Clinical trial NCT03996798: Disability Case Manager: Full Member of the Revalidation Team
Official title: Disability Case Manager: Full Member of the Revalidation Team
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Vocational Rehabilitation
Keywords: vocational rehabilitation
back-to-work
social participation
disability case manager
Lead sponsor: PXL University College
Sponsor class: OTHER
Collaborators: name: Jessa Hospital
name: Revalidatie & MS Centrum Overpelt
name: RIZIV
First posted: 2019-06-25
Enrollment: 80
Sex: ALL
Minimum age (years): 18
Maximum age (years): 62
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: The first 4-6 months after an incident which caused a handicap or chronic disease, it is important to involve and motivate patients to return to work. After this period, there is a major decrease on successful vocational reintegration. To facilitate vocational rehabilitation a Disability Case Manager (DCM) may play a major role. The DCM will act as key figure between the patient, the multidisciplinary team of the revalidation centre, the employers and other back-to-work services. There is need to provide evidence on the value of this program. The aim of this study is to test the added value of including a DCM in the classic revalidation trajectory, who will focus on early vocational and/or social rehabilitation.

Detailed description: 12.5% of the population is confronted with a handicap or chronic disease which complicates quality of life, including the professional activities. 58% of this group is unemployed or inactive. The first 4-6 months after an incident which caused a handicap or chronic disease, it is important to involve and motivate patients to return to work. After this period, there is a major decrease on successful vocational reintegration. After 1-year unemployment, vocational reintegration decreases to 20%, which means an early intervention is recommended.

The classic rehabilitation trajectory is for the greater part directed at regaining patient's independence concerning daily activities, housing conditions, hobbies and its family. Revalidation is not (or only in the end) focused on back to work.

The revalidation centre Sint-Ursula, Jessa Hospital, Hasselt developed an interdisciplinary methodology 'Back-To-Work', which included an early focus on vocational and/or social rehabilitation using a 'Disability Case Manager (DCM)'. The DCM act as key figure between the patient, the multidisciplinary team of the revalidation centre, the employers and other back-to-work services to facilitate return to work.

The program is initiated by an interdisciplinary screening at time of hospitalisation. Together with the patient, there can be chosen for two revalidation pathways: 1/ focus on vocational rehabilitation; or 2/ focus on social participation. The labour pathway includes the matching of the persons characteristics and capacity with the requirements of the job, followed by a task-oriented vocational training; the social participation pathway consists of guidance to alternative daytime activities combined with psychological support in coping and acceptance. The combination of these components with the focus on vocational rehabilitation and social participation is new in rehabilitation services.

Previous research, testing the involvement of a DCM, showed empirically better results, with more patients going back to work or choosing an alternative job. Even when back to work was eventually not possible, those patients reported a better quality of life.

This project aims at a scientifically validation of the 'Back-To-Work' methodology and the role of DCM. Patients with complex neuro-locomotoric conditions and amputations, aged between 18-62 years, will be asked to participate in a controlled, longitudinal study, receiving either a revalidation therapy including the experimental 'Back-to-work' methodology (Jessa hospital, campus Sint-Ursula) or a standard revalidation therapy (Revalidation \& MS Clinic Overpelt, control group). At the start of rehabilitation, at the end of rehabilitation and 6 months after rehabilitation, data for qualitative and quantitative analysis is gathered.

Eligibility criteria: Inclusion Criteria:

* Complex neuro-motoric conditions
* Age between 18-62 year
* Working
* Persons belonging to the National Institute for Health and Disability Insurance (NIHDI) target group

Exclusion Criteria:

* Comatose patients
* Retired patients
* Students
* Persons who not belong to the NIHDI target group

Primary outcomes:
measure: Change in Quality of Life: Short Form 36 questionnaire
timeFrame: pre (at moment of inclusion), post (at the end of the revalidation period, on average after 6 months) and follow-up (6 months after revalidation)
measure: Change in mental functioning: depressive feelings, anxiety and stress
timeFrame: pre (at moment of inclusion), post (at the end of the revalidation period, on average after 6 months) and follow-up (6 months after revalidation)
measure: Change in functional status
timeFrame: pre (at moment of inclusion), post (at the end of the revalidation period, on average after 6 months) and follow-up (6 months after revalidation)
measure: Change in participation
timeFrame: pre (at moment of inclusion), post (at the end of the revalidation period, on average after 6 months) and follow-up (6 months after revalidation)
measure: Change in work status (questionnaire)
timeFrame: pre (at moment of inclusion), post (at the end of the revalidation period, on average after 6 months) and follow-up (6 months after revalidation)
Secondary outcomes:
measure: Change in coping
timeFrame: pre (at moment of inclusion), post (at the end of the revalidation period, on average after 6 months) and follow-up (6 months after revalidation)
measure: Change in self-effectiveness
timeFrame: pre (at moment of inclusion), post (at the end of the revalidation period, on average after 6 months) and follow-up (6 months after revalidation)
measure: Expectations concerning back-to-work
timeFrame: pre (at moment of inclusion)
measure: Change in satisfaction with revalidation traject
timeFrame: post (at the end of the revalidation period, on average after 6 months) and follow-up (6 months after revalidation)
measure: Change in expectations concerning back-to-work
timeFrame: pre (at moment of inclusion), post (at the end of the revalidation period, on average after 6 months) and follow-up (6 months after revalidation)
measure: Satisfaction with revalidation traject and back-to-work focus: Semi-structured interview
timeFrame: follow-up (6 months after revalidation)
Other outcomes:
Locations:
city: Hasselt
country: Belgium
facility: Jessa Hospital, Campus Sint-Ursula
state: Limburg
city: Overpelt
country: Belgium
facility: Revalidation & MS Clinic Overpelt
state: Limburg
Study officials:
affiliation: PXL University College
name: Annemie Spooren, PhD
role: PRINCIPAL_INVESTIGATOR
References: