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Norbye A.D.1, Omdal A.V.1, Nygaard M.E.1, Romild U.2, Eldoen G.1, Midgard R.1
1Molde Hospital, Moere and Romsdal Health Trust, Department of Neurology, Molde, Norway, 2Swedish National Institute of Public Health, Ostersund, Sweden
Background: Back pain is the reason for numerous absent days from work. In Norway, the government initiated a priority program, Earlier Return to Work (ERTW), to reduce work absences through early intervention. However, no proper evaluation has been performed on populations With chronic low back pain (CLBP). There is no consensus on how return to work (RTW) should be measured. Only a few studies have examined how waiting time affects RTW.
Purpose: To investigate the feasibility of running a trial to explore if early intervention in individuals with CLBP would lead to an early RTW and reduce sick leave during 12 months of follow-up compared to patients on a 3-month waiting list.
Methods: Fifty-eight patients were included in the study. The group with early intervention was examined within 2 weeks, and the group on the waiting list was examined after 12 weeks. The intervention was identical in both groups and consisted of an outpatient, intensive back school. The data were obtained by questionnaire after 3, 6 and 12 months. The primary outcome was absence from work.
Results: The sample size in a full-scale study must comprise at least 382 patients based on the assumptions in the pilot. In the pilot study, early intervention directly compared to an ordinary waiting list did not significantly affect the number of sick leave days after 12 months of follow-up.
Conclusion(s): A prerequisite for launching a full-scale clinical trial is a redesign of the intervention, an improvement of procedures concerning inclusion and randomisation and finally a more precise definition of RTW.
Implications: In this pilot study, we found that early intervention did not lead to earlier RTW. Specifically, early intervention directly compared with the ordinary waiting list group did not significantly affect the number of sick leave days after 12 months of follow-up. Few studies have examined how waiting time affects RTW; instead, most research on this topic has focused on how different treatments affect RTW. The CLBP population is characterized by different influencing factors that contribute to the further development of disability and to RTW. Research examining sick leave in this group is challenging, also because of its fluctuating course. In our planned full-scale study, we intend to include a larger population to increase the reliability of our results. Health economic outcome measures may also be included in this full-scale study.
Funding acknowledgements: No funds were received in support of this work.
Topic: Musculoskeletal: spine
Ethics approval: The ethics committee for medical research in Eastern Norway
(REK Sør Øst) approved the study.
All authors, affiliations and abstracts have been published as submitted.
