Table 3.
Level of evidence for workplace-based RTW interventions and accompanying messages
| Levels of evidence (direction of effect) | Intervention (No. of H and M studies) | Outcome | Message |
|---|---|---|---|
| Strong (positive) | Multi-domain MSK interventions (4H, 10M) | Lost time | Implementing a multi-domain intervention (with components in at least 2 of the following domains: health-focused, service coordination, or work modification) can help reduce lost time for MSK and pain-related conditions |
| Work-focused CBT for MH conditions (6H, 1M) Work-focused CBT for MH conditions (4H) |
Lost time Cost |
Implementing a work-focused CBT intervention can help reduce lost time and costs associated with work disability for mental health conditions | |
| Strong (no effect) | CBT for MH conditions (6H, 1M) | Lost time | Implementing a traditional CBT intervention has no effect on reducing lost time for mental health conditions |
| Moderate (positive) | Graded activity (2H, 1M) Work accommodations (2H, 3M) Multi-domain MSK interventions (1H, 2M) Work-focused CBT for MH conditions (2H) Multi-domain MSK interventions (2H, 4M) |
Lost time Lost time Work functioning Work functioning Cost |
Consider implementing these interventions in practices if applicable to the work context |
| Limited (positive) | Work accommodations (1H, 1M) Health-focused multi-component (1H) |
Cost Work functioning |
Not enough evidence from the scientific literature to guide current policies/practices |
| Limited (no effect) | Work hardening (1H) Physician training (1H) RTW plan (1H, 1M) RTW plan (1H) |
Work functioning Lost time Lost time Cost |
Not enough evidence from the scientific literature to guide current policies/practices |
| Mixed | Work hardening (1H, 1M) Health-focused multi-component (3H, 2M) Graded activity (1H, 1M) Health-focused multi-component (2H) |
Lost time Lost time Cost Cost |
Not enough evidence from the scientific literature to guide current policies/practices |
| Insufficient | Case management (1M) Work accommodations (1M) Worker education/training (1M) Supervisor education/training (1M) Work hardening (1M) |
Lost time Work functioning Cost Cost Cost |
Not enough evidence from the scientific literature to guide current policies/practices |
H high quality, M medium quality, MSK musculoskeletal or pain-related conditions, CBT cognitive behavioural therapy, MH mental health conditions, RTW return-to-work