SmaRTWork - a Decision Support System to Promote Return to Work Among People Sick-listed With Musculoskeletal Disorders

N/ANot Yet RecruitingNCT07034040

Norwegian University of Science and Technology298 enrolled

Overview

The objective of this study is to evaluate the effect of an intervention, SmaRTWork, on return to work compared to usual care for individuals who are sick-listed due to musculoskeletal disorders. Potential participants are individuals of working age (20-59 years) sick-listed due to a musculoskeletal disorder (neck pain, low back pain, or widespread pain) for up to 12 weeks living in Norway. The primary outcome will be time to sustainable return to work. We will also evaluate the effect on other work outcomes and health outcomes. We will also interview participants and stakeholders about their experience with the intervention.

The objective of this study is to determine the effectiveness of SmaRTWork (intervention) on return to work (RTW) compared to usual care (comparator) for individuals sick-listed due to musculoskeletal disorders. The study is designed as a single-blinded randomised controlled trial (RCT) with two parallel groups. Individuals of working age (20-59 years) sick-listed due to a musculoskeletal disorder (neck pain, low back pain, or widespread pain) for up to 12 weeks living in Norway are eligible for the study. Potential participants are identified and informed about the project by their general practitioner. We plan to include a total of 298 participants in the trial (and 15-20 in a pilot, giving a total of 318). The primary outcome will be time to sustainable RTW, i.e., one month without receiving sickness benefits, during the 12 months of follow-up based on registry data. Secondary outcomes include other work outcomes and health outcomes. Along with the RCT we will also conduct qualitative studies and a process evaluation. If the SmaRTWork turns out to be effective on RTW, we will also perform a health economic evaluation.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Interventions

SmaRTWorkBEHAVIORAL

The SmaRTWork app provides weekly individually tailored self-management plans by matching the participant's health information and sick leave status with targeted educational messages, physical activity advice, and exercise recommendations. In addition, participants with specific problems regarding i) work accommodations, ii) workplace conflicts, iii) large responsibilities as caregivers, iv) financial problems, or v) who do not think they will return to the old workplace are offered to be set in contact with a caseworker at the social insurance office. The intervention is given in addition to usual care.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 59 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Individuals 20-59 years old (working age) * Living in Norway * Sick-listed due to a musculoskeletal disorder for up to 12 weeks * Musculoskeletal complaints are the main reason for sick leave. * The main diagnosis for sick leave is unspecific pain, for example one of the following (ICPC-2 diagnoses codes): * Neck symptom/complaint (L01) * Back symptom/complaint (L02) * Low back symptom/complaint (L03) * Muscle pain (L18) * Back syndrome without radiating pain (L84) Exclusion Criteria: * Do not have a smartphone with internet access (i.e., to be able to download and access the SmaRTWork app). * Pregnant * No employer (unemployed or self-employed) * Poor Norwegian comprehension * Sick listed for more than 3 months the last year * Have a planned date for RTW during the next week * Have previously participated in the study or currently participating in other studies * Unable to take part in exercise/physical activity (e.g., use of walking aids, unable to get up and down on the floor independently) * Leg pain worse than back pain * Red flags that could indicate serious underlying pathology: * Changes in bladder or bowel function * General feeling of being unwell (malaise), fever and/or unexplained weight loss * Reduced muscle (motor) function, sensory loss, walking problems or balance problems * Neck or back pain that started after the age of 55 or feel different from previous pain episodes * Pain that does not improve with rest or light activity or pain that is much worse during the night * Previous or ongoing cancer * Use of steroids/immune suppressing medications or drug use * Pain that is trauma (injury) related * Serious ongoing somatic (e.g., unstable heart disease) or mental disorder (e.g., psychosis, ongoing manic episode, suicidal ideation) that prevents participation * Pain has not been assessed by a physician

Outcomes

Primary Outcomes

Time to sustainable return-to-work (RTW)

Time to sustainable return-to-work (RTW), i.e., one month without receiving sickness benefits, during the 12 months of follow-up from randomization based on registry data