Efficacy of an indicated prevention strategy on sickness absence and termination of the employment contract: a 5-year follow-up study.

Autor:	Klasen SH; CAPHRI School for Public Health and Primary Care. Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands. sophie.klasen@maastrichtuniversity.nl., van Amelsvoort LG, Jansen NW, Slangen JJ, Tjin A Ton G, Kant I
Jazyk:	angličtina
Zdroj:	Scandinavian journal of work, environment & health [Scand J Work Environ Health] 2021 May 01; Vol. 47 (4), pp. 258-267. Date of Electronic Publication: 2021 Jan 07.
DOI:	10.5271/sjweh.3945
Abstrakt:	Objective: It was shown that an indicated prevention strategy (IPS), based on screening and early intervention, can considerably decrease future risk of long-term sickness absence (LTSA>28 days) over one year. Given the nature of the interventions, the potential of an effect extending beyond the original one year of follow-up might be present. This study aims to determine the efficacy of this IPS on LTSA and termination of employment contract over five years by extended follow up of IPS trials. Methods: Company records on sickness absence and termination of employment contract over five years were used from two randomized controlled trials (RCT) on the efficacy of the IPS (RCT I employees at high-risk for LTSA: intervention: N=263; RCT II high-risk employees with concurrent mild depressive complaints: intervention: N=139). Survival analysis was used to model time until the first LTSA episode and termination of employment contract. Results: RCT I showed a decrease of 43.2 days of sickness absence (P=0.05) and a lower 5-year risk of LTSA in the intervention, as compared to the control group [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.41-0.90], however no considerable impact on employment contract (HR 0.85, 95% CI 0.54-1.35) (intention-to-treat, ITT). For RCT II, we found no large difference in days of SA and no difference in LTSA risk over five years (HR 1.31, 95% CI 0.70-2.47), whereas the risk of termination of the employment contract was lower (HR 0.62, 95% CI 0.39-0.99) (ITT). Conclusion: Effects of the IPS were observed over five years, albeit differential between the two approaches. A combination of elements of both interventions might lead to optimal results but needs further study.
Databáze:	MEDLINE
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