PhD ceremony Ms. I. Arends: Prevention of recurrent sickness absence in workers with common mental disorders

PhD ceremony: Ms. I. Arends, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Prevention of recurrent sickness absence in workers with common mental disorders

Promotor(s): prof. J.J.L. van der Klink, prof. U. Bültmann

Faculty: Medical Sciences

Workers who returned to work after sickness absence due to common mental disorders (CMDs) frequently experience recurrent sickness absence. Standard treatment by occupational physicians (OPs) in the Netherlands has limited attention for the prevention of recurrent sickness absence. For this reason, the “SHARP-at work” intervention was developed. This is a problem solving intervention, provided by OPs to workers who returned to work after sickness absence due to CMDs, to prevent recurrent sickness absence. The intervention was compared to care as usual by OPs. The results showed that the intervention was properly applied by the OPs. Furthermore, over a period of one year, the intervention reduced the risk of recurrent sickness absence with 60%. When recurrent sickness absence occurred, the mean time to a recurrent episode was 100 days longer for the participants treated with the intervention.

In an economic evaluation, the effects of the intervention were weighed against the costs, for example due to extra care by the OP. This evaluation showed that, although the intervention was effective, it was also more costly. Important to note is that this result was extremely influenced by one participant who had very high costs due to psychiatric hospitalisation with no relationship to the intervention. When this participant was not included in the results, the intervention was cost-effective. For decision making about the implementation of the intervention into practice, the costs, effects and applicability in a specific context need to be considered.