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Regina Kunz - One of the best experts on this subject based on the ideXlab platform.
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Return to Work coordination programmes for improving Return to Work in Workers on sick leave
Cochrane Database of Systematic Reviews, 2017Co-Authors: Nicole Vogel, Stefan Schandelmaier, Thomas Zumbrunn, Shanil Ebrahim, Wout El De Boer, Jason W Busse, Regina KunzAbstract:Background to limit long-term sick leave and associated consequences, insurers, healthcare providers and employers provide programmes to facilitate disabled people's Return to Work. These programmes include a variety of coordinated and individualised interventions. Despite the increasing popularity of such programmes, their benefits remain uncertain. We conducted a systematic review to determine the long-term effectiveness of Return-to-Work coordination programmes compared to usual practice in Workers at risk for long-term disability. Objectives to assess the effects of Return-to-Work coordination programmes versus usual practice for Workers on sick leave or disability. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11), MEDLINE, Embase, CINAHL and PsycINFO up to 1 November 2016. Selection criteria We included randomised controlled trials (RCTs) that enrolled Workers absent from Work for at least four weeks and randomly assigned them to Return-to-Work coordination programmes or usual practice. Data collection and analysis Two review authors independently screened titles, abstracts and full-text articles for study eligibility; extracted data; and assessed risk of bias from eligible trials. We contacted authors for additional data where required. We conducted random-effects meta-analyses and used the GRADE approach to rate the quality of the evidence. Main results We identified 14 studies from nine countries that enrolled 12,568 Workers. Eleven studies focused on musculoskeletal problems, two on mental health and one on both. Most studies (11 of 14) followed Workers 12 months or longer. Risk of bias was low in 10 and high in 4 studies, but findings were not sensitive to their exclusion. We found no benefits for Return-to-Work coordination programmes on Return-to-Work outcomes. For short-term follow-up of six months, we found no effect on time to Return to Work (hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.93 to 1.88, low-quality evidence), cumulative sickness absence (mean difference (MD) −16.18 Work days per year, 95% CI −32.42 to 0.06, moderate-quality evidence), the proportion of participants at Work at end of the follow-up (risk ratio (RR) 1.06, 95% CI 0.86 to 1.30, low-quality evidence) or on the proportion of participants who had ever Returned to Work, that is, regardless of whether they had remained at Work until last follow-up (RR 0.87, 95% CI 0.63 to 1.19, very low-quality evidence). For long-term follow-up of 12 months, we found no effect on time to Return to Work (HR 1.25, 95% CI 0.95 to 1.66, low-quality evidence), cumulative sickness absence (MD −14.84 Work days per year, 95% CI −38.56 to 8.88, low-quality evidence), the proportion of participants at Work at end of the follow-up (RR 1.06, 95% CI 0.99 to 1.15, low-quality evidence) or on the proportion of participants who had ever Returned to Work (RR 1.03, 95% CI 0.97 to 1.09, moderate-quality evidence). For very long-term follow-up of longer than 12 months, we found no effect on time to Return to Work (HR 0.93, 95% CI 0.74 to 1.17, low-quality evidence), cumulative sickness absence (MD 7.00 Work days per year, 95% CI −15.17 to 29.17, moderate-quality evidence), the proportion of participants at Work at end of the follow-up (RR 0.94, 95% CI 0.82 to 1.07, low-quality evidence) or on the proportion of participants who had ever Returned to Work (RR 0.95, 95% CI 0.88 to 1.02, low-quality evidence). We found only small benefits for Return-to-Work coordination programmes on patient-reported outcomes. All differences were below the minimal clinically important difference (MID). Authors' conclusions Offering Return-to-Work coordination programmes for Workers on sick leave for at least four weeks results in no benefits when compared to usual practice. We found no significant differences for the outcomes time to Return to Work, cumulative sickness absence, the proportion of participants at Work at end of the follow-up or the proportion of participants who had ever Returned to Work at short-term, long-term or very long-term follow-up. For patient-reported outcomes, we found only marginal effects below the MID. The quality of the evidence ranged from very low to moderate across all outcomes.
