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A Health System Program To Reduce Work Disability Related to Musculoskeletal Disorders

Lydia Abásolo, MD; Margarita Blanco, MD, PhD; Javier Bachiller, MD; Gloria Candelas, MD, PhD; Paz Collado, MD, PhD; Cristina Lajas, MD, PhD; Marcelino Revenga, MD; Patricia Ricci, MD; Pablo Lázaro, MD, PhD; Maria Dolores Aguilar, MD, PhD; Emilio Vargas, MD, PhD; Benjamín Fernández-Gutiérrez, MD, PhD; César Hernández-García, MD, PhD; Loreto Carmona, MD, PhD; and Juan A. Jover, MD, PhD
[+] Article and Author Information

From Hospital Clinico San Carlos, Hospital Ramón y Cajal, and Hospital Severo Ochoa, Madrid, Spain.


Grant Support: In part by grants from the Fondo de Investigaciones Sanitarias of the Spanish Ministry of Health numbers FIS 98/1050 and 00/0201.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Juan A. Jover, MD, PhD, Servicio de Reumatología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; e-mail, jjover.hcsc@salud.madrid.org.

Current Author Addresses: Drs. Abásolo, Blanco, Candelas, Lajas, Vargas, Fernández-Gutiérrez, Hernández-García, Carmona, and Jover: Servicio de Reumatología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain.

Drs. Bachiller and Revenga: Servicio de Reumatología, Hospital Ramón y Cajal, Carretera de Colmenar, Km 9.1, 28034 Madrid, Spain.

Drs. Collado and Ricci: Servicio de Reumatología, Hospital Severo Ochoa, Avenida Orellana s/n 28911, Madrid, Spain.

Drs. Lázaro and Aguilar: TAISS (Técnicas Avanzadas de Investigación en Servicios de Salud), C/ Cambrils 41, 28034 Madrid, Spain.

Author Contributions: Conception and design: C. Hernández-García, J.A. Jover, E. Vargas.

Analysis and interpretation of the data: L. Abásolo, L. Carmona, C. Hernández-García, J.A. Jover, C. Lajas, P. Lázaro, E. Vargas.

Drafting of the article: L. Abásolo, L. Carmona, B. Fernández-Gutiérrez, C. Hernández-García, J.A. Jover.

Critical revision of the article for important intellectual content: L. Abásolo, M.D. Aguilar, L. Carmona, B. Fernández-Gutiérrez, C. Hernández-García, J.A. Jover, C. Lajas, P. Lázaro.

Final approval of the article: L. Abásolo, L. Carmona, B. Fernández-Gutiérrez, C. Hernández-García, J.A. Jover.

Provision of study materials or patients: M. Blanco, J. Bachiller, G. Candelas, P. Collado, C. Lajas, M. Revenga, P. Ricci.

Statistical expertise: L. Abásolo, M.D. Aguilar, L. Carmona, C. Hernández-García, E. Vargas.

Obtaining of funding: J.A. Jover.

Administrative, technical, or logistic support: J. Bachiller, M. Blanco, G. Candelas, P. Collado, C. Lajas, M. Revenga, P. Ricci.

Collection and assembly of data: L. Abásolo, J. Bachiller, M. Blanco, G. Candelas, P. Collado, C. Lajas, M. Revenga, P. Ricci.


Ann Intern Med. 2005;143(6):404-414. doi:10.7326/0003-4819-143-6-200509200-00005
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A total of 13 077 patients were included in the study, representing 3% of the working population. These patients generated 16 297 episodes of MSD-related temporary work disability during the 2 years of the study. On average, patients were randomly assigned to a study group 3 days after starting their first episode of temporary work disability. Of the 5272 patients assigned to receive the intervention, 3311 (62.8%) participated in the program. The main reason for nonparticipation was that the patient was already back at work (Figure 1). The median time to program visit from the issue of the temporary work disability initiation form was 5 days (25th, 75th percentiles: 2, 7 days; range, 1 to 477 days). Mean follow-up was similar in the two groups (555 days [SD, 109] in the control group and 554 days [SD, 109] in the intervention group; P > 0.2).

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Figures

Grahic Jump Location
Figure 1.
Flow diagram of the study.

WD= work disability.

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Figure 2.
Survival curves showing the rate to return to work during a 1-year period, by study group, in each district and combined.
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Summary for Patients

An Intervention Program To Decrease the Duration and Cost of Work Disability Related to Musculoskeletal Disorders

The summary below is from the full report titled “A Health System Program To Reduce Work Disability Related to Musculoskeletal Disorders.” It is in the 20 September 2005 issue of Annals of Internal Medicine (volume 143, pages 404-414). The authors are L. Abásolo, M. Blanco, J. Bachiller, G. Candelas, P. Collado, C. Lajas, M. Revenga, P. Ricci, P. Lázaro, M.D. Aguilar, E. Vargas, B. Fernández-Gutiérrez, C. Hernández-García, L. Carmona, and J.A. Jover.

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