Effectiveness of improved assessment and recording of work related primary care visits combined with enhanced follow-up in reducing work disability: a cluster randomized controlled trial
| ISRCTN | ISRCTN45728263 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN45728263 |
| Secondary identifying numbers | N/A |
- Submission date
- 12/04/2016
- Registration date
- 18/04/2016
- Last edited
- 16/03/2020
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English Summary
Background and study aims
Occupational health care (OHC) aims to keep employees healthy and safe at work and manage any risks in the workplace. Research has shown that healthy employees are good for business and it’s important that OHCs and employers work together. Their cooperation results in the most efficient and valuable results, namely improved wellbeing and productivity at workplaces. This study looks at increasing occupational health (OH)/workplace co-operation by focusing on its quality, effectiveness and good practices.
Who can participate?
All employees of the workplaces that are clients of the OHC units recruited to the study.
What does the study involve?
OHC units are randomly allocated to one of two groups. Those in group 1 are placed in the intervention group Those in group 2 are placed in the control group. Doctors and nurses working in occupational health services in the intervention group are trained to improve their assessment and recording of work relatedness or potential impact on work ability of each primary care visit. As a patient visits a doctor with a complaint, the doctor assesses the patient’s diagnosis with regard to work-relatedness or impact on work ability. This assessment is recorded on an electronic patient register. Once weekly an OH nurse accesses all client visits within the electronic register, which are tagged in the system as being work related or which have been tagged as potentially impacting on work ability and ensures that relevant procedures for addressing work ability are initiated. These procedures are case-specific, but may involve some of the following: a workplace assessment; rehabilitation; meetings with employers, occupational health professionals and the employee; referral to specialists (occupational health psychologists, occupational health physiotherapists, others). Occupational health doctors working in occupational health services in the control group may assess and record work relatedness and impact on work ability. No effort is made for special follow up by occupational nurses, cases are dealt with within usual team meetings.
What are the possible benefits and risks of participating?
Participating in the intervention causes no harm to patients, service providers or client organisations. This improved follow up could present a new model of activities within occupational health, that connects health care with prevention of work disability.
Where is the study run from?
A number of OH centres that are part of the Dextra Pihlajalinna consortium.
When is the study starting and how long is it expected to run for?
November 2015 to June 2018
Who is funding the study?
European Social Fund
Who is the main contact?
Prof. Jukka Uitti
Contact information
Scientific
School of Health Sciences
University of Tampere
Medisiinarinkatu 3
Tampere
33014
Finland
Study information
| Study design | Pragmatic cluster randomised controlled intervention trial. The trial will be conducted at 22 occupational health units (multisite). |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Cluster randomised trial |
| Study setting(s) | Other |
| Study type | Other |
| Participant information sheet | No participant information sheet available |
| Scientific title | Does an intervention to increase assessment and recording of work related primary care visits' relation to work in occupational health services combined with enhanced follow-up reduce rates of work disability pensions as measured by disability pensions and sickness absences and disability pensions when compared with no intervention after two years? A cluster randomized controlled trial |
| Study hypothesis | Enhanced recording and assessment of primary care visits’ work relatedness and diagnoses’ impact on work ability of primary care visits and of occupational diseases at occupational health care units will initiate improved follow-up to address work-related problems, and through that, will reduce rates of work disability as defined by disability pensions and sickness absences and disability pensions among client organisations' employees at two years from start of intervention. |
| Ethics approval(s) | Pirkanmaa Hospital District review board, 10/03/2016, ref: R16041 |
| Condition | Work ability/work disability |
