In a controlled trial training general practitioners and occupational physicians to collaborate did not influence sickleave of patients with low back pain

Faber, E.; Bierma-Zeinstra, S.M.A.; Burdorf, A.; Nauta, A.P.; Hulshof, C.T.J.; Overzier, P.M.; Miedema, H.S.; Koes, B.W.

doi:10.1016/j.jclinepi.2004.04.015

« Previous Next »Journal of Clinical Epidemiology
Volume 58, Issue 1 , Pages 75-82, January 2005

In a controlled trial training general practitioners and occupational physicians to collaborate did not influence sickleave of patients with low back pain

E. Faber
- Netherlands Expert Centre for Workrelated Musculoskeletal Disorders, Erasmus MC, PO Box 2040, Rotterdam 3000 CA, The Netherlands
- Department of General Practice, Erasmus MC, Rotterdam, The Netherlands
- Corresponding author. Tel.: +31 10 463 20 11; fax: +31 10 463 20 10.
S.M.A. Bierma-Zeinstra
- Department of General Practice, Erasmus MC, Rotterdam, The Netherlands
A. Burdorf
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
A.P. Nauta
- Netherlands Expert Centre for Workrelated Musculoskeletal Disorders, Erasmus MC, PO Box 2040, Rotterdam 3000 CA, The Netherlands
C.T.J. Hulshof
- SKB, Expert Centre for Work and Health, Amsterdam, The Netherlands
P.M. Overzier
- Netherlands Expert Centre for Workrelated Musculoskeletal Disorders, Erasmus MC, PO Box 2040, Rotterdam 3000 CA, The Netherlands
H.S. Miedema
- Netherlands Expert Centre for Workrelated Musculoskeletal Disorders, Erasmus MC, PO Box 2040, Rotterdam 3000 CA, The Netherlands
B.W. Koes
- Department of General Practice, Erasmus MC, Rotterdam, The Netherlands

Accepted 20 April 2004.

Abstract

Objective

The objective of this study was to determine the effectiveness of a training to increase collaboration between general practitioners and occupational health physicians in the treatment of patients with low back pain (LBP) because more collaboration might improve a patient's recovery and shorten sick leave.

Methods

In a controlled trial, the intervention in one region was compared with usual care in a control region. Participating physicians enrolled patients with LBP on sick leave for 3–12 weeks. Patients filled out three questionnaires: at inclusion, at 3 months, and at 6 months. Information on sick leave was gathered from occupational health services. All analyses were performed on an intention-to-treat basis.

Results

Fifty-six patients with LBP were enrolled in each region. There was little collaboration between physicians during the project. Patients in the intervention region returned to work significantly later (P=.005) but were significantly more satisfied with their occupational health physician (P=.01). No differences were found between the intervention and control patients for pain, disability, quality of life, and medical consumption.

Conclusion

Our study does not show a positive effect of the training to increase collaboration between general practitioners and occupational health physicians. The training may not have improved collaboration enough to influence the prognosis of LBP.

Keywords: Low back pain, General practitioner, Occupational health physician, collaboration, Return to work, Clinical trial