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Effectiveness of early intervention among employees at high risk for long-term sickness absence.


- candidate number1378
- NTR NumberNTR214
- ISRCTNISRCTN91445383
- Date ISRCTN created20-dec-2005
- date ISRCTN requested18-okt-2005
- Date Registered NTR5-sep-2005
- Secondary IDsN/A 
- Public TitleEffectiveness of early intervention among employees at high risk for long-term sickness absence.
- Scientific TitleEffectiveness of early intervention among employees at high risk for long-term sickness absence.
- ACRONYMN/A
- hypothesisWhat is the effectiveness of early preventive intervention among employees at high risk for long-term sickness absence?
- Healt Condition(s) or Problem(s) studiedSick leave
- Inclusion criteriaEmployees at high risk for future long-term sickness absence as identified by a validated screening questionnaire called "Balansmeter".
- Exclusion criteria1. Employees on sick leave;
2. Pregnant employees;
3. Treatment/guidance by occupational physician.
- mec approval receivedyes
- multicenter trialno
- randomisedyes
- masking/blindingSingle
- controlActive
- groupParallel
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-jan-2003
- planned closingdate1-jan-2006
- Target number of participants327
- InterventionsThe effectiveness of early intervention among employees at high risk for sickness absence will be determined by means of a randomised controlled trial, with an initial total follow-up period of 12 months.
The study will be based on a sample of 10,000 employees of ABN AMRO in the Netherlands. Selection of this sample will be based on the initial letter of the employees’ surname. To ensure smooth enrolment in the trial, the study population will be divided in five batches. Employees at high risk for long-term sickness absence will be identified by the screening questionnaire Balansmeter. The study involves employees whose high risk for long-term sickness absence can be prompted by either somatic conditions or mental health complaints, or both. Employees will be asked to provide informed consent and those scoring above the cutoff point of the Balansmeter will be randomised over the experimental group and the control condition.
Employees in the experimental group will receive early treatment. Early treatment involves an interview by the occupational physician, which may be followed either by further guidance by the occupational physician or by external referral/guidance. External referral may include psychotherapy, cognitive behavioural therapy or social work.
The control group receives care as usual, as provided by the occupational physician, if the employee asks for help. In case of sickness absence the control group will receive socio-medical counselling in accordance with the practice guidelines of the NVAB. Outcomes will be evaluated at 6 and 12 months after randomisation.
- Primary outcomePrimary outcome is sickness absence. All information regarding sickness absence will be gathered through record linkage on an individual level with the company register on sickness absence.
Sickness absence measures include absence frequency, time to onset of first absence spell, and sickness absence duration. Sickness absence will be assessed during the complete follow-up period of 12 months.
- Secondary outcomeSecondary outcome measures will be assessed at baseline and during follow-up by means of questionnaires. Secondary outcomes include (mental) health status, capturing amongst others need for recovery from work, prolonged fatigue, and psychological distress), and working conditions, such as for example social support from supervisor and colleagues, psychological job demands, decision latitude, and working hours.
Additionally medical consumption will be inventoried. Follow-up measurements will take place at 6 and 12 months after randomisation.
- TimepointsN/A
- Trial web siteN/A
- statusstopped: trial finished
- CONTACT FOR PUBLIC QUERIESDr. N.W.H. Jansen
- CONTACT for SCIENTIFIC QUERIESDr. I.J. Kant
- Sponsor/Initiator University Maastricht (UM), Department of Epidemiology
- Funding
(Source(s) of Monetary or Material Support)
ABN AMRO Arbo Services, Amsterdam
- PublicationsJ Occup Rehabil. 2008 Mar;18(1):79-86. Epub 2008 Jan 15.
- Brief summaryThe reduction of both sickness absence and work disability is given high priority in the Netherlands by both employers and employees organisations and the government. So far, the reduction of sickness absence is mainly focused on improving the effectiveness of the socio-medical counselling/treatment of employees already on sick leave.
To date however, the results of treatment and rehabilitation of employees on sick leave are limited.
Therefore, a preventive approach aimed at early treatment of employees before sickness absence occurs, is likely to be more effective in preventing future sickness absence. So far, scientific evidence to support this preventive approach is lacking and thereby hindering the implementation of such a strategy. In this study, the effectiveness of an innovative preventive strategy will be examined by conducting a randomised controlled trial.


The study will be based on a sample of 10,000 employees of ABN AMRO in the Netherlands. Employees at high risk for long-term sickness absence will be identified by the screening questionnaire Balansmeter.
The study involves employees whose high risk for long-term sickness absence can be prompted by either somatic conditions or mental health complaints, or both. Employees will be asked to provide informed consent and those scoring above the cutoff point of the Balansmeter will be randomised over the experimental group and the control condition.
Employees in the experimental group will receive early treatment. Early treatment involves an interview by the occupational physician, which may be followed either by further guidance by the occupational physician or by external referral/guidance. External referral may include psychotherapy, cognitive behavioural therapy or social work.
The control group receives care as usual, as provided by the occupational physician, if the employee asks for help. In case of sickness absence the control group will receive socio-medical counselling in accordance with the practice guidelines of the NVAB. Outcomes will be evaluated at 6 and 12 months after randomisation.
- Main changes (audit trail)
- RECORD5-sep-2005 - 16-okt-2008


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