Return to Work Among Patients With Stress Related Mental Disorders - An Intervention in the Swedish Primary Care

Study Overview
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Brief Summary
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The aim of this project is to develop a model for return to work (RTW) for patients sick listed due to stress related mental disorders, which takes into account each patient's specific situation; includes the workplace, and is well adapted to the Swedish primary care setting. In late 2016, general practitioners (GPs) and rehabilitation coordinators at both public and private primary care centers will be offered a one-day training about work and workability for patients with stress related mental disorders. Also, the participants will be trained in a specific method that includes the patient's employer early in the rehabilitation process The project has a quasi-experimental and longitudinal design. The intervention will be conducted on 15 different primary care centers, which will be matched with a comparison group. Return to work for 500 patients will be analyzed using registry data, 6, 12 and 18 months after sick-listing. The hypothesis is that patients who are sick-listed at primary care centers that completely or partially implemented the specific method on average will return earlier to work than patients sick-listed at primary care centers that did not implement the method. Alongside studying if the intervention has an effect on the patients' RTW over time, the investigators aim to investigate the mechanisms explaining the effects and the individual and organizational level (primary care units) circumstances necessary for these mechanisms to be triggered. To gain deeper knowledge about mechanisms and context, the investigators will conduct interviews with the treatment staff and collect registry data about the primary care units.

Official Title
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Return to Work Among Patients With Stress Related Mental Disorders - An Intervention in the Swedish Primary Care (PRIMA)

Conditions
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Stress, Psychological, Burnout, Professional, Adjustment Disorders

Intervention / Treatment
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* Behavioral: Work-related measures


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of International Classification of Diseases (ICD)10 F43 Has an employment Good command in spoken and written Swedish Exclusion Criteria: Participants must not have been on long term sick-leave (>60 days) during the last three years, regardless of causative diagnosis.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Work-related measures<br>One-day training for GP:s and rehabilitation coordinators A treatment protocol which includes contact with the patient's employer Clinical support from the Institute of Stress Medicine | Behavioral: Work-related measures<br>* After mapping the patient's psychosocial work situation using tools provided at the one-day training, the patient's employer will be contacted and involved in the rehabilitation planning.<br>|
| No Intervention: Treatment as usual<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Following sick leave data from the Swedish Social Insurance Agency's records we will measure time taken to return to work (RTW) among patients in the intervention group vs. time taken to RTW among patients in the control group. |  | Three measurement time points. First measurement will occur 6 months from baseline. | 
| Following sick leave data from the Swedish Social Insurance Agency's records we will measure time taken to return to work (RTW) among patients in the intervention group vs. time taken to RTW among patients in the control group. |  | Second measurement time point will occur at 12 months from baseline. | 
| Following sick leave data from the Swedish Social Insurance Agency's records we will measure time taken to return to work (RTW) among patients in the intervention group vs. time taken to RTW among patients in the control group. |  | Third measurement time point will occur at 18 months from baseline. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exhaustion Disorder