Clinical trial NCT03250026: Cooperation for Primary Care Patients on Sick Leave for CMD: Care Manager and Workplace Intervention - CO-WORK-CARE
Official title: Cooperation for Patients With Common Mental Disorders: Care Manager Function at the Primary Care Centre and Intervention at the Workplace - CO-WORK-CARE
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Depressive Disorder
Anxiety Disorders
Keywords: primary care
convergence dialogue
sick leave
care manager
Lead sponsor: Göteborg University
Sponsor class: OTHER
Collaborators: name: Vastra Gotaland Region
First posted: 2017-08-15
Enrollment: 349
Sex: ALL
Minimum age (years): 18
Maximum age (years): 67
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Pragmatic randomised controlled trial; randomisation on primary care centre level
Primary purpose: TREATMENT

Brief summary: This study aims to evaluate whether a convergence dialogue during sick leave, between the employee and the employer, with the Primary Care Centre Rehab Coordinator as discussion leader, leads to reduced sick leave time compared to those individuals who only have contact with a Care Manager during the period of sick leave. The study will be performed as a randomised controlled trial with randomisation at the PCC level where intervention PCCs offers a convergence dialogue meeting with the work place representative during sick leave in addition to Care Manager contact.

Detailed description: In Sweden sick leave time and frequency are increasing. This is primarily in the area of common mental disorders (CMD), and CMD is now the most common single cause of sickness absence. Primary care is the area in which most individuals with mental illness seek care and also receive care. A Care Manager function at the primary care centre (PCC) where the Care Manager is responsible for the support and close contact with patients with CMD and act as the "spider in the web" and combine patient support with other measures, have been shown to have beneficial effects for depression course. In Region Västra Götaland an implementation of the Care Manager function at the PCC has been set out, and the function is now available in nearly 100 PCCs in the region. The present study aims to evaluate whether a convergence dialogue during sick leave, between the employee and the employer, with the PCCs Rehab Coordinator as discussion leader, leads to reduced sick leave time compared to those individuals who only have contact with the Care Manager during the period of sick leave. The study will be performed as pragmatic randomised controlled trial with randomisation at the PCC level. Around 20 PCCs with a Care Manager function for patients on sick-leave with CMD diagnosis will be recruited and randomized to intervention where patients in addition to a Care Manager contact (12 weeks) will have one convergence dialogue meeting with the work place representative during sick leave. Control PCCs will give Care Manager contact 12 weeks only.

Eligibility criteria: Inclusion Criteria:

Patients attending primary care centers with care manager function

* aged \>=18 to 67 years
* diagnosed with a new (\< 1 month) depression diagnose (F32, F33), anxiety syndrome (F41, F48) or stress related adjustment disorder (F43)
* on sick-leave \> 14 days

Exclusion Criteria:

* Bipolar disorder
* psychosis
* addiction
* other serious mental disorder
* suicidal ideation or earlier suicide attempt
* cognitive impairment or not speaking/understanding Swedish

Primary outcomes:
measure: Net and gross sick-leave days
timeFrame: 12 months
Secondary outcomes:
measure: Depressive symptoms
timeFrame: 6 and 12 months
measure: Anxiety symptoms
timeFrame: 6 and 12 months
measure: Quality-of-life questionnaire score
timeFrame: 6 and 12 months
measure: Work ability
timeFrame: 6 and 12 months
measure: Exhaustion
timeFrame: 6 and 12 months
Other outcomes:
Locations:
city: Göteborg
country: Sweden
facility: Department of Primary Health Care, Sahlgrenska Academy
state: Region Västra Götaland
Study officials:
affiliation: Göteborg University
name: Cecilia Björkelund, prof
role: PRINCIPAL_INVESTIGATOR
References:
citation: Petersson EL, Tornbom K, Hange D, Nejati S, Jerlock M, Wikberg C, Bjorkelund C, Svenningsson I. The experiences of care managers and rehabilitation coordinators of a primary care intervention to promote return to work for patients with common mental disorders: a qualitative study. BMC Fam Pract. 2020 Dec 18;21(1):272. doi: 10.1186/s12875-020-01348-x.
citation: Petersson EL, Tornbom K, Bjorkelund C, Jerlock M, Hange D, Udo C, Svenningsson I. Process evaluation of the CO-WORK-CARE model: Collaboration and a person-centred dialogue meeting for patients with common mental disorder in primary health care. Scand J Caring Sci. 2024 Sep;38(3):602-613. doi: 10.1111/scs.13268. Epub 2024 May 8.
citation: Saxvik A, Svenningsson I, Tornbom K, Petersson EL, Bjorkelund C, Gabartaite G, Hange D. GPs' experiences of a collaborative care model for patients with common mental disorders who need sick leave certification: a qualitative study. BJGP Open. 2022 Dec 20;6(4):BJGPO.2022.0042. doi: 10.3399/BJGPO.2022.0042. Print 2022 Dec.
citation: Saxvik A, Tornbom K, Petersson EL, Hange D, Nejati S, Bjorkelund C, Svenningsson I. Experiences of patients with common mental disorders concerning team-based primary care and a person-centered dialogue meeting: An intervention to promote return to work. PLoS One. 2022 Jul 8;17(7):e0271180. doi: 10.1371/journal.pone.0271180. eCollection 2022.
citation: Bjorkelund C, Petersson EL, Svenningsson I, Saxvik A, Wiegner L, Hensing G, Jonsdottir IH, Larsson M, Wikberg C, Ariai N, Nejati S, Hange D. Effects of adding early cooperation and a work-place dialogue meeting to primary care management for sick-listed patients with stress-related disorders: CO-WORK-CARE-Stress - a pragmatic cluster randomised controlled trial. Scand J Prim Health Care. 2024 Sep;42(3):378-392. doi: 10.1080/02813432.2024.2329212. Epub 2024 Mar 31.
citation: Bjorkelund C, Saxvik A, Svenningsson I, Petersson EL, Wiegner L, Larsson M, Tornbom K, Wikberg C, Ariai N, Nejati S, Hensing G, Hange D. Rehabilitation cooperation and person-centred dialogue meeting for patients sick-listed for common mental disorders: 12 months follow-up of sick leave days, symptoms of depression, anxiety, stress and work ability - a pragmatic cluster randomised controlled trial from the CO-WORK-CARE project. BMJ Open. 2023 Jun 9;13(6):e074137. doi: 10.1136/bmjopen-2023-074137.
citation: Svenningsson I, Bjorkelund C, Hange D, Wiegner L, Ariai N, Petersson EL. Symptom patterns in patients newly sick listed for common mental disorders and associations with work-related and socioeconomic factors: a cross-sectional study in Swedish primary care. BMJ Open. 2022 Jul 8;12(7):e054250. doi: 10.1136/bmjopen-2021-054250.