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Interventions for enhancing return to work in individuals with a common mental illness: systematic review and meta-analysis of randomized controlled trials

Published online by Cambridge University Press:  09 September 2016

Y. T. Nigatu ,
Y. Liu ,
M. Uppal ,
S. McKinney ,
S. Rao ,
K. Gillis  and
J. Wang
Y. T. Nigatu*
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada
Y. Liu
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada
M. Uppal
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada
S. McKinney
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada
S. Rao
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ontario, Canada
K. Gillis
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ontario, Canada
J. Wang
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
*
*Address for correspondence: Dr Y. T. Nigatu, Department of Psychiatry, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, Canada. (Email: yeshambel.nigatu1@ucalgary.ca)
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Abstract

Common mental disorders (CMDs) are highly prevalent in the working population, and are associated with long-term sickness absence and disability. Workers on sick leave with CMDs would benefit from interventions that enable them to successfully return to work (RTW). However, the effectiveness of RTW interventions for workers with a CMD is not well studied. The objective of this review is to assess the effectiveness of existing workplace and clinical interventions that were aimed at enhancing RTW. A systematic review of studies of interventions for improving RTW in workers with a CMD was conducted. The main outcomes were proportion of RTW and sick-leave duration until RTW. Randomized controlled trials (RCTs) were identified from Medline/PubMed, PsycINFO, EMBASE, SocINDEX, and Human resource and management databases from January 1995 to 2016. Two authors independently selected studies, assessed risk of bias and extracted data. We pooled studies that we deemed sufficiently homogeneous in different comparison groups and assessed the overall quality of the evidence. We reviewed 2347 abstracts from which 136 full-text articles were reviewed and 16 RCTs were included in the analysis. Combined results from these studies suggested that the available interventions did not lead to improved RTW rates over the control group [pooled risk ratio 1.05, 95% confidence interval (CI) 0.97–1.12], but reduced the number of sick-leave days in the intervention group compared to the control group, with a mean difference of −13.38 days (95% CI −24.07 to −2.69).

Keywords

Clinical trialinterventionmental illnessmeta-analysisreturn to work
Type
Review Article
Information
Psychological Medicine , Volume 46 , Issue 16 , December 2016 , pp. 3263 - 3274
Copyright
Copyright © Cambridge University Press 2016 

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