Effectiveness of early intervention among employees at high risk for long-term sickness absence.

The reduction of both sickness absence and work disability is given high priority in the Netherlands by both employers and employees organisations and the government. So far, the reduction of sickness absence is mainly focused on improving the effectiveness of the socio-medical counselling/treatment of employees already on sick leave.

To date however, the results of treatment and rehabilitation of employees on sick leave are limited.

Therefore, a preventive approach aimed at early treatment of employees before sickness absence occurs, is likely to be more effective in preventing future sickness absence. So far, scientific evidence to support this preventive approach is lacking and thereby hindering the implementation of such a strategy. In this study, the effectiveness of an innovative preventive strategy will be examined by conducting a randomised controlled trial.




The study will be based on a sample of 10,000 employees of ABN AMRO in the Netherlands. Employees at high risk for long-term sickness absence will be identified by the screening questionnaire Balansmeter.

The study involves employees whose high risk for long-term sickness absence can be prompted by either somatic conditions or mental health complaints, or both. Employees will be asked to provide informed consent and those scoring above the cutoff point of the Balansmeter will be randomised over the experimental group and the control condition.

Employees in the experimental group will receive early treatment. Early treatment involves an interview by the occupational physician, which may be followed either by further guidance by the occupational physician or by external referral/guidance. External referral may include psychotherapy, cognitive behavioural therapy or social work.


The control group receives care as usual, as provided by the occupational physician, if the employee asks for help. In case of sickness absence the control group will receive socio-medical counselling in accordance with the practice guidelines of the NVAB. Outcomes will be evaluated at 6 and 12 months after randomisation.

What is the effectiveness of early preventive intervention among employees at high risk for long-term sickness absence?

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The effectiveness of early intervention among employees at high risk for sickness absence will be determined by means of a randomised controlled trial, with an initial total follow-up period of 12 months.

The study will be based on a sample of 10,000 employees of ABN AMRO in the Netherlands. Selection of this sample will be based on the initial letter of the employees’ surname. To ensure smooth enrolment in the trial, the study population will be divided in five batches. Employees at high risk for long-term sickness absence will be identified by the screening questionnaire Balansmeter. The study involves employees whose high risk for long-term sickness absence can be prompted by either somatic conditions or mental health complaints, or both.
Employees will be asked to provide informed consent and those scoring above the cutoff point of the Balansmeter will be randomised over the experimental group and the control condition.
Employees in the experimental group will receive early treatment. Early treatment involves an interview by the occupational physician, which may be followed either by further guidance by the occupational physician or by external referral/guidance. External referral may include psychotherapy, cognitive behavioural therapy or social work.

The control group receives care as usual, as provided by the occupational physician, if the employee asks for help. In case of sickness absence the control group will receive socio-medical counselling in accordance with the practice guidelines of the NVAB. Outcomes will be evaluated at 6 and 12 months after randomisation.