Use of a mental health guideline by occupational physicians and associations with return to work in workers sick-listed due to common mental disorders: a retrospective cohort study |
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| Authors: | Karlijn M van Beurden Margot C W Joosen Berend Terluin Jaap van Weeghel Jac J L van der Klink |
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| Institution: | 1. Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands;2. Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands;3. Board of Directors, Phrenos Centre of Expertise, Utrecht, The Netherlands;4. Parnassia Group, Dijk en Duin Mental Health Center, Castricum, The Netherlands;5. Netherlands School of Public &6. Occupational Health, Utrecht, The Netherlands |
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| Abstract: | AbstractPurpose: The aim of this study was to evaluate (1) whether adherence to the Dutch occupational mental health guideline by occupational physicians was associated with time to return to work in workers sick-listed due to common mental disorders; and (2) whether adherence to specific guideline items was associated with time to return to work.Methods: Twelve performance indicators were developed to assess occupational physicians’ guideline adherence. Medical records of 114 sick-listed workers were audited. Performance indicators were scored as indicating no (0), minimal (1) or adequate adherence (2). Cox regression analysis was used to assess the association between guideline adherence and first or full return to work.Results: Guideline adherence was predominantly minimal on most performance indicators. This low overall adherence was not associated with first return to work (Hazard Ratio 1.07, p?=?0.747) or with full return to work (Hazard Ratio 1.25, p?=?0.301). Only one performance indicator (regular contact between occupational physician and employer) was significantly associated with earlier full return to work (Hazard Ratio 1.87, p?=?0.021).Conclusions: Overall, the guideline adherence of occupational physicians was not related to earlier return to work. However, there was considerable room for improvement in guideline use. Whether this leads to earlier return to work is still an ununanswered question.- Implications for Rehabilitation
Adherence of occupational physicians to an evidence-based occupational mental health guideline was low. Regular contact between occupational physician and employer was associated with earlier full return to work in workers with common mental disorders. It is important to focus on how implementation problems and barriers for guideline use can be overcome, in order to improve the quality of occupational mental health care and to potentially reduce sickness absence duration in workers with common mental disorders.
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| Keywords: | Guideline adherence mental health problems occupational health care practice guideline sickness absence duration |
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