Effects of Acceptance and Commitment Therapy in Primary Health Care

Study Overview
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Brief Summary
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How does education of health personnel with Acceptance and Commitment Therapy affect the extent of medical certificates of sick leave and drug prescriptions in primary health care centers in Kalmar compared with similar centers in Jönköping in which the personnel do not get such therapy?

Detailed Description
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Five primary health care centers in the County Council of Jönköping who do not get education according to Acceptance and Commitment Therapy (ACT) serve as controls. Six primary health care centers in County Council of Kalmar, with the same total number of listed patients (about 45 000 in total per County Council) in their areas undergo group education according to ACT. Data on medical certificates of sick leave and drug prescriptions are taken from registries (this is routine in primary health care in Sweden) at baseline and after 6, 12 and 24 months in both regions. The personnel at both centers also fill out questionnaires about their own quality of life at baseline and after 12 months. The investigators also plan to interview about 20 subjects on these matters.

Official Title
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How Does Education of Health Personnel With Acceptance and Commitment Therapy Affect the Extent of Medical Certificates of Sick Leave and Drug Prescriptions?

Conditions
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Medical Certificates for Sick Leave and Drug Prescriptions

Intervention / Treatment
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* Behavioral: Education with Acceptance and Commitment Therapy
* Other: Control, no intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: over 18 years of age working at the health care center Exclusion Criteria: age less than 18 years do not work at the Health care center

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Prospective non-randomized trial with one interventional group and a parallel group without intervention
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ACT in County Council of Kalmar<br>Group education with ACT in six primary health care centers in County Council of Kalmar | Behavioral: Education with Acceptance and Commitment Therapy<br>* Group education with Acceptance and Commitment Therapy of the personnel at each center.<br>|
| Placebo Comparator: Control health care centers of County Council of Jönköping<br>Five primary health care centers of County Council of Jönköping that do not get education. | Other: Control, no intervention<br>* Control, no interventions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Extent of medical certificates of sick leave by the doctors | Data on entire extent of medical certificates, i.e. how many sick days that were certified by all doctors at the primary health care centers, for all patients treated, during the time period. | 24 months in total | 
| Prescription of drugs by the doctors | Data on all prescription of all different drugs, during the time period, made by all the doctors at the primary Health care centers that participate, to all patients that were treated. | 24 months in total | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of how the education with ACT affect the personnel according to SF36 | Questionnaire SF36 is filled out by the personnel at baseline and after 12 months | 12 months | 
| Assessment of how the education with ACT affect the personnel according to KEDS | Questionnaire Karolinska Exhaustion Disorder Scale (KEDS) is filled out by the personnel at baseline and after 12 months | 12 months | 
| Assessment of how the education with ACT affect the personnel according to WAI | Questionnaire Work ability Index (WAI) is filled out by the personnel at baseline and after 12 months | 12 months |