TY - JOUR
T1 - Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders
T2 - the MI-NAV randomised controlled trial
AU - Aanesen, Fiona
AU - Grotle, Margreth
AU - Rysstad, Tarjei Langseth
AU - Tveter, Anne Therese
AU - Tingulstad, Alexander
AU - Løchting, Ida
AU - Småstuen, Milada C.
AU - Van Tulder, Maurits W.
AU - Berg, Rigmor
AU - Foster, Nadine E.
AU - Wynne-Jones, Gwenllian
AU - Sowden, Gail
AU - Fors, Egil
AU - Bagøien, Gunnhild
AU - Hagen, Roger
AU - Storheim, Kjersti
AU - Øiestad, Britt Elin
N1 - Publisher Copyright:
© 2023 Author(s). Published by BMJ.
PY - 2023/1
Y1 - 2023/1
N2 - OBJECTIVES: To evaluate if adding motivational interviewing (MI) or a stratified vocational advice intervention (SVAI) to usual case management (UC), reduced sickness absence over 6 months for workers on sick leave due to musculoskeletal disorders.METHODS: We conducted a three-arm parallel pragmatic randomised controlled trial including 514 employed workers (57% women, median age 49 (range 24-66)), on sick leave for at least 50% of their contracted work hours for ≥7 weeks. All participants received UC. In addition, those randomised to UC+MI were offered two MI sessions from social insurance caseworkers and those randomised to UC+SVAI were offered vocational advice from physiotherapists (participants with low/medium-risk for long-term sickness absence were offered one to two sessions, and those with high-risk were offered three to four sessions).RESULTS: Median sickness absence was 62 days, (95% CI 52 to 71) in the UC arm (n=171), 56 days (95% CI 43 to 70) in the UC+MI arm (n=169) and 49 days (95% CI 38 to 60) in the UC+SVAI arm (n=169). After adjusting for predefined potential confounding factors, the results showed seven fewer days in the UC+MI arm (95% CI -15 to 2) and the UC+SVAI arm (95% CI -16 to 1), compared with the UC arm. The adjusted differences were not statistically significant.CONCLUSIONS: The MI-NAV trial did not show effect on return to work of adding MI or SVAI to UC. The reduction in sickness absence over 6 months was smaller than anticipated, and uncertain due to wide CIs.TRIAL REGISTRATION NUMBER: NCT03871712.
AB - OBJECTIVES: To evaluate if adding motivational interviewing (MI) or a stratified vocational advice intervention (SVAI) to usual case management (UC), reduced sickness absence over 6 months for workers on sick leave due to musculoskeletal disorders.METHODS: We conducted a three-arm parallel pragmatic randomised controlled trial including 514 employed workers (57% women, median age 49 (range 24-66)), on sick leave for at least 50% of their contracted work hours for ≥7 weeks. All participants received UC. In addition, those randomised to UC+MI were offered two MI sessions from social insurance caseworkers and those randomised to UC+SVAI were offered vocational advice from physiotherapists (participants with low/medium-risk for long-term sickness absence were offered one to two sessions, and those with high-risk were offered three to four sessions).RESULTS: Median sickness absence was 62 days, (95% CI 52 to 71) in the UC arm (n=171), 56 days (95% CI 43 to 70) in the UC+MI arm (n=169) and 49 days (95% CI 38 to 60) in the UC+SVAI arm (n=169). After adjusting for predefined potential confounding factors, the results showed seven fewer days in the UC+MI arm (95% CI -15 to 2) and the UC+SVAI arm (95% CI -16 to 1), compared with the UC arm. The adjusted differences were not statistically significant.CONCLUSIONS: The MI-NAV trial did not show effect on return to work of adding MI or SVAI to UC. The reduction in sickness absence over 6 months was smaller than anticipated, and uncertain due to wide CIs.TRIAL REGISTRATION NUMBER: NCT03871712.
KW - Musculoskeletal System
KW - Occupational Health
KW - Rehabilitation
KW - Sick Leave
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U2 - 10.1136/oemed-2022-108637
DO - 10.1136/oemed-2022-108637
M3 - Article
C2 - 36428098
SN - 1351-0711
VL - 80
SP - 42
EP - 50
JO - Occupational and Environmental Medicine
JF - Occupational and Environmental Medicine
IS - 1
ER -