The Effectiveness of Case-management Rehabilitation Intervention in Facilitating Return to Work and Maintenance of Employment After Myocardial Infarction: Results of a Randomized Controlled Trial.
Oren Zack, Samuel Melamed, Haim Silber and 3 others
PMID 35191331WHAT IT FOUND
Case management by a social worker significantly improved return-to-work and job retention after heart attack.
Patients receiving this coordinated care were more likely to keep their same job and remain employed two years later compared to standard cardiac rehabilitation alone.
Key findings
01Patients in the case-management group had significantly higher rates of returning to work within six months (89% vs 74%) and retaining the same job (98% vs 73%) compared to the control group.
02The intervention group maintained higher employment rates at one year (92% vs 75%) and two years (87% vs 72%), with more patients keeping their previous role and working full-time.
03After adjusting for confounders, case management was associated with significantly increased odds of maintaining employment at one year (OR = 5.89) and two years (OR = 3.12).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study included only patients with uncomplicated myocardial infarctions, so results may not apply to those with severe cardiac impairment or heart failure. Follow-up data collection was conducted by the case manager for the intervention group, introducing potential bias despite the use of a standardized questionnaire. Most participants were also enrolled in standard cardiac rehabilitation, making it difficult to isolate the effect of case management from the benefits of rehab. The study did not record participants' specific workplaces, so it could not assess whether the intervention's success depended on employer characteristics.
Declared interests
The study was funded by the Social Security Services of Israel, the Ministry of Labor and Social Affairs, and Maccabi Healthcare Services. The authors declared no potential conflicts of interest.
The easy way to misread this
Do not assume case management replaces standard cardiac rehabilitation. Most participants in both groups attended rehab, and the study did not test case management in isolation. The benefit appears to come from adding coordinated vocational and psychosocial support to standard care, not from substituting it.