Participatory interventions for return-to-work for temporary agency workers and unemployed workers, sicklisted due to musculoskeletal disorders. A randomised controlled trial and cost-effectiveness evaluation.

BACKGROUND Musculoskeletal disorders are next to mental disorders the most common cause for sickness absence and work disability among the working population in the Netherlands and other countries. This also applies to the vulnerable working population, i.e. temporary workers and unemployed workers. Recently a protocol for participatory ergonomics (PE) as a return-to-work method was developed for employees sicklisted due to nonspecific low backpain. PE accelerated return-to-work with 30 days and was evaluated positively by the workers and occupational health care professionals. A comparable method for temporary workers and unemployed workers, sicklisted due to musculoskeletal complaints, is not avalilable at present and cost-effectiveness has not yet been established. OBJECTIVE To develop a PE method for temporary agency workers and unemployed workers, sicklisted due to musculoskeletal complaints, based on the PE protocol for LBP. STUDY POPULATION Temporary workers and unemployed workers with musculoskeletal complaints and sicklisted between 2 and 8 weeks. INTERVENTION - Using Intervention Mapping, the PE protocol will be adapted for the study population. - The sicklisted temporary worker or unemployed worker and his/her occupational health care professional will be guided by a trained coach. The aim of the method is to achieve consensus regarding work adaptations to facilitate return-to-work. In addition a matching temporary adapted workplace is offered to achieve actual RTW. STUDY DESIGN RCT Patients will be randomized to PE or usual care (n= 2 x 80). A process analysis is part of the study. OUTCOME MEASURES Outcome measures are: sick leave duration, musculoskeletal complaints, functional status, coping and direct and indirect costs. Measurements will take place at baseline, 12, 26 and 52 weeks after inclusion.

Is participatory intervention for return-to-work for sicklisted temporary workers and sicklisted unemployed workers with musculoskeletal disorders more (cost-)effective than the usual care?

The participatory intervention is based on the active participation and strong commitment of the sicklisted temporay worker or sicklisted unemployed worker and occupational health professionals of the social security agency. It is a stepwise program to identify obstacles for return-to-work. Then solutions are chosen on a consensus basis. Finally a temporary adapted workplace is offered to facilitate actual return-to-work.