[Occupational Health Physicians and Rehabilitation - A Cross-sectional Study on Occupational Health Care in Schleswig-Holstein and Baden-Württemberg]

[Holistic clarification of the need for intervention at the interface of rehabilitation and occupational medicine when work participation is at risk]

Introduction

For employees whose work participation is at risk, a comprehensive and workplace-oriented diagnosis is required in order to understand the health problems and to support affected persons with individual solutions. We developed a novel diagnostic service to ensure work participation that combines rehabilitative and occupational health medicine. The aim of this feasibility study was to evaluate the implementation and to analyze changes in health and working ability.

Methods

The observational study (German Clinical Trials Register: DRKS00024522) included employees with health restrictions and limited working ability. Participants received an initial consultation from an occupational health physician, a 2-day holistic diagnostics work-up at a rehabilitation center and up to four follow-up consultations. Questionnaire data collected at the initial consultation and at the first and last follow-up consultations included subjective working ability (0-10 points) and general health (0-10).

Results

Data from 27 participants were analyzed. The participants were 63% female and on average 46 years old (standard deviation, SD = 11.5). From the initial consultation to the final follow-up consultation, participants reported improvement in their general health (difference = 1.52; 95% confidence interval. CI: 0.37-2.67; d = 0.97).

Discussion and conclusion

The model project GIBI offers low-threshold access to a confidential, comprehensive and workplace-oriented diagnostic service to support work participation. Successful implementation of GIBI requires intensive cooperation between occupational health physicians and rehabilitation centers. To evaluate the effectiveness, a randomized controlled trial (n = 210) with a waiting list control group is currently underway.

A comprehensive diagnostic service to clarify intervention needs when work participation is at risk: study protocol of a randomized controlled trial (GIBI, DRKS00027577)

Background

Effective care services for people whose work participation is at risk require low-threshold access, a comprehensive diagnostic clarification of intervention needs, a connection to the workplace and job demands, and interdisciplinary collaboration between key stakeholders at the interface of rehabilitation and occupational medicine. We have developed a comprehensive diagnostic service to clarify intervention needs for employees with health restrictions and limited work ability: this service is initiated by occupational health physicians.

Methods/design

Our randomized controlled trial tests the effectiveness of a comprehensive diagnostic service for clarifying intervention needs (GIBI: Comprehensive clarification of the need for intervention for people whose work participation is at risk). The comprehensive intervention comprises three elements: initial consultation, two-day diagnostics at a rehabilitation center and follow-up consultations. We will include 210 employees with health restrictions and limited work ability, who are identified by occupational health physicians. All individuals will receive an initial consultation with their occupational health physician to discuss their health, work ability and job demands. After this, half the individuals are randomly assigned to the intervention group and the other half to the waiting-list control group. Individuals in the intervention group start two-day diagnostics, carried out by a multi-professional rehabilitation team in a rehabilitation center, shortly after the initial consultation. The diagnostics will allow first recommendations for improving work participation. The implementation of these recommendations is supported by an occupational health physician in four follow-up consultations. The control group will receive the comprehensive two-day diagnostic service and subsequent follow-up consultations six months after the initial consultation. The primary outcome of the randomized controlled trial is self-rated work ability assessed using the Work Ability Score (0 to 10 points) six months after study inclusion. Secondary outcomes include a range of patient-reported outcomes regarding physical and mental health, impairment, and the physical and mental demands of jobs.

Discussion

This randomized controlled trial is designed to test the effects of a new complex intervention involving a comprehensive clarification of intervention needs in order to promote work participation and prevent the worsening of health and work disability.

Trial registration

German Clinical Trials Register (DRKS00027577, February 01, 2022).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08513-1.