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The Cochrane Library - Return to Work coordination programmes for improving Return to Work in Workers on sick leave
The Cochrane database of systematic reviews, 2017Co-Authors: Nicole Vogel, Stefan Schandelmaier, Thomas Zumbrunn, Shanil Ebrahim, Wout El De Boer, Jason W Busse, Regina KunzAbstract:Background to limit long-term sick leave and associated consequences, insurers, healthcare providers and employers provide programmes to facilitate disabled people's Return to Work. These programmes include a variety of coordinated and individualised interventions. Despite the increasing popularity of such programmes, their benefits remain uncertain. We conducted a systematic review to determine the long-term effectiveness of Return-to-Work coordination programmes compared to usual practice in Workers at risk for long-term disability. Objectives to assess the effects of Return-to-Work coordination programmes versus usual practice for Workers on sick leave or disability. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11), MEDLINE, Embase, CINAHL and PsycINFO up to 1 November 2016. Selection criteria We included randomised controlled trials (RCTs) that enrolled Workers absent from Work for at least four weeks and randomly assigned them to Return-to-Work coordination programmes or usual practice. Data collection and analysis Two review authors independently screened titles, abstracts and full-text articles for study eligibility; extracted data; and assessed risk of bias from eligible trials. We contacted authors for additional data where required. We conducted random-effects meta-analyses and used the GRADE approach to rate the quality of the evidence. Main results We identified 14 studies from nine countries that enrolled 12,568 Workers. Eleven studies focused on musculoskeletal problems, two on mental health and one on both. Most studies (11 of 14) followed Workers 12 months or longer. Risk of bias was low in 10 and high in 4 studies, but findings were not sensitive to their exclusion. We found no benefits for Return-to-Work coordination programmes on Return-to-Work outcomes. For short-term follow-up of six months, we found no effect on time to Return to Work (hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.93 to 1.88, low-quality evidence), cumulative sickness absence (mean difference (MD) −16.18 Work days per year, 95% CI −32.42 to 0.06, moderate-quality evidence), the proportion of participants at Work at end of the follow-up (risk ratio (RR) 1.06, 95% CI 0.86 to 1.30, low-quality evidence) or on the proportion of participants who had ever Returned to Work, that is, regardless of whether they had remained at Work until last follow-up (RR 0.87, 95% CI 0.63 to 1.19, very low-quality evidence). For long-term follow-up of 12 months, we found no effect on time to Return to Work (HR 1.25, 95% CI 0.95 to 1.66, low-quality evidence), cumulative sickness absence (MD −14.84 Work days per year, 95% CI −38.56 to 8.88, low-quality evidence), the proportion of participants at Work at end of the follow-up (RR 1.06, 95% CI 0.99 to 1.15, low-quality evidence) or on the proportion of participants who had ever Returned to Work (RR 1.03, 95% CI 0.97 to 1.09, moderate-quality evidence). For very long-term follow-up of longer than 12 months, we found no effect on time to Return to Work (HR 0.93, 95% CI 0.74 to 1.17, low-quality evidence), cumulative sickness absence (MD 7.00 Work days per year, 95% CI −15.17 to 29.17, moderate-quality evidence), the proportion of participants at Work at end of the follow-up (RR 0.94, 95% CI 0.82 to 1.07, low-quality evidence) or on the proportion of participants who had ever Returned to Work (RR 0.95, 95% CI 0.88 to 1.02, low-quality evidence). We found only small benefits for Return-to-Work coordination programmes on patient-reported outcomes. All differences were below the minimal clinically important difference (MID). Authors' conclusions Offering Return-to-Work coordination programmes for Workers on sick leave for at least four weeks results in no benefits when compared to usual practice. We found no significant differences for the outcomes time to Return to Work, cumulative sickness absence, the proportion of participants at Work at end of the follow-up or the proportion of participants who had ever Returned to Work at short-term, long-term or very long-term follow-up. For patient-reported outcomes, we found only marginal effects below the MID. The quality of the evidence ranged from very low to moderate across all outcomes.
Jane M. Armer - One of the best experts on this subject based on the ideXlab platform.
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Return to Work among breast cancer survivors: A literature review
Supportive Care in Cancer, 2017Co-Authors: Yuanlu Sun, Cheryl L. Shigaki, Jane M. ArmerAbstract:Purpose Breast cancer survivors in their employment years are likely to try to go back to Work after the primary treatment. Because the literature on Return to Work among breast cancer survivors is limited, we have undertaken a review of the literature to summarize what is known, including identifying important contributing variables and outcomes. This knowledge may be used to develop hypotheses and potential interventions to support breast cancer survivors who wish to Return to Work. Method We searched the following databases: CINAHL, MEDLINE, SCOUP, and PUBMED, within a 10-year timeframe (2004 to 2014). Results The majority of reviewed articles ( N = 25) focused on three outcomes: Return-to-Work period, Work ability, and Work performance. The most frequently studied independent variables were collapsed into the following groups: health and well-being, symptoms and functioning, Work demands and Work environment, individual characteristics, and societal and cultural factors. Gaps in the literature include evidence of effective interventions to support Return to Work among breast cancer survivors and research to better understand the roles of government and business-related policy. Conclusion All the studies reported a reduced Work engagement and Work ability. Employment status and Work performance is associated with a combination of individual factors, Work environment, culture, and resources. Implications Significant gaps are apparent in the literature addressing breast cancer survivorship and Return to Work. This is a complex problem and it will likely require interdisciplinary research teams to develop effective and feasible interventions for this population.
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Return to Work among breast cancer survivors a literature review
Supportive Care in Cancer, 2017Co-Authors: Yuanlu Sun, Cheryl L. Shigaki, Jane M. ArmerAbstract:Purpose Breast cancer survivors in their employment years are likely to try to go back to Work after the primary treatment. Because the literature on Return to Work among breast cancer survivors is limited, we have undertaken a review of the literature to summarize what is known, including identifying important contributing variables and outcomes. This knowledge may be used to develop hypotheses and potential interventions to support breast cancer survivors who wish to Return to Work.
Jos Verbeek - One of the best experts on this subject based on the ideXlab platform.
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Return to Work interventions integrated into cancer care a systematic review
Occupational and Environmental Medicine, 2010Co-Authors: Sietske J Tamminga, A G E M De Boer, Jos Verbeek, M H W FringsdresenAbstract:Objectives The purpose of this study was to review the literature on the content of interventions focusing on Return to Work, employment status, or Work retention in patients with cancer. Furthermore, the effect of the interventions on Return to Work was assessed in studies reporting Return to Work. Methods A literature search was conducted using the databases MEDLINE, PsycINFO, EMBASE and CINAHL. Articles that described a Work-directed intervention focusing on Return to Work, employment status, or Work retention in patients with cancer were included. The content of the Work-directed part of the interventions was assessed based on two criteria for content analysis: 1. does the setting fit the shared care model of cancer survivor care? 2. Does the intervention target Work ability and physical Workload? For studies reporting Return-toWork outcomes, the Return-to-Work rates were assessed. For studies that used a control group the ORs and the 95% CIs were calculated. Results Twenty-three articles describing 19 interventions met the inclusion criteria. Seven studies reported Return-to-Work outcomes of which four used a control group. Only three interventions aimed primarily at enhancing Return to Work or employment status. The most frequently reported Work-directed components were encouragement, education or advice about Work or Work-related subjects (68%), vocational or occupational training (21%), or Work accommodations (11%). One intervention fit the shared care model of cancer survivor care and five interventions enhanced Work ability or decreased physical Workload. The rate of Return to Work ranged from 37% to 89%. In one of the four controlled studies the intervention increased Return to Work significantly and in the other studies the results were insignificant. Conclusions Only few interventions are primarily aimed at enhancing Return to Work in patients with cancer and most do not fit the shared care model involving integrated cancer care. Future studies should be developed with well-structured Work-directed components that should be evaluated in randomised controlled trials.
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Work ability and Return to Work in cancer patients
British Journal of Cancer, 2008Co-Authors: A G E M De Boer, Jos Verbeek, Evelien Spelten, A L J Uitterhoeve, A C Ansink, T M De Reijke, M Kammeijer, Mirjam A G SprangersAbstract:The extent to which self-assessed Work ability collected during treatment can predict Return-to-Work in cancer patients is unknown. In this prospective study, we consecutively included employed cancer patients who underwent treatment with curative intent at 6 months following the first day of sick leave. Work ability data (scores 0–10), clinical and sociodemographic data were collected at 6 months, while Return-to-Work was measured at 6, 12 and 18 months. Most of the 195 patients had been diagnosed with breast cancer (26%), cancer of the female genitals (22%) or genitourological cancer (22%). Mean current Work ability scores improved significantly over time from 4.6 at 6 months to 6.3 and 6.7 at 12 and 18 months, respectively. Patients with haematological cancers and those who received chemotherapy showed the lowest Work ability scores, while patients with cancer of urogenital tract or with gastrointestinal cancer had the highest scores. Work ability at 6 months strongly predicted Return-to-Work at 18 months, after correction for the influence of age and treatment (hazard ratio=1.37, CI 1.27–1.48). We conclude that self-assessed Work ability is an important factor in the Return-to-Work process of cancer patients independent of age and clinical factors.
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factors reported to influence the Return to Work of cancer survivors a literature review
Psycho-oncology, 2002Co-Authors: Evelien Spelten, Mirjam A G Sprangers, Jos VerbeekAbstract:An overview is provided of research into the Return to Work of cancer survivors, examining both the rate of Return to Work and factors impacting this Return. A series of literature searches was conducted on MEDLINE and PSYCLIT databases for the years 1985-1999. Studies had to focus on the patient's perspective and had to include either the percentage of Return to Work or factors associated with Return to Work. Case studies and studies of cancer as an occupational disease were excluded. The search identified 14 studies. The mean rate of Return to Work was 62% (range 30-93%). The following factors were negatively associated with Return to Work: a non-supportive Work environment, manual labour, and having head and neck cancer. Sociodemographic characteristics were not associated with Return to Work. For increasing age, associations were mixed. The increased survival rate of cancer patients warrants attention to the problems survivors may encounter upon their Return to Work. More systematic research is needed to establish more clearly the relative importance of factors associated with Return to Work of cancer survivors, which, in turn, would contribute to an increase in the labour-participation of cancer survivors.
Ellen Maceachen - One of the best experts on this subject based on the ideXlab platform.
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The Importance of Workplace Social Relations in the Return to Work Process: A Missing Piece in the Return to Work Puzzle?
Handbooks in Health Work and Disability, 2016Co-Authors: Åsa Tjulin, Ellen MaceachenAbstract:The chapter elaborates how Workplace social relations influence practice in the Return to Work process. The social conditions in which the Return to Work process is embedded, and the way social interaction and relations between the sick-listed Worker and other Workplace actors (supervisor and coWorkers) evolve, have only been researched to a limited extent. In this book chapter, we will discuss critical new dimensions of social relations research in the field of Return to Work that can “make” or “break” a Workplace Return to Work process. These critical new dimensions highlight the importance of viewing Return to Work as a dynamic process over time, where supervisors and coWorkers display shifting roles depending on phases of the process. The chapter conveys new dimensions of social relations, acknowledging the positive contribution of coWorker efforts in the process, which may have an important impact on Workplace-based Return to Work interventions.
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The social interaction of Return to Work explored from co-Workers experiences.
Disability and rehabilitation, 2011Co-Authors: Åsa Tjulin, Ellen Maceachen, Elinor Edvardsson Stiwne, Kerstin EkbergAbstract:Purpose.The objective was to explore the role and contribution of co-Workers in the Return-to-Work process. The social interaction of co-Workers in the Return-to-Work process are analysed within th ...
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exploring Workplace actors experiences of the social organization of Return to Work
Journal of Occupational Rehabilitation, 2010Co-Authors: Åsa Tjulin, Ellen Maceachen, Kerstin EkbergAbstract:Introduction There is a limited body of research on how the actual social exchange among Workplace actors influences the practice of Return-to-Work. The objective of this study was to explore how Workplace actors experience social relations at the Workplace and how organizational dynamics in Workplace-based Return-to-Work extends before and beyond the initial Return of the sick listed Worker to the Workplace. Method An exploratory qualitative method approach was used, consisting of individual open-ended interviews with 33 Workplace actors at seven Worksites that had re-entering Workers. The Workplace actors represented in these interviews include: re-entering Workers, supervisors, co-Workers, and human resource managers. Results The analysis identified three distinct phases in the Return to Work process: while the Worker is off Work, when the Worker Returns back to Work, and once back at Work during the phase of sustainability of Work ability. The two prominent themes that emerged across these phases include the theme of invisibility in relation to Return-to-Work effort and uncertainty, particularly, about how and when to enact Return-to-Work. Conclusion The findings strengthen the notion that Workplace-based Return-to-Work interventions need to take social relations amongst Workplace actors into account. They also highlight the importance and relevance of the varied roles of different Workplace actors during two relatively unseen or grey areas, of Return-to-Work: the pre-Return and the post-Return sustainability phase. Attention to the invisibility of Return-to-Work efforts of some actors and uncertainty about how and when to enact Return-to-Work between Workplace actors can promote successful and sustainable Work ability for the re-entering Worker.
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systematic review of the qualitative literature on Return to Work after injury
Scandinavian Journal of Work Environment & Health, 2006Co-Authors: Ellen Maceachen, Renée-louise Franche, Judy Clarke, Emma IrvinAbstract:Objectives This paper reports on a systematic review of the international qualitative research literature on Return to Work. This review was undertaken in order to better understand the dimensions, processes, and practices of Return to Work. Because Return to Work often includes early Return before full recovery while a person is undergoing rehabilitation treatment, physical recovery is embedded in complicated ways with Workplace processes and practices and social organization. These process-oriented dimensions of Return to Work are well described in the qualitative literature. Methods This systematic review of the literature covered peer-reviewed papers that focused on musculoskeletal and pain-related injuries and were published in English or French between 1990 and 2003. Findings from papers meeting relevance and quality criteria were synthesized using the meta-ethnographic approach. Results This review found that Return to Work extends beyond concerns about managing physical function to the complexities related to beliefs, roles, and perceptions of many players. Good will and trust are overarching conditions that are central to successful Return-to-Work arrangements. In addition, there are often social and communication barriers to Return to Work, and intermediary players have the potential to play a key role in facilitating this process. Conclusions This paper identifies key mechanisms of Workplace practice, process, and environment that can affect the success of Return to Work. The findings illustrate the contribution that qualitative literature can make to important aspects of implementation in relation to Return to Work. Key terms meta-ethnographic approach; occupational health; social relations; synthesis; Work organization.
Nicole Vogel - One of the best experts on this subject based on the ideXlab platform.
