Detailed Search Results
| Author/Association: | Gross DP, Park J, Rayani F, Norris CM, Esmail S |
| Title: | Motivational interviewing improves sustainable return to work in injured workers after rehabilitation: a cluster randomized controlled trial [with consumer summary] |
| Source: | Archives of Physical Medicine and Rehabilitation 2017 Dec;98(12):2355-2363 |
| Method: | clinical trial |
| Method Score: | 7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
| Consumer Summary: | HIGHLIGHTS: (1) Motivational interviewing is a goal-oriented, client-centred counselling approach that facilitates behavioural change through identifying and resolving ambivalence. (2) We studied whether use of motivational interviewing leads to better sustainable return-to-work outcomes for injured workers undergoing rehabilitation using a cluster randomized controlled trial design. (3). Claimants who were unemployed at program admission and randomized to receive motivational interviewing had significantly more partial disability benefits over the follow-up year (average of 8.2 versus 0.2 days, p = 0.02), indicating return to modified work duties. (4) Claimants who were employed at program admission and randomized to receive motivational interviewing had a lower percentage of benefit recurrence over the follow-up year (4.5% versus 9.1% p = 0.04). (5) Use of motivational interviewing appears to lead to more sustainable RTW outcomes following occupational rehabilitation, and facilitates transition to modified work duties. |
| Abstract: | OBJECTIVE: To examine whether motivational interviewing (MI) leads to more sustainable return-to-work outcomes for injured workers undergoing rehabilitation. MI is a client-centred counselling approach that facilitates behavioural change through identifying and resolving ambivalence. DESIGN: A cluster randomised controlled trial was conducted with analysis at level of claimant (registration ISRCTN45748422). SETTING: The study was conducted at a workers' compensation rehabilitation facility in Edmonton, Canada. PARTICIPANTS: Data were collected on claimants undergoing rehabilitation for musculoskeletal conditions. Participants were predominantly employed (72.7%) males (63.2%) with chronic conditions (mean duration 234 days). INTERVENTIONS: Treating clinicians at the facility were randomised into 2 groups. One group included 6 clinicians who were trained to conduct MI interventions during the course of rehabilitation, while the control group included 6 clinicians who continued standard procedures. MAIN OUTCOME MEASURES: Outcomes included compensation outcomes over 1 year after discharge. This included reception of disability benefits and recurrence rates. Analysis was stratified by admission employment status and included Chi square, t tests, and multivariable regression. RESULTS: Participants included 728 claimants of whom 367 (50.4%) were treated with MI. Unemployed claimants in the MI group received significantly more partial disability benefits (average of 8.2 versus 0.2 days, p = 0.02), indicating return to modified work duties. Employed claimants in the control group had a higher recurrence rate (9.1% versus 4.5%, p = 0.04). Adjusted odds ratio for benefit recurrence was 2.7 (1.1 to 6.5) after controlling for age, sex, and number of previous claims. CONCLUSIONS: Use of MI appears to lead to more sustainable return-to-work following rehabilitation, and facilitates transition to modified work duties. Full text (sometimes free) may be available at these link(s):  help |
