wow-inequalities/02-data/intermediate/wos_sample/4319a1d1e56874bd733cd56a6792bc43-hansen-bjarke-brand/info.yaml

abstract: 'Background Occupational medicine seeks to reduce sick leave; however,

  evidence for an add-on effect to usual care is sparse. The objective of

  the GOBACK trial was to test whether people with low back pain (LBP) in

  physically demanding jobs and at risk of sick leave gain additional

  benefit from a 3-month complex intervention that involves occupational

  medicine consultations, a work-related evaluation and workplace

  intervention plan, an optional workplace visit, and a physical activity

  program, over a single hospital consultation and an MRI. Methods and

  findings We enrolled people from the capital region of Denmark to an

  open-label, parallel-group randomized controlled trial with a

  superiority design from March 2014 through December 2015. In a hospital

  setting 305 participants (99 women) with LBP and in physically demanding

  jobs were randomized to occupational intervention (n = 153) or no

  additional intervention (control group; n = 152) added to a single

  hospital consultation giving a thorough explanation of the pain (i.e.,

  clinical examination and MRI) and instructions to stay active and

  continue working. Primary outcome was accumulated sick leave days due to

  LBP during 6 months. Secondary outcomes were changes in neuropathic pain

  (painDETECT questionnaire {[}PDQ]), pain 0-10 numerical rating scale

  (NRS), Fear-Avoidance Beliefs Questionnaire (FABQ), Roland-Morris

  Disability Questionnaire (RMDQ), Short Form Health Survey (SF-36) for

  physical and mental health-related quality of life (HRQoL), and

  self-assessed ability to continue working (range 0-10). An

  intention-to-treat analysis of sick leave at 6 months showed no

  significant difference between groups (mean difference in days

  suggestively in favor of no additional intervention: 3.50 {[}95\% CI

  -5.08 to 12.07], P = 0.42). Both groups showed significant improvements

  in average pain score (NRS), disability (RMDQ), fear-avoidance beliefs

  about physical activities and work (FABQ), and physical HRQoL (SF-36

  physical component summary); there were no significant differences

  between the groups in any secondary outcome. There was no statistically

  significant improvement in neuropathic pain (PDQ score), mental HRQoL

  (SF-36 mental component summary), and self-assessed ability to stay in

  job. Four participants could not complete the MRI or the intervention

  due to a claustrophobic attack or accentuated back pain. Workplace

  visits may be an important element in the occupational intervention,

  although not always needed. A per-protocol analysis that included the 40

  participants in the intervention arm who received a workplace visit as

  part of the additional occupational intervention did not show an add-on

  benefit in terms of sick leave (available cases after 6 months, mean

  difference: -0.43 days {[}95\% CI -12.8 to 11.94], P = 0.945). The main

  limitations were the small number of sick leave days taken and that the

  comprehensive use of MRI may limit generalization of the findings to

  other settings, for example, general practice. Conclusions When given a

  single hospital consultation and MRI, people in physically demanding

  jobs at risk of sick leave due to LBP did not benefit from a complex

  additional occupational intervention. Occupational interventions aimed

  at limiting biopsychological obstacles (e.g., fear-avoidance beliefs and

  behaviors), barriers in the workplace, and system barriers seem

  essential to reduce sick leave in patients with LBP. This study

  indicates that these obstacles and barriers may be addressed by thorough

  usual care.'
affiliation: 'Hansen, BB (Corresponding Author), Copenhagen Univ Hosp, Parker Inst,
  Bispebjerg, Denmark.

  Hansen, BB (Corresponding Author), Copenhagen Univ Hosp, Parker Inst, Frederiksberg,
  Denmark.

  Hansen, BB (Corresponding Author), Copenhagen Univ Hosp, Dept Occupat \& Environm
  Med, Bispebjerg, Denmark.

  Hansen, BB (Corresponding Author), Copenhagen Univ Hosp, Dept Occupat \& Environm
  Med, Frederiksberg, Denmark.

