leave due to work-related stress.

Aim: We compared the cumulative number of sick leave weeks between a cohort of patients who received a CBT-based stress management intervention in the period 2011-2018 (N = 331) and a cohort of patients from 2010 to 2011 (N = 221) who did not receive the intervention. We also compared time until sustainable RTW (3 consecutive months of no sick registrations) between the cohorts.

Methods: Registry data on sickness absence were obtained from the national DREAM register (Danish Public Transfer Payments Database). The cumulative time of registered sick leave in DREAM until first sustainable period of RTW was visualized using Kaplan-Meier plots. A Cox proportional hazard model was used to compare the effectiveness of the intervention relative to the comparison cohort and was reported as hazard rate ratio.

Results: The intervention cohort's cumulated number of weeks in DREAM across the total period from 0 to 36 months (median 29 range 26-32) was lower than that of the comparison cohort (median 40 range 34-52), (P = 0.005), corresponding to a 14% (95% CI 0.04-0.24) reduction. For RTW, a hazard ratio rate of 1.25 (95% CI 1.02-1.54) favouring the intervention group was found (P = 0.034).

Conclusion: The CBT stress management intervention significantly reduced the amount of sick leave and reduced the time until sustainable RTW for the intervention cohort compared to the comparison cohort.