Workplace involvement in rehabilitation for patients with musculoskeletal pain may improve work ability. Convergence dialogue meeting (CDM) is a model aimed at helping the patient, the care giver and the employer to support work ability and return to work. Our aim was to study the effect on work ability when adding a workplace dialogue according to CDM in physiotherapy practice for pain patients in ordinary primary care. We conducted a prospective pair wise cluster randomised controlled trial (ClinicalTrials.gov ID NCT02609750) in primary care involving 20 primary care rehabilitation units with one-year follow-up. Adult patients with acute/subacute neck and back pain, worked >= 4 weeks last year and not currently on sick leave or no more than 60 days sick leave and considered at risk for sick leave were included (n = 352). All patients received structured physiotherapy and the intervention was the addition of CDM, delivered by the treating physiotherapist. The main confirmatory outcome, work ability (defined as working at least four consecutive weeks at follow-up), was assessed by a weekly short text message question on number of sick leave days last week. Work ability was reached by significantly more patients in the intervention group (108/127, 85%) compared to the reference group (127/171, 74%) (p = 0.02). The intervention increased the odds of having work ability at one-year follow-up also after adjustment for baseline health related quality of life (odds ratio 1.85 CI 1.01 to 3.38). We conclude that an early workplace dialogue in addition to structured physiotherapy improved work ability significantly.

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