Expert@Work - Effectiveness of a Digital Expert Team on Return to Work

Study Overview
=================
Brief Summary
-----------------
Long-term sick leave is a challenge in Norway, and the healthcare and labor- and welfare services are often not coordinated in helping the sick-listed employees return to work. In this study, the investigators want to evaluate the effectiveness of an intervention where an expert team provides advice for an individualized patient pathway based on information from a digital questionnaire and a video meeting with the sick-listed employee and the participant's general practitioner. The patient pathway should include both healthcare and labor- and welfare services measures. Sick-listed patients with musculoskeletal- and/or common mental disorders are invited to join the study. They will receive a digital questionnaire and be randomized to either treatment as usual or personalized advice from an expert team. The team will be put together based on the response from the individual's questionnaire. The investigators will evaluate the effect on return to work and the use of health care services 12 months after the intervention.

Official Title
-----------------
Expert@Work - Effectiveness of a Digital Expert Team on Return to Work

Conditions
-----------------
Musculoskeletal Diseases, Mental Disorder

Intervention / Treatment
-----------------
* Procedure: Digital expert team


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Sick-listed minimum 50% between 11 and 20 weeks Musculoskeletal disorder and/or common mental disorder Living in the county of Trøndelag or Møre- og Romsdal Exclusion Criteria: Specific conditions such as fracture, trauma, infections, malignancy, dislocations, etc. Serious mental conditions or another serious disease that makes participation difficult Most likely to return to work within 2 weeks Not speaking/reading Norwegian

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Sick-listed employees with musculoskeletal disorders and/or common mental disorders will receive an invitation to the study from the labor-and welfare administration. Individuals who consent to participate will be allocated to either treatment as usual or personalized advice from an expert-team.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Digital expert team<br>The participants allocated to this arm will receive personalized advice from an expert team. The participants will have one video meeting with the team and receive a written report. | Procedure: Digital expert team<br>* A digital team will be appointed based on the participant's answers in the digital screening questionnaire. Members of the team can be specialists in Physical and rehabilitation medicine, psychologist, physiotherapist, social workers, and consultants in the labor- and welfare administration. The general practitioner will also be invited to the meeting.<br>|
| No Intervention: Treatment as usual<br>The participants will answer a digital questionnaire and will get normal follow-up from his/her general practitioner and labor- and welfare administration (NAV). | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Return to work | Time to return to work within 12 months for at least 4 consecutive weeks | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Function | Approvement in function measured by Versus Arthritis Musculoskeletal Health Questionnaire (MSK-HQ). The MSK-HQ is scored on a range of 0-56, with a better score indicating better MSK-HQ health status | 12 months | 
| Change in pain | Change in pain measured on a numeric rating scale (0-10), with a higher score indicating more pain | 12 months | 
| Change in depression symptoms | Improvement in depression symptoms measured by Patient Health Questionnaire-9 (PHQ-9). PHQ-9 is scored on a range of 0-27, with higher score indicating more serious symptoms | 12 months | 
| Change in anxiety symptoms | Improvement in anxiety symptoms measured by Generalized Anxiety Disorder 7-item (GAD-7). GAD-7 is scored on a range of 0-21, with higher score indicating more serious symptoms | 12 months | 
| Days lost from work | Lost workdays during one year after intervention | 12 months |