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Return to Work coordination programmes for improving Return to Work in Workers on sick leave
Cochrane Database of Systematic Reviews, 2017Co-Authors: Nicole Vogel, Stefan Schandelmaier, Thomas Zumbrunn, Shanil Ebrahim, Wout El De Boer, Jason W Busse, Regina KunzAbstract:Background to limit long-term sick leave and associated consequences, insurers, healthcare providers and employers provide programmes to facilitate disabled people's Return to Work. These programmes include a variety of coordinated and individualised interventions. Despite the increasing popularity of such programmes, their benefits remain uncertain. We conducted a systematic review to determine the long-term effectiveness of Return-to-Work coordination programmes compared to usual practice in Workers at risk for long-term disability. Objectives to assess the effects of Return-to-Work coordination programmes versus usual practice for Workers on sick leave or disability. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11), MEDLINE, Embase, CINAHL and PsycINFO up to 1 November 2016. Selection criteria We included randomised controlled trials (RCTs) that enrolled Workers absent from Work for at least four weeks and randomly assigned them to Return-to-Work coordination programmes or usual practice. Data collection and analysis Two review authors independently screened titles, abstracts and full-text articles for study eligibility; extracted data; and assessed risk of bias from eligible trials. We contacted authors for additional data where required. We conducted random-effects meta-analyses and used the GRADE approach to rate the quality of the evidence. Main results We identified 14 studies from nine countries that enrolled 12,568 Workers. Eleven studies focused on musculoskeletal problems, two on mental health and one on both. Most studies (11 of 14) followed Workers 12 months or longer. Risk of bias was low in 10 and high in 4 studies, but findings were not sensitive to their exclusion. We found no benefits for Return-to-Work coordination programmes on Return-to-Work outcomes. For short-term follow-up of six months, we found no effect on time to Return to Work (hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.93 to 1.88, low-quality evidence), cumulative sickness absence (mean difference (MD) −16.18 Work days per year, 95% CI −32.42 to 0.06, moderate-quality evidence), the proportion of participants at Work at end of the follow-up (risk ratio (RR) 1.06, 95% CI 0.86 to 1.30, low-quality evidence) or on the proportion of participants who had ever Returned to Work, that is, regardless of whether they had remained at Work until last follow-up (RR 0.87, 95% CI 0.63 to 1.19, very low-quality evidence). For long-term follow-up of 12 months, we found no effect on time to Return to Work (HR 1.25, 95% CI 0.95 to 1.66, low-quality evidence), cumulative sickness absence (MD −14.84 Work days per year, 95% CI −38.56 to 8.88, low-quality evidence), the proportion of participants at Work at end of the follow-up (RR 1.06, 95% CI 0.99 to 1.15, low-quality evidence) or on the proportion of participants who had ever Returned to Work (RR 1.03, 95% CI 0.97 to 1.09, moderate-quality evidence). For very long-term follow-up of longer than 12 months, we found no effect on time to Return to Work (HR 0.93, 95% CI 0.74 to 1.17, low-quality evidence), cumulative sickness absence (MD 7.00 Work days per year, 95% CI −15.17 to 29.17, moderate-quality evidence), the proportion of participants at Work at end of the follow-up (RR 0.94, 95% CI 0.82 to 1.07, low-quality evidence) or on the proportion of participants who had ever Returned to Work (RR 0.95, 95% CI 0.88 to 1.02, low-quality evidence). We found only small benefits for Return-to-Work coordination programmes on patient-reported outcomes. All differences were below the minimal clinically important difference (MID). Authors' conclusions Offering Return-to-Work coordination programmes for Workers on sick leave for at least four weeks results in no benefits when compared to usual practice. We found no significant differences for the outcomes time to Return to Work, cumulative sickness absence, the proportion of participants at Work at end of the follow-up or the proportion of participants who had ever Returned to Work at short-term, long-term or very long-term follow-up. For patient-reported outcomes, we found only marginal effects below the MID. The quality of the evidence ranged from very low to moderate across all outcomes.