| Intervention | Intervention arm: Doctors and nurses working in occupational health services are trained to improve their assessment and recording of work relatedness or potential impact on work ability of each primary care visit. As a patient visits a doctor with a complaint, the doctor assesses the patient’s diagnosis with regard to work-relatedness or impact on work ability. This assessment is recorded on an electronic patient register. Once weekly an OH nurse accesses all client visits within the electronic register, which are tagged in the system as being work related or which have been tagged as potentially impacting on work ability and ensures that relevant procedures for addressing work ability are initiated. These procedures are case-specific, but may involve some of the following: a workplace assessment; rehabilitation; meetings with employers, occupational health professionals and the employee; referral to specialists (occupational health psychologists, occupational health physiotherapists, others). Control: Usual care. Occupational health doctors may assess and record work relatedness and impact on work ability. No effort is made for special follow up by occupational nurses, cases are dealt with within usual team meetings. |
| Intervention type | Behavioural |
| Primary outcome measure | Reduction in medium term (3-9 days) sickness absences from the workplace after the intervention up to two years of follow up as measured by OHS records |
| Secondary outcome measures | 1. Reduction in long-term (9+ days) sickness absences from the workplace after the intervention until two years of follow up as measured by OHS records 2. Reduction in short term (up to three days) sickness absences from the workplace during the following two years from the start of the intervention as measured by self report or OHS report of sickness absence 3. Reduction of sickness absences of 60 days and over after the intervention until two years of follow up as measured by OHS records 4. Reduction of any form of work disability pensions as measured by an employee registering as receiving work disability pension on the central pensions register up to two years from the intervention |
| Overall study start date | 01/11/2015 |
| Overall study end date | 30/06/2018 |
Eligibility
| Participant type(s) | All |
|---|---|
| Age group | Adult |
| Sex | Both |
| Target number of participants | 55000 |
| Participant inclusion criteria | All employees of the client organisations of the selected intervention arm occupational health care units will be eligible |
| Participant exclusion criteria | Does not meet inclusion criteria |
| Recruitment start date | 14/04/2016 |
| Recruitment end date | 01/05/2017 |
Locations
Countries of recruitment
- Finland
Study participating centres
37800
Finland
Helsinki
00100
Finland
Hämeenkyrö
39100
Finland
Jyväskylä
40100
Finland
Mänttä
37100
Finland
Nokia
37100
Finland
Parkano
39700
Finland
Pietarsaari
68600
Finland
Sirkka
99130
Finland
Tampere
33200
Finland
Valkeakoski
37600
Finland
Helsinki
00350
Finland
Ikaalinen
39500
Finland
Kangasala
36220
Finland
Kankaanpää
38700
Finland
Lappeenranta
53200
Finland
Kuusankoski
45700
Finland
Myllykatu
76100
Finland
Rauma
26100
Finland
Vantaa
01530
Finland
Ylöjärvi
33470
Finland
Jämsä
42100
Finland
Sponsor information
University/education
Kalevantie 4
Tampere
33014
Finland
| Website | http://www.uta.fi |
|---|---|
"ROR" |
https://ror.org/033003e23 |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- Европейският социален фонд, Evropský sociální fond, Den Europæiske Socialfond, Europäischer Sozialfonds, Euroopa Sotsiaalfond, Ευρωπαϊκό Κοινωνικό Ταμείο, Fondo Social Europeo, Fonds social européen, Europski socijalni fond, Fondo sociale europeO, Eiropas Sociālais fonds, Europos socialinis fondas, Európai Szociális Alap, Fond Soċjali Ewropew, Europees Sociaal FondS, Europejski Fundusz Społeczny, Fundo Social Europeu, Fondul Social European, Európsky sociálny fond, Evropski socialni sklad, Euroopan sosiaalirahasto, Europeiska socialfonden, European Social Fund, Fondo Social Europeo Plus, Европейски социален фонд плюс, Evropský sociální fond plus, Europæiske Socialfond Plus, Europäische Sozialfonds+, Euroopa Sotsiaalfond+, Ευρωπαϊκό Κοινωνικό Ταμείο+, Fonds social européen+, Europski socijalni fond plus, Fondo sociale europeo Plus, Eiropas Sociālais fonds Plus, Europos socialinis fondas +, Európai Szociális Alap Plusz, Europees Sociaal Fonds Plus, Europejski Fundusz Społeczny Plus, Fundo Social Europeu Mais, Fondul social european Plus, Európsky sociálny fond +, Evropski socialni sklad +, Euroopan sosiaalirahasto plus, Europeiska socialfonden+, ESF, ЕСФ, EKT, FSE, ESZA, EFS, ESS, ESR, ESF+, ESZA+, EFS+, FSE+, ESS+, ESR+
Results and Publications
| Intention to publish date | 01/12/2018 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Other |
| Publication and dissemination plan | Not provided at time of registration. |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol article | protocol | 26/07/2017 | Yes | No | |
| Results article | results | 12/03/2020 | 16/03/2020 | Yes | No |
Editorial Notes
16/03/2020: Publication reference added.
18/01/2018: The recruitment end date has been updated from 31/12/2017 to 01/05/2017.
31/07/2017: Publication reference added.
