AB1219 EFFECTS OF A WORKPLACE-CENTERED COUNSELING OF INDIVIDUALS WITH MUSCULOSKELETAL COMPLAINTS: A PROSPECTIVE COHORT STUDY
Authors: Harald Leiss, Miriam Hucke, Veronika Machold-Fabrizii, Josef S. Smolen, Klaus Machold
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Employed people with musculoskeletal complaints often seek medical advice when symptoms are chronic and lead to loss of workability. <h3>Objectives:</h3> A brief examination was offered in the workplace setting to detect and to counsel individuals with symptoms of Rheumatic and musculoskeletal diseases(RMDs). <h3>Methods:</h3> Employees received a questionnaire regarding musculoskeletal problems. In case of a positive screening, consultation by RMD specialists was offered. If necessary, participants were referred to a clinic specialized in RMDs. Employees' work was categorized into physically-highly-demanding(HD) and less-demanding(LD). Following 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. Follow-up information about data mentioned above 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) compared to women with both LD (p=0.034) and HD (p=0.001). LD and HD differed significantly regarding percentage with painful upper (p=0.006) and lower (p=0.016) limbs. Back pain was distributed equally among all groups. HD women reported significantly higher use of NSAIDs (p=0.001). 235 individuals participated in telephone follow-up. There was significant improvement in wellbeing(p=0.006) and in rating of RMD pain (p=0.001). Participants who were suspected to suffer from RMDs had significantly increased out of pocket costs after one year (p=0.026). Use of NSAIDs decreased significantly from 29.1 to 17.4% (p=0.02). Rates of use of physiotherapy (p=0.001), gymnastics (p=0.001), physical therapy (p=0.027) and complementary/alternative methods (p=0.003) were significantly increased. <h3>Conclusion:</h3> We found most physical/psychological problems related to RMDs in HD-working women. After one year, participants reported improved quality of life, reduction of RMD pain, higher utilization of medical services and of gymnastics, less use of NSAIDs, and, if suspected to suffer from RMDs, higher out of pocket costs. Thus, this workplace-centered intervention appears to have beneficial effects on both subjective well-being and physical/physiological health. <h3>Disclosure of Interests::</h3> Harald Leiss Consultant for: Lilly, MSD, Miriam Hucke Grant/research support from: Abbvie, Veronika Machold-Fabrizii: None declared, Josef S. Smolen Grant/research support from: AbbVie, Eli Lilly, Janssen, MSD, Pfizer, Roche, Consultant for: AbbVie, Amgen, Astra-Zeneca, Astro, Celgene Corporation, Celtrion, Eli Lilly, Glaxo, ILTOO, Janssen, MedImmune, MSD, Novartis, Pfizer, Roche, Samsun, Sanofi, UDB, Speakers bureau: AbbVie, Amgen, Astra-Zeneca, Astro, Celgene Corporation, Celtrion, Eli Lilly, Glaxo, ILTOO, Janssen, MedImmune, MSD, Novartis, Pfizer, Roche, Samsun, Sanofi, UDB, Klaus Machold Grant/research support from: Abbvie