Occupational rehabilitation programs for musculoskeletal pain and common mental health disorders: Study protocol of a randomized controlled trial

摘要

Background: Long-term sick leave has considerably negative impact on the individual and society. Hence, theneed to identify effective occupational rehabilitation programs is pressing. In Norway, group based occupationalrehabilitation programs merging patients with different diagnoses have existed for many years, but no rigorousevaluation has been performed. The described randomized controlled trial aims primarily to compare twostructured multicomponent inpatient rehabilitation programs, differing in length and content, with a comparativecognitive intervention. Secondarily the two inpatient programs will be compared with each other, and with a usualcare reference group.Methods/design: The study is designed as a randomized controlled trial with parallel groups. The Social SecurityOffice performs monthly extractions of sick listed individuals aged 18–60 years, on sick leave 2–12 months, with sickleave status 50% - 100% due to musculoskeletal, mental or unspecific disorders. Sick-listed persons are randomizedtwice: 1) to receive one of two invitations to participate in the study or not receive an invitation, where the latter“untouched” control group will be monitored for future sick leave in the National Social Security Register, and2) after inclusion, to a Long or Short inpatient multicomponent rehabilitation program (depending on whichinvitation was sent) or an outpatient cognitive behavioral therapy group comparative program. The Long programconsists of 3 ½ weeks with full rehabilitation days. The Short program consists of 4 + 4 full days, separated by twoweeks, in which a workplace visit will be performed if desirable. Three areas of rehabilitation are targeted: mentaltraining, physical training and work-related problem solving. The primary outcome is number of sick leave days.Secondary outcomes include time until full sustainable return to work, health related quality of life, health relatedbehavior, functional status, somatic and mental health, and perceptions of work. In addition, health economicevaluation will be performed, and the implementation of the interventions, expectations and experiences of usersand service providers will be investigated with different qualitative methods.