Psychiatry Medical News about early cognitive-behavioral treatment;work disability;musculoskeletal disorders

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Effectiveness of an early cognitive-behavioral treatment in patients with work disability due to musculoskeletal disorders
Arthritis Care and Research , 07/07/09

Leon L et al. – Data provide evidence that early cognitive-behavioral treatment complementary to a rheumatologic care program for patients with recent-onset temporary work disability caused by musculoskeletal disorders (MSDs) is cost-effective, adds >20% efficacy to the rheumatologic care program, and reduces the duration of relapses.

Methods

An evaluation of whether an early cognitive-behavioral treatment complementary to a rheumatologic care program is effective
Pts with work disability episode from 3-8 wks' duration were randomized into:
- Control group: rheumatologic care program or
- Intervention group: rheumatologic care program plus cognitive-behavioral treatment
Enrollment lasted 24 mo and f/u lasted 6-24 mo
Efficacy variables included:
- Duration of temporary work disability episodes
- Total number of work days saved
- Relative efficacy, and
- Relative rate to return to work
An economic evaluation was also performed

Results

181 pts (66 control and 115 intervention pts), generating 222 episodes of MSD-related temporary work disability
Episodes were shorter in the intervention group vs control group, with a relative efficacy of 22.9%
No differences in duration of first episode between groups, but relapse episodes were shorter in the intervention group
Costs were also lower in the intervention group
To save 1 day of temporary work disability, $13.50 had to be invested in the program
Each dollar invested generated a benefit of $4.08
The program had a net benefit of $172,607

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