gms | German Medical Science

15th Congress of the European Forum for Research in Rehabilitation (EFRR)

15.04. - 17.04.2019, Berlin

Effectiveness of work-related medical rehabilitation in patients with chronic musculoskeletal diseases

Meeting Abstract

15th Congress of the European Forum for Research in Rehabilitation (EFRR). Berlin, 15.-17.04.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. Doc051

doi: 10.3205/19efrr051, urn:nbn:de:0183-19efrr0516

Veröffentlicht: 16. April 2019

© 2019 Bethge et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: In Germany, work-related medical rehabilitation programs were developed for patients with musculoskeletal disorders. Randomized controlled trials have shown that return to work rates can be increased by about 20 points compared to common medical rehabilitation programs. Since 2014, the Federal German Pension Insurance has approved several new departments to implement these programs.

Aim: Our study was launched to assess the effects of the programs under real-life conditions.

Method: Participants received either a common or a work-related medical rehabilitation program. Propensity score matching was used to create balanced samples. Effects were assessed by patient-reported outcomes 10 months after completing the rehabilitation program.

Results/findings: We included 1282 patients. Work-related medical rehabilitation increased stable return to work (OR = 1.42; 95% CI: 1.02 to 1.96) and self-rated work ability (b = 0.38; 95% CI: 0.05 to 0.72) and decreased time to return to work compared to common medical rehabilitation. Subgroup analyses showed that the effect on stable return to work was affected by the prior risk of not returning to work and the dose received as rated by the participants. In patients with a high initial risk of not returning to work and a high dose received, the absolute risk difference was about 20 points in favor of work-related medical rehabilitation and in line with the effects known from the randomized controlled trials.

Discussion and conclusions: Implementation of work-related medical rehabilitation in German rehabilitation centers affected work participation. Reaching patients with a high risk of failing return to work and improving the treatment consistency according to the recommendations of the guideline may improve outcomes in real care.