Elements of Return-to-Work Interventions for Workers on Long-Term Sick Leave: A Systematic Literature Review.
Christa J C de Geus, Maaike A Huysmans, H Jolanda van Rijssen and 3 others
PMID 38849612WHAT IT FOUND
Vocational rehabilitation can help people on long-term sick leave return to work, but no specific intervention elements explain why some programs succeed while others fail.
Effective interventions varied widely in duration and intensity, meaning there is no single recipe for success.
Key findings
01Ten of the twenty-five interventions analyzed showed a positive effect on return to work compared to usual care, while twelve were not effective.
02The specific elements included in the interventions, such as counseling, physical training, or workplace advice, could not explain why some interventions were effective and others were not.
03Interventions that included all three aims (preparing for work, finding work, and remaining in work) were not necessarily more effective, with only two of six such interventions showing positive results.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The quality of the included studies was variable, with eight studies rated as weak, often due to selection bias or reliance on self-reported return-to-work data rather than registry data. Many studies provided minimal descriptions of their interventions, making it difficult to accurately identify all components used. The review did not account for contextual factors or personal characteristics (like motivation or illness perception) that likely influence outcomes. Usual care varied significantly across studies, making direct comparisons of intervention effects difficult.
Declared interests
The work was funded by the Dutch Institute of Employee Benefit Schemes (UWV).
The easy way to misread this
Do not conclude that vocational rehabilitation is ineffective for long-term sick leave. While many specific programs failed, ten interventions did show positive effects, proving that return to work is possible. The lack of identified 'active ingredients' means the field does not yet know how to replicate success, not that success is impossible.