Table 2 General characteristics of included RCTs (n = 18)
Study | Country | n | Target Population | Intervention 1 | Intervention 2 | RTW Measure(s) | Secondary Outcome(s) | ||
|---|---|---|---|---|---|---|---|---|---|
Description | Provider(s) | Description | Provider | ||||||
Aasdahl, Pape [25] | Norway | 168 | Adults with musculoskeletal or mental health disorders, on 50–100% sick leave for 2–12 months | Outpatient group-based ACT in addition to 2 individual sessions to clarify personal values and work-related issues; homework assigned between sessions including daily 15-min mindfulness practice; group-based motivational discussion about benefits of physical training; concluding with an individual session to write a letter to GP | Physician, psychologist, social worker, physiotherapist | Inpatient multi-component intervention including group ACT, physical training, mindfulness, psychoeducation, problem solving, RTW plan creation | Mentors / coordinators, rehabilitation center staff | Number of sickness absence days and time until RTW (1 month without relapse) | None |
Andersen, Birgit [26] | Denmark | 141 | Adults with pain in back or upper body, mixed employment status, on sick leave for a maximum of 9-weeks | Health guidance dialogue about lifestyle, motivation, resources, power to act; opportunity to create health plan for improving daily wellbeing | Health supervisor | Health guidance + tailored physical activity: group fitness and strength training OR | Health supervisor, physiotherapists | RTW status | Pain; BMI; aerobic capacity; work ability; kinesiophobia |
Health guidance + chronic pain self-management including group-based problem solving, exercise, and psychoeducation | Health supervisor, trained non-health professional facilitators | ||||||||
Bitsch, Nielsen [27] | Denmark | 244 | Adults with ischemic heart disease or heart failure undergoing cardiac rehabilitation | Standard cardiac rehabilitation involving structured deductive teaching (pre-written slideshows) without rationale; education topics included lifestyle implications, emotional reactions, importance of social networks, importance of exercise, future life with chronic disease | Nurse, physiotherapist, experienced patients | Learning and coping (LC) education program in addition to standard cardiac rehabilitation; inductive learning with rationale; 2 individual clarifying interviews | Nurse, physiotherapist, experienced patients, LC trained health professionals | RTW status and relapse (RTW, but not at work 1 year later) | None |
Brendbekken, Eriksen [28] | Norway | 284 | Adults with musculoskeletal pain, on 50–100% sick leave for less than 12 months | Brief intervention focusing on education, reduction of fear and concern, helping patient stay active; opportunity for patient to express problems and worries; thorough medical and educational examination | Physician, physiotherapist | Multi-disciplinary comprehensive intervention involving multiple interviews and assessments, visual feedback tools | Social worker, physician, physiotherapist | Full-time RTW status | None |
De Weerd, Van Dijk [29] | Netherlands | 60 | Adults with common psychological disorders, employed and on part-time sick leave | Work-focused CBT focusing on activation, day structure, socialising, and self-worth within a work context | Provisional and registered psychologists | Work-focused CBT plus a 1.5 h convergence dialogue meeting between patient, employer, and psychologist discussing RTW | Provisional and registered psychologists, supervisor | Time until first and full RTW | Mental health |
Du Bois and Donceel [30] | Belgium | 506 | Adults with low back pain, employed and on sick leave | Rehabilitation-oriented coaching involving medical and psychosocial education, importance of activity, response rates, and encouragement based on resilience | Physician | CAU involving brief disability evaluation without medical advice | Unclear | RTW status; sick leave recurrence; sick leave duration | Subsequent surgery |
Finnes, Ghaderi [31] | Sweden | 352 | Adults with common psychological disorders, employed and on 25–100% sick leave for previous 1–12 months | ACT alone involving some work focus, psychoeducation about avoidance patterns, mindfulness, diffusion, self-compassion, value-driven behaviour, exposure exercises | Psychologists | WDI: three-steps, to facilitate dialogue between participant and workplace OR WDI + ACT OR TAU: saw medical doctors, psychologists, social workers, physical therapists, and nurses in the study period. | Supervisor, psychologists, medical doctors, social workers, physical therapists, and nurses | Number of sickness absence days | Work ability; general functioning; exhaustion; depression; anxiety |
Glasscock, Carstensen [32] | Denmark | 137 | Adults with work-related adjustment, stress or mild depression, employed and on sick leave for < 4 months | Individual work-focused CBT; psycho-education; establishing shared treatment goals; stress coping; cognitive restructuring; relapse prevention; workplace intervention involving meeting with employers with option of psychologist attendance | Psychologists | No-treatment control group | N/A | Lasting RTW (> 4 weeks) | Stress; general health |
Lytsy, Carlsson [33] | Sweden | 308 | Adult females with pain or mental illness, mixed employment status and about to reach maximum sick leave duration of 1 year | ACT focused on behavioural strategies to increase function and quality of life, rather than symptom reduction | Psychologists | Multidisciplinary assessments, creation of individualised rehabilitation plans, and weekly meetings to evaluate / synchronise plans and activities. ACT was an option where suggested by the team. OR “Usual care” by regular health contacts | Physician, psychologist, occupational therapist, social worker. | Insurance status; insurance days; working hours; work engagement | None |
