Comparing multidisciplinary and brief intervention in sick-listed employees with low back pain

ISRCTN ISRCTN18609003
DOI https://doi.org/10.1186/ISRCTN18609003
Secondary identifying numbers N/A
Submission date
04/03/2011
Registration date
17/03/2011
Last edited
14/11/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Claus Vinther Nielsen
Scientific

Marselisborgcentret
P.P. Oerumsgade 11, bygning 1b
Aarhus C
8000
Denmark

Email Claus.Vinther@stab.rm.dk

Study information

Study designRandomised single-centre comparative trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleRandomised trial comparing multidisciplinary and brief intervention in sick-listed employees with low back pain
Study objectivesReturn to work, pain and disability improves more in sick-listed subjects with low back pain if they receive a hospital-based multidisciplinary team-intervention in addition to a brief intervention than in subjects who only receive the brief intervention consisting of a clinical examination and advice given by a rehabilitation doctor and a physiotherapist.
Ethics approval(s)The study was discussed with the regional research ethics committee. Approval was not considered necessary by the committee, because all participants received the best available clinical care and no biological material was involved.
We have later acquired a written response from the Research Ethics Committee of Central Region Denmark (komite@rm.dk) filed as:
Number: Forespørgsel 38/2010: The Study does not fall within the scope of the work of the Committee according to the Act on Biomedical Research Ethics Committee System and The Processing of Biomedical Research Projects 8, section 1 and 7, number 1 and therefore shall not be notified to the Committee.
Health condition(s) or problem(s) studiedLow back pain
InterventionBrief intervention:
A standard clinical low backpain (LBP) examination was carried out by a doctor. Patients with non-specific LBP were informed about the difficulties of visualising the cause of pain with certainty, the best documented treatment being exercise and training and psychological distress possibly worsening and prolonging pain. Patients with nerve root pain were informed about the good spontaneous prognosis and about the possibility of surgery if no improvement occurred. Furthermore, they were informed about exercise being beneficial if leg pain did not worsen. Information was given in a reassuring way and medical pain management was adjusted. The participants were advised to resume work when possible. A physiotherapy examination included a standardised, mechanical evaluation and advice on exercise was chosen accordingly. General advice was given to increase physical activity and exercise. In order to ensure coordination between stake holders, copies of the medical records were always sent to the participant, the general practitioner and the municipal social services responsible for reimbursement of sick leave compensation. For all participants, a follow-up visit at the physiotherapist was scheduled two weeks later and a follow-up visit at the doctor was arranged for participants needing answers in relation to test results.

Multidisciplinary intervention:
In addition to the brief clinical intervention described above, participants allocated to the multidisciplinary intervention group were scheduled for an interview with a case manager within two to three workdays. This interview was standardised and included questions of work history, private life and questions on how pain and disability was perceived. It normally lasted for one to two hours. The participant was seen once or more times by the case manager depending on need and progress. The case manager and the participant together made a tailored rehabilitation plan aiming at full or partial RTW. If this was deemed unrealistic, a plan towards staying on the labor market in other ways was made, for instance by jobs supported by the social system. Each case was discussed several times by the entire multidisciplinary team including the rehabilitation doctor, a specialist in clinical social medicine, a physiotherapist, a social worker and an occupational therapist. Appointments with other members of the team and meetings at the work place or at the social service centre were regularly arranged. The case manager kept in contact with the participant and problems were discussed at regular team conferences where the participant was not present. The case was closed when the participant resumed work or if this was deemed impossible (in the latter case the social worker at the social service centre was contacted). Three different persons could be assigned as case manager (the specialist in clinical social medicine, the social worker or the occupational therapist). Every two weeks, supervision of the entire team was arranged for 1-2 hours by a former general practitioner specialised in cognitive therapy to ensure a standardised intervention.
Intervention typeOther
Primary outcome measureReturn to work using register-based data on sick leave.
Secondary outcome measures1. Pain (Low Back Pain Rating scale)
2. Disability (Roland Morris Disability Questionnaire)
Overall study start date01/10/2004
Completion date01/07/2007

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants350
Total final enrolment351
Key inclusion criteria1. Age 16-60 years
2. Partly or fully sick-listed from work for 4 to 12 weeks due to Low Back Pain
Key exclusion criteria1. Unemployed
2. Continuing or progressive signs or symptoms of nerve root affection implicating plans for surgery
3. Low back surgery within the last year or specific back diseases (e.g. tumor)
4. Pregnant
5. Known dependency on drugs or alcohol
6. Any primary psychiatric disease
Date of first enrolment01/10/2004
Date of final enrolment01/07/2007

Locations

Countries of recruitment

  • Denmark

Study participating centre

Marselisborgcentret
Aarhus C
8000
Denmark

Sponsor information

The Danish Working Environment Research Fund (Denmark)
Government

Postboks 1228
Copenhagen C
0900
Denmark

Email at@at.dk
ROR logo "ROR" https://ror.org/05fm0gf36

Funders

Funder type

Government

The Danish Working Environment Research Fund (Denmark) (ref: No. 20080016279/3)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing planNot provided at time of registration

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Other publications subgroup analyses 25/05/2011 Yes No
Results article 25/08/2012 14/11/2022 Yes No

Editorial Notes

14/11/2022: Publication reference and total final enrolment added.