Evaluation of a Structuralized Sick-Leave Programme Compared with usual Care Sick-Leave Management for Patients after an Acute Myocardial Infarction.
Lars Tjessum, Stefan Agewall
PMID 37486246WHAT IT FOUND
A structured sick-leave package after heart attack reduced days absent from work compared with usual care.
Quality of life did not differ, and readmissions did not differ. The programme was tested in employed patients under 65 without major complications.
Key findings
01The structured programme reduced mean absence from work compared with usual care: 17.2 days versus 20.4 days (p < 0.001).
02Quality of life did not differ between groups: UBQ-H improvement was 0.012 versus 0.010 (p = 0.36), and SF-36 general health at 12 months was 59.5 versus 61.7 (p = 0.254).
03Readmission occasions were not significantly different between groups: 20 in usual care and 16 in the structured group (p = 0.50).
STILL TO COME
How it was doneWhat they found
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What it does not show
Only 143 patients were included, and 17 were lost to follow-up, so the findings may not be stable. The study was done in one hospital and included only employed patients under 65 without major post-infarction complications, so it may not apply to older, unemployed, or more complex patients. The intervention combined fixed sick leave, telephone access to cardiology staff, return-to-work encouragement, and general practitioner instructions, so it is unclear which component mattered. The paper does not report blinding of participants or assessors, and results were not adjusted for multiple comparisons. The authors note the small sample may have limited detection of quality-of-life changes. The paper does not explicitly label a primary outcome, so the relative importance of sick-leave duration and quality of life is not fully clear. The comparison was with usual care, not another structured return-to-work programme.
Declared interests
The authors declare no conflicts of interest. Funding is not reported.
The easy way to misread this
Do not conclude that this programme can be applied to every patient after a heart attack. It tested a bundle of sick-leave advice, phone support, and general practitioner instructions in employed people under 65 without major complications, and quality of life did not differ between groups.