Myhre, Marchand [34] | Norway | 405 | Adults with neck and back pain, employed and on sick leave for 1–12 months | Pain-related coaching: standard clinical examination; education about importance of activity; focus on reduction in fear-avoidance beliefs; self-care and coping | Physician, physiotherapist | Pain-related coaching plus appointments with caseworker focusing on RTW, opportunity for a meeting with employer | Physician, caseworker, physiotherapist | Lasting absence (5 weeks) of welfare benefits | None |
Nieuwenhuijsen, Antonius [35] | Netherlands | 96 | Adults with work-related chronic stress (neurasthenia), employed and on part- or full-time sick leave | RTW and mental health coaching focused on reducing burnout and improving wellbeing; problem-solving related to mental health; psycho-education; cognitive restructuring; acceptance and relaxation; employability; conflict and time management; fatigue and stress | Certified coach | RTW and mental health coaching plus light / electromagnetic field therapy OR RTW and mental health coaching plus placebo light / electromagnetic therapy | Certified coach | Percentage RTW | Emotional exhaustion; fatigue; quality of life; stress; cortisol |
Park, Esmail [36] | Canada | 728 | Adults with work-related musculoskeletal injuries, mixed employment status | Motivational interviewing focused on enhancing motivation, reducing ambivalence, eliciting reasons for change, discussing ability to change | Case managers, physicians, psychologist, occupational therapists, exercise therapists | CAU involving functional restoration – an interdisciplinary approach that focuses on improving physical and functional abilities, RTW planning, and individual counselling and educational workshops | Various stakeholders, occupational therapists, exercise therapists | RTW status | None |
Rolving, Nielsen [37] | Denmark | 90 | Adults with degenerative disc disease or spondylolisthesis receiving lumbar spinal fusion surgery, mixed employment status | Group-based and standardised preoperative CBT focusing on the relationship between thoughts and pain, cognitive restructuring, coping, pacing, RTW, ergonomics, surgery information, pleasant activity scheduling, problem-solving | Psychologist, occupational therapist, physiotherapist, social worker, spine surgeon, previous patient | CAU involving standard preoperative surgery-related information and postoperative physical rehabilitation | Operating surgeons, nurses, physiotherapists, occupational therapists | RTW status | Disability; fear avoidance; catastrophizing; pain |
Salomonsson, Santoft [38] | Sweden | 211 | Adults with common psychological disorders, on 50–100% sick leave for 1–6 months | Psychological disorder-focused treatment. CBT involving a protocol for the primary diagnosis (e.g., behavioural activation for depression, cognitive therapy for social phobia, exposure for obsessive-compulsive disorder) | Psychologists | RTW-focused CBT only OR Psychological disorder and RTW-focused CBT combined | Psychologists | Number of sick leave days | Psychological symptoms; work ability; quality of life; stress |
Salzwedel, Wegscheider [39] | Germany | 354 | Adults with recent acute cardiac event and negative RTW expectations, mixed employment status, unemployed for less than 1 year | Group-based social counselling and therapy focused on legal rights, occupational capacity and health behaviour, promoting social competency such as networking | Social workers | CAU involving cardiac rehabilitation and as-needed counselling | Social workers | RTW status | Quality of life |
Vlasveld, van der Feltz-Cornelis [40] | Netherlands | 126 | Adults with major depressive disorder, on sick leave for 1–3 months | Collaborative care involving structured problem-solving; self-help focused on cognitive restructuring, RTW, and healthy lifestyle; workplace intervention; possible prescription of anti-depressants | Occupational physician, psychiatrist | CAU involving contact with a range of health professionals and treatment for mental health problems in some cases | Occupational physician, GP, mental health professionals, social worker, medical specialist, paramedic, alternative healthcare, self-help group | Time until full RTW | Depression |
Volker, Zijlstra-Vlasveld [41] | Netherlands | 220 | Adults with common psychological disorder, on sick leave for 1–6 months | Web-based blended individually tailored eHealth including several of the following modules: 1) psycho-education, 2) CBT for RTW-related symptoms, 3) problem-solving, 4) pain and fatigue management and reactivation, 5) relapse prevention; consultations with occupational physician | Occupational physician | CAU involving access to various health professionals; regular consultations with occupational physician | Occupational physicians, general practitioner, mental health professional, social worker, self-help group | Time until first RTW; time until full RTW; number of sick leave days | Psychological symptoms |
Vonk Noordegraaf, Anema [42] | Netherlands | 215 | Adult females with hysterectomy and/or laparoscopic adnexal surgery, employed and on sick leave for less than 2 months | Web-based tailored eHealth including pre/post-operative instructions on RTW and daily activities; self-empowerment; communication with stakeholders; identification of recovery barriers; general information on the surgery; frequently asked questions; forum to communicate with other participants | None | Web-based control with generic information related to the surgery | Usual care given by gynaecologists, occupational physicians, and general practitioners | Time until full RTW | Quality of life; general recovery; pain |