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    Early interventions to promote work participation in people with regional musculoskeletal pain: a systematic review and meta-analysis


    Cochrane, Andy and Higgins, Niamh M. and FitzGerald, Oliver and Gallagher, Pamela and Ashton, Jennifer and Corcoran, Oriel and Desmond, Deirdre (2017) Early interventions to promote work participation in people with regional musculoskeletal pain: a systematic review and meta-analysis. Clinical Rehabilitation, 31 (11). pp. 1466-1481. ISSN 0269-2155

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    Abstract

    Objectives: To determine the effectiveness of early multidisciplinary interventions in promoting work participation and reducing work absence in adults with regional musculoskeletal pain. Data sources: Seven databases (CENTRAL, CINAHL, EMBASE, MEDLINE, Scopus, OT Seeker, PEDro; 1990 to December 2016) were searched for eligible studies. Review methods: Trials were included if they reported on work-based outcomes for participants experiencing difficulties at work or ≤ three months’ sick leave. Interventions had to include two or more elements of the biopsychosocial model delivered as a coordinated programme. Quality was assessed using the GRADE criteria. Results were analysed by hazard ratios for return to work data; continuous outcomes were analysed as standardised mean difference with 95% confidence intervals. Results: A total of 20 randomized controlled trials, with 16,319 participants were included; the interventions were grouped according to their main components for meta-analyses. At 12-months follow-up, moderate quality evidence suggests that programmes involving a stepped care approach (four studies) were more effective than the comparisons in promoting return to work (hazard ratio (HR) 1.29 (95% confidence interval (CI) 1.03 to 1.61), p = 0.03), whereas case management (two studies) was not (HR 0.92 (95% CI 0.69 to 1.24), p = 0.59). Analyses suggested limited effectiveness in reducing sickness absences, in pain reduction or functional improvement across the intervention categories. Conclusion: There is uncertainty as to the effectiveness of early multicomponent interventions owing to the clinical heterogeneity and varying health and social insurance systems across the trials.

    Item Type: Article
    Additional Information: Cite as: Cochrane, A., Higgins, N. M., FitzGerald, O., Gallagher, P., Ashton, J., Corcoran, O., & Desmond, D. (2017). Early interventions to promote work participation in people with regional musculoskeletal pain: a systematic review and meta-analysis. Clinical Rehabilitation, 31(11), 1466–1481. https://doi.org/10.1177/0269215517699976
    Keywords: Musculoskeletal disorders; pain; return to work; vocational rehabilitation;
    Academic Unit: Faculty of Science and Engineering > Psychology
    Item ID: 10596
    Identification Number: https://doi.org/10.1177/0269215517699976
    Depositing User: Dr. Deirdre Desmond
    Date Deposited: 01 Mar 2019 17:30
    Journal or Publication Title: Clinical Rehabilitation
    Publisher: SAGE Publications
    Refereed: Yes
    Funders: Health Research Board
    URI:

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