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The Cochrane Library - Return to Work coordination programmes for improving Return to Work in Workers on sick leave
The Cochrane database of systematic reviews, 2017Co-Authors: Nicole Vogel, Stefan Schandelmaier, Thomas Zumbrunn, Shanil Ebrahim, Wout El De Boer, Jason W Busse, Regina KunzAbstract:Background to limit long-term sick leave and associated consequences, insurers, healthcare providers and employers provide programmes to facilitate disabled people's Return to Work. These programmes include a variety of coordinated and individualised interventions. Despite the increasing popularity of such programmes, their benefits remain uncertain. We conducted a systematic review to determine the long-term effectiveness of Return-to-Work coordination programmes compared to usual practice in Workers at risk for long-term disability. Objectives to assess the effects of Return-to-Work coordination programmes versus usual practice for Workers on sick leave or disability. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11), MEDLINE, Embase, CINAHL and PsycINFO up to 1 November 2016. Selection criteria We included randomised controlled trials (RCTs) that enrolled Workers absent from Work for at least four weeks and randomly assigned them to Return-to-Work coordination programmes or usual practice. Data collection and analysis Two review authors independently screened titles, abstracts and full-text articles for study eligibility; extracted data; and assessed risk of bias from eligible trials. We contacted authors for additional data where required. We conducted random-effects meta-analyses and used the GRADE approach to rate the quality of the evidence. Main results We identified 14 studies from nine countries that enrolled 12,568 Workers. Eleven studies focused on musculoskeletal problems, two on mental health and one on both. Most studies (11 of 14) followed Workers 12 months or longer. Risk of bias was low in 10 and high in 4 studies, but findings were not sensitive to their exclusion. We found no benefits for Return-to-Work coordination programmes on Return-to-Work outcomes. For short-term follow-up of six months, we found no effect on time to Return to Work (hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.93 to 1.88, low-quality evidence), cumulative sickness absence (mean difference (MD) −16.18 Work days per year, 95% CI −32.42 to 0.06, moderate-quality evidence), the proportion of participants at Work at end of the follow-up (risk ratio (RR) 1.06, 95% CI 0.86 to 1.30, low-quality evidence) or on the proportion of participants who had ever Returned to Work, that is, regardless of whether they had remained at Work until last follow-up (RR 0.87, 95% CI 0.63 to 1.19, very low-quality evidence). For long-term follow-up of 12 months, we found no effect on time to Return to Work (HR 1.25, 95% CI 0.95 to 1.66, low-quality evidence), cumulative sickness absence (MD −14.84 Work days per year, 95% CI −38.56 to 8.88, low-quality evidence), the proportion of participants at Work at end of the follow-up (RR 1.06, 95% CI 0.99 to 1.15, low-quality evidence) or on the proportion of participants who had ever Returned to Work (RR 1.03, 95% CI 0.97 to 1.09, moderate-quality evidence). For very long-term follow-up of longer than 12 months, we found no effect on time to Return to Work (HR 0.93, 95% CI 0.74 to 1.17, low-quality evidence), cumulative sickness absence (MD 7.00 Work days per year, 95% CI −15.17 to 29.17, moderate-quality evidence), the proportion of participants at Work at end of the follow-up (RR 0.94, 95% CI 0.82 to 1.07, low-quality evidence) or on the proportion of participants who had ever Returned to Work (RR 0.95, 95% CI 0.88 to 1.02, low-quality evidence). We found only small benefits for Return-to-Work coordination programmes on patient-reported outcomes. All differences were below the minimal clinically important difference (MID). Authors' conclusions Offering Return-to-Work coordination programmes for Workers on sick leave for at least four weeks results in no benefits when compared to usual practice. We found no significant differences for the outcomes time to Return to Work, cumulative sickness absence, the proportion of participants at Work at end of the follow-up or the proportion of participants who had ever Returned to Work at short-term, long-term or very long-term follow-up. For patient-reported outcomes, we found only marginal effects below the MID. The quality of the evidence ranged from very low to moderate across all outcomes.
