AB1245 Effects of a workplace-centred counselling of individuals with musculoskeletal complaints: a prospective cohort study
Authors: H. Leiss, M. Hucke, M. Bécède, J. Smolen, K. Machold
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Actively employed people with musculoskeletal complaints frequently seek medical advice only when symptoms have become chronic and have led to loss of workability. <h3>Objectives</h3> In this study,a brief examination was offered in the workplace setting in order to detect and to counsel individuals with symptoms of Rheumatic and musculoskeletal diseases(RMDs). <h3>Methods</h3> Employees of four companies were sent a screening questionnaire regarding musculoskeletal problems. In case of a positive screening, consultation by RMD specialists was offered which took place close to the workplace. If necessary, participants were referred to a practice/clinic specialised in RMDs (Orthopaedics, Rheumatology, Physical Medicine). Employees' work was categorised into physically highly demanding(HD) and less demanding(LD). From participants consenting to follow-up, additional data were acquired: demographics, known pre-existing RMD, pain intensity, affected region(s), current treatment, number of sick leave-days due to musculoskeletal complaints, and out of pocket costs for treatments during the preceding year. General wellbeing and depression were measured by Euroquol-5d(EQ-5d) and Hospital Anxiety and Depression Scale(HADS). After one year, information about general wellbeing, pain intensity, treatment, individual costs, and days of sick leave during the intervening year was collected by telephone-interview. <h3>Results</h3> 6170 employees were invited.413 participated in the counselling program, 344 were enrolled in the study.56.6% of the participants had no previously diagnosed RMD, after the specialists' assessment, this percentage decreased to 35.7%. Men with LD workload had significantly higher wellbeing(EQ-5d scale):77.3±15.1 compared to women with both LD(71.0±20.1,p=0.034) and HD(64.6±21.3,p=0.001).LD and HD differed significantly regarding percentage with painful upper(28.6 vs. 45.3,p=0.006) and lower(49.6 vs. 65.3,p=0.016) limbs. Back pain was distributed equally among all groups.HD women reported significantly higher use of NSAIDs (55.1% vs. 27.7% in female LD,21.7% in male HD,23.5% in male LD,p=0.001).HD men showed the lowest (4.1±2.9), HD women showed the highest HADS anxiety-score (6.3±3.8,p=0.042). 235 individuals participated in telephone follow-up. There was significant improvement in wellbeing(mean 77.2±17.4 vs. 73.6±18.2 at baseline,p=0.006) and in rating of RMD pain(mean 27.8±24.9 vs. 40.8±24.6 at baseline,p=0.001). Participants who were suspected by the specialist to suffer from RMDs had significantly increased out of pocket costs after one year(mean in € 441.8±861.6 vs. 254.1±407.0,p=0.026). Use of NSAIDs decreased significantly from 29.1% to 17.4%,p=0.02. Converesely, rates of use of physiotherapy(7.6 vs. 24.7, p=0.001), gymnastics(2.7 vs. 23.4,p=0.001), physical therapy(12.8 vs. 43.3,p=0.027) and complementary/alternative methods(7.4 vs. 13.2,p=0.003) were significantly increased. <h3>Conclusions</h3> In our study we found most physical and psychological problems related to RMDs in HD working women. After one year, participants reported improved quality of life, reduction of RMD pain, higher utilisation of medical services and of gymnastics, less use of NSAIDs, and, if suspected to suffer from RMDs, higher out of pocket costs. Thus, this brief workplace-centred intervention appears to have had beneficial effects on both subjective well-being and on objective parameters suggesting improvements in physical/physiological health. <h3>Disclosure of Interest</h3> None declared