Return To Work for People on Long Term Sick Leave
Condition: Anxiety; Chronic Pain
MeSH terms: Chronic Pain
Study type: Interventional

Summary: 
      Vitalis was a randomized controlled intervention study that addressed women on long-term sick
      leave in Uppsala County. Participants were on sick leave due to mental illness and/or pain
      and were expected to reach the time limit within the in health insurance. Of the total of 947
      eligible reaching the time limit during 2010-2012 648 persons met the projects inclusion- and
      exclusion criteria and were invited to participate. Of these, 327 persons (50.4%) gave
      informed consent and was thereafter randomly assigned one of the following groups: 1)
      multimodal treatment team (TEAM) 2) psychotherapy with Acceptance and Commitment Therapy
      (ACT), or 3) control group. The main purpose of the study was to facilitate the return to
      work (preventing a return to the public health insurance) and to improve participants' health
      during the project period of one year.
    

Detailed description: 
      Vitalis was a randomized controlled intervention study that addressed women on long-term sick
      leave in Uppsala County. Participants were on sick leave due to mental illness and/or pain
      and were expected to reach the time limit within the in health insurance. Of the total of 947
      eligible reaching the time limit during 2010-2012 648 persons met the projects inclusion- and
      exclusion criteria and were invited to participate. Of these, 327 persons (50.4%) gave
      informed consent and was thereafter randomly assigned one of the following groups: 1)
      multimodal treatment team (TEAM) 2) psychotherapy with Acceptance and Commitment Therapy
      (ACT), or 3) control group. The main purpose of the study was to facilitate the return to
      work (preventing a return to the public health insurance) and to improve participants' health
      during the project period of one year.

      The participants of the TEAM group received individual meetings/assessments with a doctor,
      psychologist, occupational therapist and social worker, each assessing the participant's
      problems in relation to the return to work goal. The TEAM then worked out an individualized
      plan of actions/treatments, which then was presented to the participant. Suggested and
      accepted actions were psychotherapy (60%, average 9.2 sessions); Occupational Therapist (72%,
      average 3.7 sessions); social worker (36%, average 6.5 sessions) and further medical
      investigations/referrals initiated by physicians (41%).

      In the ACT group all participants received psychotherapy with ACT with an average of 10.0
      sessions (range 1-23) during the project year.

      In addition to the medical assessment/treatments all participants in the intervention groups
      also participated in scheduled collaboration meetings with representatives from the health
      insurance agency and employment office in order to establish an agreement and justification
      on the rehabilitation goals. The participant and a health professional from the project
      participated in these collaborations meetings.

      During the project year the participants filled in questionnaire at three points in time in
      which they rated their views on returning to work as well as various aspects of their health.
      Data whether the participants had returned to the health insurance as well as the number of
      reimbursed days during the first years, was collected from the health insurance register
      after one year.
    

Intervention name(s): Cognitive therapy
Intervention type(s): Behavioral
Other intervention name(s): ACT, multidisciplinary assessment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Anxiety; Chronic Pain