Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders: the MI-NAV randomised controlled trial. Issue 1 (25th November 2022)

• Record Type: Journal Article
• Authors: Aanesen, Fiona; Grotle, Margreth; Rysstad, Tarjei Langseth; Tveter, Anne Therese; Tingulstad, Alexander; Løchting, Ida; Småstuen, Milada C; van Tulder, Maurits W; Berg, Rigmor; Foster, Nadine E; Wynne-Jones, Gwenllian; Sowden, Gail; Fors, Egil; Bagøien, Gunnhild; Hagen, Roger; Storheim, Kjersti; Øiestad, Britt Elin
• Is Part Of: Occupational and environmental medicine. Volume 80:Issue 1(2023)
• Page Start: 42
• Page End: 50
• Publication Date: 2022-11-25
• Subjects: Occupational Health -- Rehabilitation -- Sick Leave -- Musculoskeletal System; Medicine, Industrial -- Periodicals; Environmental health -- Periodicals; 616.980305
• DOI: 10.1136/oemed-2022-108637
• Languages: English
• ISSNs: 1351-0711

Abstract

Abstract : Objectives: To evaluate if adding motivational interviewing (MI) or a stratified vocational advice intervention (SVAI) to usual case management (UC), reduced sickness absence over 6 months for workers on sick leave due to musculoskeletal disorders. Methods: We conducted a three-arm parallel pragmatic randomised controlled trial including 514 employed workers (57% women, median age 49 (range 24–66)), on sick leave for at least 50% of their contracted work hours for ≥7 weeks. All participants received UC. In addition, those randomised to UC+MI were offered two MI sessions from social insurance caseworkers and those randomised to UC+SVAI were offered vocational advice from physiotherapists (participants with low/medium-risk for long-term sickness absence were offered one to two sessions, and those with high-risk were offered three to four sessions). Results: Median sickness absence was 62 days, (95% CI 52 to 71) in the UC arm (n=171), 56 days (95% CI 43 to 70) in the UC+MI arm (n=169) and 49 days (95% CI 38 to 60) in the UC+SVAI arm (n=169). After adjusting for predefined potential confounding factors, the results showed seven fewer days in the UC+MI arm (95% CI −15 to 2) and the UC+SVAI arm (95% CI −16 to 1), compared with the UC arm. The adjusted differences were not statistically significant. Conclusions: The MI-NAV trial did not show effect on return to work of adding MI or SVAI to UC. The reduction in sickness absence over 6 months was smaller than anticipated, and uncertain due to wide CIs. Trial registration number: NCT03871712 .