Effectiveness of two vocational interventions on sickness absence and costs for people with musculoskeletal disorders: 12 months results from the MI-NAV multi-arm randomized trial.

IF 4.3 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Scandinavian journal of work, environment & health Pub Date : 2025-09-03 DOI:10.5271/sjweh.4248

Britt Elin Øiestad, Esther Maas, Fiona Aanesen, Alexander Tingulstad, Tarjei Rysstad, Maurits van Tulder, Anne Therese Tveter, Milada Hagen, Rigmor C Berg, Nadine E Foster, Gwenllian Wynne-Jones, Gail Sowden, Gunnhild Bagøien, Roger Hagen, Kjersti Storheim, Margreth Grotle

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引用次数: 0

Abstract

Objectives: This study aimed to assess 12-month outcomes on return to work (RTW) and cost-effectiveness in adults on sick leave due to musculoskeletal disorders who were randomized to either usual case management (UC), UC+motivational interviewing (MI) or UC+stratified vocational advice intervention (SVAI).

Methods: The study was conducted in the Norwegian Labor and Welfare Administration (NAV). Workers on sick leave due to musculoskeletal disorders for ≥50% of their contracted work hours for ≥7 consecutive weeks were included. Trained caseworkers delivered MI in two face-to-face sessions, and physiotherapists provided SVAI and identified RTW obstacles. The main outcomes were sick leave days over 12 months and cost-effectiveness, cost-utility and cost-benefit.

Results: The trial included 509 workers with a mean age of 48 years. There were statistically significant differences between UC+MI versus UC [-15.6 days, 95% confidence interval (CI) -31.0- -0.2], and UC+SVAI versus UC (-17.6 days, 95% CI -33.0- -2.2). Compared to UC, odds ratios (OR) for receiving wage replacement benefits each month were lower for UC+MI (OR=0.73, 95% CI 0.64-0.84), and UC+SVAI (OR 0.74, 95% CI 0.64-0.84). The probabilities of cost-effectiveness were high for adding either MI or SVAI to UC (ceiling ratio 0.90), and the net benefit for MI was €5225 (95% CI -592-10 985) and for SVAI €7214 ((95% CI 1548-12 851) per person.

Conclusions: Adding MI or SVAI to UC significantly improved RTW outcomes and was cost-effective among people on sickness absence due to musculoskeletal disorders.

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两种职业干预对肌肉骨骼疾病患者缺勤和成本的影响：MI-NAV多组随机试验的12个月结果

目的：本研究旨在评估因肌肉骨骼疾病而请病假的成年人12个月重返工作岗位（RTW）的结果和成本效益，这些人被随机分为常规病例管理（UC）、UC+动机访谈（MI）或UC+分层职业咨询干预（SVAI）。方法：研究在挪威劳动和福利管理局（NAV）进行。包括因肌肉骨骼疾病而请病假的工人，其合同工作时间≥50%，连续≥7周。训练有素的个案工作者在两次面对面的会议中提供MI，物理治疗师提供SVAI并确定RTW障碍。主要结果是超过12个月的病假天数和成本效益、成本效用和成本效益。结果：试验纳入509名工人，平均年龄48岁。UC+MI与UC的差异有统计学意义[-15.6天，95%可信区间(CI) -31.0- -0.2]， UC+SVAI与UC的差异（-17.6天，95% CI -33.0- -2.2）。与UC相比，UC+MI （OR=0.73, 95% CI 0.64-0.84）和UC+SVAI （OR 0.74, 95% CI 0.64-0.84）每月获得工资替代福利的优势比（OR）较低。将MI或SVAI添加到UC（上限比0.90）的成本效益概率很高，MI的净收益为每人5225欧元（95% CI -592-10 985）， SVAI的净收益为每人7214欧元（95% CI 1548-12 851）。结论：在UC中加入MI或SVAI可显著改善RTW结果，并且在因肌肉骨骼疾病缺勤的患者中具有成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Scandinavian journal of work, environment & health 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.20

自引率

9.50%

发文量

审稿时长

>12 weeks

期刊介绍： The aim of the Journal is to promote research in the fields of occupational and environmental health and safety and to increase knowledge through the publication of original research articles, systematic reviews, and other information of high interest. Areas of interest include occupational and environmental epidemiology, occupational and environmental medicine, psychosocial factors at work, physical work load, physical activity work-related mental and musculoskeletal problems, aging, work ability and return to work, working hours and health, occupational hygiene and toxicology, work safety and injury epidemiology as well as occupational health services. In addition to observational studies, quasi-experimental and intervention studies are welcome as well as methodological papers, occupational cohort profiles, and studies associated with economic evaluation. The Journal also publishes short communications, case reports, commentaries, discussion papers, clinical questions, consensus reports, meeting reports, other reports, book reviews, news, and announcements (jobs, courses, events etc).