  Hansen, Bjarke Brandt; Bliddal, Henning; Christensen, Robin; Kristensen, Lars Erik,
  Copenhagen Univ Hosp, Parker Inst, Bispebjerg, Denmark.

  Hansen, Bjarke Brandt; Bliddal, Henning; Christensen, Robin; Kristensen, Lars Erik,
  Copenhagen Univ Hosp, Parker Inst, Frederiksberg, Denmark.

  Hansen, Bjarke Brandt; Begtrup, Luise Moelenberg; Andreasen, Ditte Lundsgaard; Flachs,
  Esben Meulengracht; Kryger, Ann Isabel, Copenhagen Univ Hosp, Dept Occupat \& Environm
  Med, Bispebjerg, Denmark.

  Hansen, Bjarke Brandt; Begtrup, Luise Moelenberg; Andreasen, Ditte Lundsgaard; Flachs,
  Esben Meulengracht; Kryger, Ann Isabel, Copenhagen Univ Hosp, Dept Occupat \& Environm
  Med, Frederiksberg, Denmark.

  Kirkeskov, Lilli, Copenhagen Univ Hosp, Ctr Social Med, Bispebjerg, Denmark.

  Kirkeskov, Lilli, Copenhagen Univ Hosp, Ctr Social Med, Frederiksberg, Denmark.

  Boesen, Mikael, Copenhagen Univ Hosp, Dept Radiol, Bispebjerg, Denmark.

  Boesen, Mikael, Copenhagen Univ Hosp, Dept Radiol, Frederiksberg, Denmark.

  Christensen, Robin, Univ Southern Denmark, Odense Univ Hosp, Dept Clin Res, Res
  Unit Rheumatol, Odense, Denmark.'
article-number: e1002898
author: Hansen, Bjarke Brandt and Kirkeskov, Lilli and Begtrup, Luise Moelenberg and
  Boesen, Mikael and Bliddal, Henning and Christensen, Robin and Andreasen, Ditte
  Lundsgaard and Kristensen, Lars Erik and Flachs, Esben Meulengracht and Kryger,
  Ann Isabel
author-email: dr.bjarke@gmail.com
author_list:
- family: Hansen
  given: Bjarke Brandt
- family: Kirkeskov
  given: Lilli
- family: Begtrup
  given: Luise Moelenberg
- family: Boesen
  given: Mikael
- family: Bliddal
  given: Henning
- family: Christensen
  given: Robin
- family: Andreasen
  given: Ditte Lundsgaard
- family: Kristensen
  given: Lars Erik
- family: Flachs
  given: Esben Meulengracht
- family: Kryger
  given: Ann Isabel
da: '2023-09-28'
doi: 10.1371/journal.pmed.1002898
eissn: 1549-1676
files: []
issn: 1549-1277
journal: PLOS MEDICINE
keywords-plus: 'HEALTH-CARE; SICK-LEAVE; QUESTIONNAIRE; WORKPLACE; MANAGEMENT; WORKERS;

  RETURN; RATES'
language: English
month: AUG
number: '8'
number-of-cited-references: '33'
orcid-numbers: 'Bliddal, Henning/0000-0002-7951-1668

  Boesen, Mikael/0000-0002-8774-6563

  Christensen, Robin/0000-0002-6600-0631

  Hansen, Bjarke Brandt/0000-0002-4440-1960

  Flachs, Esben Meulengracht/0000-0002-2252-8426'
papis_id: 0c7b316434483e8885b6c193555a90e0
ref: Hansen2019earlyoccupational
researcherid-numbers: 'Kristensen, Lars Erik/AAZ-2615-2020

  '
times-cited: '9'
title: 'Early occupational intervention for people with low back pain in physically
  demanding jobs: A randomized clinical trial'
type: article
unique-id: WOS:000489050500023
usage-count-last-180-days: '1'
usage-count-since-2013: '4'
volume: '16'
web-of-science-categories: Medicine, General \& Internal
year: '2019'