Risk Assessment for Prolonged Sickness Absence Due to Musculoskeletal Conditions
- Conditions
- Musculoskeletal Pain Disorder
- Interventions
- Other: Risk assessment
- Registration Number
- NCT04196634
- Lead Sponsor
- Oslo Metropolitan University
- Brief Summary
Musculoskeletal (MSK) conditions are a leading cause of years lived with disability worldwide and for the last decade they have also been the most common cause of sickness absence and disability pension in Norway.
Although most sickness absence is short-termed, a small proportion of people with MSK conditions are on long-term sick leave, contributing to large cost due to disbursement of benefits, productivity loss and extensive use of health care. There is growing evidence that long-term sickness absence is harmful to mental and physical health, with a reduced probability of return to work (RtW) with prolonged sickness absence. Thus, focusing on early RtW in people on sick leave due to MSK conditions is important to reduce the burden on both the individual and the society. However, to provide interventions to reduce the duration of sickness absence to all people on sick leave would require enormous resources. By targeting those at risk of long-term sickness absence, resources may be used differently, e.g. more resource-saving. By using information on modifiable risk factors from simple risk assessment tools, health care providers and other stakeholders may facilitate RtW in a better way.
The overall purposes of this project are 1) to identify the most accurate screening tool to identify people at a high risk of prolonged sickness absence due to a MSK condition, and 2) to investigate severity of MSK health, health-related quality-of-life, health care consumption, and costs across different risk profiles in people on sick leave due to MSK conditions. We will use registered data on sickness absence from 1 year before to 1 year after inclusion in the study.
- Detailed Description
Main aims are:
* To compare the predictive ability of the STarT MSK tool and the ÖMPSQ-SF, and other established risk factors for long-term sickness absence (e.g. symptoms of depression and emotional distress, low motivation for returning to work, low self-efficacy, work expectancies) for identifying prolonged sickness absence at 6- and 12-months follow-up due to MSK conditions
* To develop a prognostic model to predict risk of prolonged sickness absence at 12-month follow-up in people with MSK conditions
* To assess predictors for high costs (productivity loss and health care use) at 6- and 12-months follow-up in people on sick leave due to MSK conditions
The study will also include additional methodological and descriptive aims.
Prior to the data collection we translated and culturally adapted the Keele STarT MSK and MSK-HQ following the Beaton guidelines.
The study is conducted within the Norwegian Welfare and Labor Administration (NAV) system in collaboration with OsloMet - Oslo Metropolitan University. Data on sickness absence from the NAV registry will be retrieved prospectively in the period from study inclusion to 12 months follow-up, and retrospectively 12 months prior to inclusion in the study.
Previous studies show that 30-40% of people with MSK conditions have not RtW after 3 to 12 months. In order to conduct analyses including 15- 20 predictor variables, we aim at including 500-600 people on sick leave due to MSK conditions. As the main outcomes are collected through registries, we do not expect any dropouts.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 560
- People older than 18 years on sick leave due to musculoskeletal pain for at least 4 weeks
- People on sick leave for other pain conditions or diseases
- People not able to read or write Norwegian or English
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description People on sick leave Risk assessment People on sick leave due to musculoskeletal conditions for at least 4 weeks.
- Primary Outcome Measures
Name Time Method Sickness absence days 12 months Total number of absence days during 12 months of follow-up adjusted for percentage of work and percentage of sickness absence. Register data from the national health and welfare services
Time to sustainable return to work 12 months The time until full sustainable return to work, i.e. at least 4 weeks without relapse during 12 months of follow-up. Register data from the national health and welfare services
Probability of return to work 12 months Probability of working (i.e. not receiving medical benefits) each month during 12 months of follow-up, measured as repeated events. Register data from the national health and welfare services
Sickness absence costs 12 months Sickness absence costs will be calculated based on data from the NAV registry
Proportion who have returned to work 12 months Proportion of people with sustainable return to work (at least 4 weeks) at 12 months. Register data from the national health and welfare services
Health care costs 12 months Use of health care will be collected from public registries including Norwegian Patient Registry (NPR), Municipal Patient and User Registry (KPR) and Control and Payment of Health Refunds (KUHR).
- Secondary Outcome Measures
Name Time Method Sickness absence costs 6 months Sickness absence costs will be calculated based on data from the NAV registry
Institute of Medical Technology Assessment (iMTA) Productivity Cost Questionnaire (iPCQ) Baseline and 4 weeks Measure and value health-related productivity loss for both paid and unpaid work. The instrument is found to be suitable for measuring absenteeism from paid work and productivity loss related to unpaid labor. Nine questions related to paid work and three questions related to unpaid work.
Probability of return to work 6 months Probability of working (i.e. not receiving medical benefits) each month during 6 months of follow-up, measured as repeated events. Register data from the national health and welfare services
Sickness absence days 6 months Total number of absence days during 6 months of follow-up adjusted for percentage of work and percentage of sickness absence. Register data from the national health and welfare services
Proportion who have returned to work 6 months Proportion of people with sustainable return to work (at least 4 weeks) at 6 months. Register data from the national health and welfare services
Musculoskeletal Health Questionnaire (MSK-HQ) Baseline and 4 weeks 14 questions scored on a 0-4-point scale, summed up to a 0 to 56 points score, with higher score indicating better musculoskeletal health.
Health care costs 6 months Use of health care will be collected from public registries including Norwegian Patient Registry (NPR), Municipal Patient and User Registry (KPR) and Control and Payment of Health Refunds (KUHR).
EuroQol 5 Dimensions (EQ5D-5L) Baseline and 4 weeks The EQ5D-5L covers five domains: mobility, self-care, activities of daily living, pain/discomfort, and anxiety/depression, scored on a 5-point scale from 0 (worst imaginable health) to 5 (best imaginable health). Responses can be transformed into an index ranging from -0.59 to 1, where -0.59 represents worst possible state and 1 represents perfect health. The EQ5D Visual Analogue Scale (VAS) is also included, which is a question asking about the respondent's self-rated health on a vertical 0 to 100 visual analog scale, with 100 being best health.
Time to sustainable return to work 6 months The time until full sustainable return to work, i.e. at least 4 weeks without relapse during 6 months of follow-up. Register data from the national health and welfare services
Trial Locations
- Locations (1)
Oslo Metropolitan University
🇳🇴Oslo, Norway