AB1612-HPR SICK LEAVE FOR MUSCULOSKELETAL DISORDERS: ATTITUDES OF PRESCRIBING PHYSICIANS
Authors: S. Bouzid, D. Ben Nessib, H. Ferjani, F. Majdoub, L. Kharrat, D. Kaffel, K. Maatallah, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Musculoskeletal disorders are the most common cause of severe long-term pain and physical disability, leading to frequent prescriptions of paid sick leave. Sick leaves are an important public health problem with both social and economic consequences [1]. <h3>Objectives:</h3> Our study aimed to describe the attitude of doctors dealing with musculoskeletal disorders when prescribing sick leaves. <h3>Methods:</h3> We conducted a cross-sectional study including rheumatologists, orthopedists, and physiatrists. They were asked to respond to an anonymous online questionnaire designed to determine the reasons and types of disorders motivating the prescription of sick leave. <h3>Results:</h3> The 47 participants were rheumatologists (70%), physiatrists (17%), and orthopedists (13%). Ninety-five percent of the respondents were working in hospitals. The average number of years in practice (including training years) was 3.74 ± 1.59 years [1-7]. On average, forty participants (83%) reported prescribing less than five sick leaves per week. Three prescribed between five and 10 sick leaves per week. Only two participants prescribed more than 10 sick leaves per week. The average duration of sick leaves prescribed was less than seven days in 72% of cases (n=34), between seven and 15 days in 17% (n=8), between 15 and 21 days in 6% (n=3), and more than 21 days in 4% (n=2). As for why sick leaves were prescribed, pain caused by the illness was the main reason according to 87% of participants (n=41), followed by the nature of the patient's work according to 64% (n=30). The patient's request for a sick leave motivated the prescription according to 21% of participants (n=10). The psychological impact of the disorder motivated sick leave prescriptions in 15% of cases (n=7). The disorders requiring a sick leave were a rheumatoid arthritis flare-up according to 94% of practitioners (n=44), acute lumbociatalgia according to 91% (n=43), a congestive osteoarthritis flare-up according to 70% (n=33), and ankylosing spondylitis according to 57% (n=27). When a patient requested sick leave that was not indicated, 51% of participants ignored the request (n=24), 62% referred the patient to occupational medicine (n=29), and 13% of them prescribed sick leave anyway, but for a shorter duration (n=6). <h3>Conclusion:</h3> The results of this questionnaire highlight the disparities and differences in the attitudes of physicians toward sick leave prescriptions. The prescription and the duration of a sick leave should be based on objective criteria previously established and shared between practitioners, to reduce the subjectivity of these decisions. <h3>REFERENCES:</h3> [1] Hubertsson J, Englund M, Hallgårde U, Lidwall U, Löfvendahl S, Petersson IF. Sick leave patterns in common musculoskeletal disorders--a study of doctor prescribed sick leave. BMC Musculoskelet Disord. 2014 May 24;15:176. doi: 10.1186/1471-2474-15-176. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>