Supporting Work Participation in Rheumatic and Musculoskeletal Disorders: Outcomes from Work-Able Solutions a Multisite Work-Focused Occupational Therapy Intervention.

Abstract

Purpose: To describe the implementation and outcomes of Work-Able Solutions a multisite, early access, work-focused occupational therapy intervention, adopting a transdiagnostic approach to support job retention, return to work, and work role functioning.

Methods: Working-age adults with rheumatic and musculoskeletal disorders (RMDs), employed or receiving illness benefits ≤ 6 months, and reporting work difficulties were recruited across three sites. Participants received a 2 h assessment followed by individualised occupational therapy sessions, delivered face-to-face, virtually, or at the workplace. Interventions were guided by the Person-Environment-Occupation-Performance framework, incorporating biopsychosocial and person-centred strategies for symptom management, overcoming workplace barriers, self-advocacy, reasonable accommodations, and return-to-work planning. Primary outcomes were work status and illness benefit; secondary outcomes included work role functioning, future work ability, perceived job loss risk, quality of life, and symptom burden. Outcomes were collected pre-post-intervention and three-month follow-up. Non-parametric analyses included McNemar, Friedman, and Wilcoxon signed-rank tests.

Results: 283 participants were recruited (mean age 47.9 ± 11.7 years, 72% female); 195 completed three-month follow-up. Work status improved post-intervention (p < 0.001) and was sustained at follow-up (p = 0.003). Illness benefit usage declined (p < 0.001). Work role functioning, quality of life, coping, and symptom measures (pain, fatigue, disability) improved post-intervention and at three months (all p < 0.001). Future work concerns and perceived likelihood of job loss due to RMD decreased (p < 0.001).

Conclusion: Early individualised work-focused occupational therapy supports adults with RMDs to maintain employment, enhance role functioning, improve quality of life, and symptoms, indicating real-world effectiveness for job retention and return to work.