Effect of Inpatient Multicomponent Occupational Rehabilitation Versus Less Comprehensive Outpatient Rehabilitation on Sickness Absence in Persons with Musculoskeletal- or Mental Health Disorders: A Randomized Clinical Trial.

Only 275 of 3318 invited people accepted, so the sample may not represent all workers on sick leave. Participants had very long sickness absence, with a median of 226 days in the previous 12 months, so results may not apply to shorter sick leave episodes. There was no usual care control group, so the trial cannot show whether either program reduced sickness absence compared with doing nothing. Researchers were not blinded, although sickness absence data were collected by registry staff unaware of allocation. The workplace visit, intended to connect rehabilitation with the job, was performed for only 13% of inpatient participants, and reasons for not performing it were poorly registered. The inpatient program was shorter than traditional 4-week inpatient programs, so lack of difference may reflect dose rather than lack of value. No data were available on how many inpatient sessions participants attended. Both programs included several components, so the contribution of any single treatment element cannot be separated. Post hoc sensitivity analyses were performed, but they also showed no clear difference.

The study was funded by Norges Forskningsråd, the Liason Committee between Central Norway Regional Health Authority and The Norwegian University of Science and Technology, and Helse Midt-Norge. No author conflicts of interest are reported in the supplied text.

Do not conclude that the outpatient program was better. It was not just acceptance and commitment therapy: it also included mindfulness assignments, social work sessions, physiotherapy discussion and a closing session with a summary letter, and the primary outcome showed no significant difference.