Predictors of return-to-work in patients with chronic musculoskeletal pain: A randomized clinical trial

Abstract

OBJECTIVE: To assess the predictive effect of a multidisciplinary intervention programme, pain, work-related factors and health, including anxiety/depression and beliefs, on return-to-work for patients sick-listed due to musculoskeletal pain. DESIGN: A randomized clinical study. METHODS: A total of 284 patients were randomized to either a multidisciplinary intervention programme (n = 141) or to a less resource-demanding brief intervention (n = 143). Work participation was estimated monthly from register data for 12 months. Return-to-work was defined as increased work participation in 3 consecutive months. RESULTS: In the adjusted model, return-to-work by 3 months was associated with a multidisciplinary intervention programme (odds ratio (OR) = 2.7, 95% confidence interval (95% CI) = 1.1-6.9), the factor "belief that work was cause of the pain" (OR = 2.2, 95% CI = 1.1-4.3), anxiety and depression (OR = 0.5, 95% CI = 0.2-0.98), and by an interaction between the multidisciplinary intervention and perceived support at work (OR = 0.3, 95% CI = 0.1-0.9). At 12 months, only duration of sick leave was associated with return-to-work (OR = 0.6, 95% CI = 0.5-0.8). CONCLUSION: Multidisciplinary intervention may hasten return-to-work and benefit those who perceive low support at work, but at 12 months only duration of sick leave at baseline was associated with return-to-work.