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Factors affecting return to work after injury or illness: best evidence synthesis of systematic reviews

View Article: PubMed Central - PubMed

ABSTRACT

Background: Work disability is a major personal, financial and public health burden. Predicting future work success is a major focus of research.

Objectives: To identify common prognostic factors for return-to-work across different health and injury conditions and to describe their association with return-to-work outcomes.

Methods: Medline, Embase, PsychINFO, Cinahl, and Cochrane Database of Systematic Reviews and the grey literature were searched from January 1, 2004 to September 1, 2013. Systematic reviews addressing return-to-work in various conditions and injuries were selected. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria to identify low risk of bias reviews.

Results: Of the 36,193 titles screened and the 94 eligible studies reviewed, 56 systematic reviews were accepted as low risk of bias. Over half of these focused on musculoskeletal disorders, which were primarily spine related (e.g., neck and low back pain). The other half of studies assessed workers with mental health or cardiovascular conditions, stroke, cancer, multiple sclerosis or other non-specified health conditions. Many factors have been assessed, but few consistently across conditions. Common factors associated with positive return-to-work outcomes were higher education and socioeconomic status, higher self-efficacy and optimistic expectations for recovery and return-to-work, lower severity of the injury/illness, return-to-work coordination, and multidisciplinary interventions that include the workplace and stakeholders. Common factors associated with negative return-to-work outcomes were older age, being female, higher pain or disability, depression, higher physical work demands, previous sick leave and unemployment, and activity limitations.

Conclusions: Expectations of recovery and return-to-work, pain and disability levels, depression, workplace factors, and access to multidisciplinary resources are important modifiable factors in progressing return-to-work across health and injury conditions. Employers, healthcare providers and other stakeholders can use this information to facilitate return-to-work for injured/ill workers regardless of the specific injury or illness. Future studies should investigate novel interventions, and other factors that may be common across health conditions.

No MeSH data available.


Flow chart of literature search
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Related In: Results  -  Collection

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Fig1: Flow chart of literature search

Mentions: A total of 36,468 records were identified in the electronic database search and 28,696 records were identified from the grey literature (Fig. 1). After duplicates were removed 36,193 titles remained. After applying the inclusion and exclusion criteria to titles and abstracts, 36,060 records were excluded and 133 full-text articles were assessed for eligibility. Of these, 94 articles were eligible and critically reviewed and 38 were deemed inadmissible due to having a high risk of bias. We deemed the majority of these reviews inadmissible primarily because they did not assess the quality of primary studies and synthesize the results according to study quality. Thus, our findings are based on the synthesis of 56 systematic reviews.Fig. 1


Factors affecting return to work after injury or illness: best evidence synthesis of systematic reviews
Flow chart of literature search
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5015229&req=5

Fig1: Flow chart of literature search
Mentions: A total of 36,468 records were identified in the electronic database search and 28,696 records were identified from the grey literature (Fig. 1). After duplicates were removed 36,193 titles remained. After applying the inclusion and exclusion criteria to titles and abstracts, 36,060 records were excluded and 133 full-text articles were assessed for eligibility. Of these, 94 articles were eligible and critically reviewed and 38 were deemed inadmissible due to having a high risk of bias. We deemed the majority of these reviews inadmissible primarily because they did not assess the quality of primary studies and synthesize the results according to study quality. Thus, our findings are based on the synthesis of 56 systematic reviews.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Work disability is a major personal, financial and public health burden. Predicting future work success is a major focus of research.

Objectives: To identify common prognostic factors for return-to-work across different health and injury conditions and to describe their association with return-to-work outcomes.

Methods: Medline, Embase, PsychINFO, Cinahl, and Cochrane Database of Systematic Reviews and the grey literature were searched from January 1, 2004 to September 1, 2013. Systematic reviews addressing return-to-work in various conditions and injuries were selected. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria to identify low risk of bias reviews.

Results: Of the 36,193 titles screened and the 94 eligible studies reviewed, 56 systematic reviews were accepted as low risk of bias. Over half of these focused on musculoskeletal disorders, which were primarily spine related (e.g., neck and low back pain). The other half of studies assessed workers with mental health or cardiovascular conditions, stroke, cancer, multiple sclerosis or other non-specified health conditions. Many factors have been assessed, but few consistently across conditions. Common factors associated with positive return-to-work outcomes were higher education and socioeconomic status, higher self-efficacy and optimistic expectations for recovery and return-to-work, lower severity of the injury/illness, return-to-work coordination, and multidisciplinary interventions that include the workplace and stakeholders. Common factors associated with negative return-to-work outcomes were older age, being female, higher pain or disability, depression, higher physical work demands, previous sick leave and unemployment, and activity limitations.

Conclusions: Expectations of recovery and return-to-work, pain and disability levels, depression, workplace factors, and access to multidisciplinary resources are important modifiable factors in progressing return-to-work across health and injury conditions. Employers, healthcare providers and other stakeholders can use this information to facilitate return-to-work for injured/ill workers regardless of the specific injury or illness. Future studies should investigate novel interventions, and other factors that may be common across health conditions.

No MeSH data available.