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Collaborative care for sick-listed workers with major depressive disorder: a randomised controlled trial from the Netherlands Depression Initiative aimed at return to work and depressive symptoms
  1. Moniek C Vlasveld1,2,
  2. Christina M van der Feltz-Cornelis1,3,4,
  3. Herman J Adèr5,
  4. Johannes R Anema2,6,
  5. Rob Hoedeman7,8,
  6. Willem van Mechelen2,6,
  7. Aartjan T F Beekman9
  1. 1Diagnostics and Treatment, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
  2. 2Department of Public and Occupational Health, The EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
  3. 3Department of Tranzo, University of Tilburg, Tilburg, The Netherlands
  4. 4GGZ Breburg, Tilburg, The Netherlands
  5. 5Johannes van Kessel Advising, Huizen, The Netherlands
  6. 6Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
  7. 7365/ArboNed Occupational Health Services, Utrecht, The Netherlands
  8. 8Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  9. 9GGZinGeest and Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Dr Moniek C Vlasveld, Netherlands Institute of Mental Health and Addiction, the Trimbos-institute, PO Box 725, 3500 AS Utrecht, The Netherlands; mvlasveld{at}trimbos.nl

Abstract

Objectives Major depressive disorder (MDD) is associated with absenteeism. In this study, the effectiveness of collaborative care, with a focus on return to work (RTW), was evaluated in its effect on depressive symptoms and the duration until RTW in sick-listed workers with MDD in the occupational health setting.

Methods In this randomised controlled trial, 126 sick-listed workers with MDD were randomised to usual care (N=61) or collaborative care (N=65). Collaborative care was applied by the occupational physician care manager, supported by a web-based tracking system and a consultant psychiatrist. Primary outcome measure was time to response. Secondary outcome measures were time to remission, depressive symptoms as continuous measure and the duration until full RTW.

Results Collaborative care participants had a shorter time to response, with a difference of 2.8 months. However, no difference was found on time to remission or depressive symptoms as continuous measure. With a mean of 190 days in the collaborative care group, and 210 days in the usual care group, the groups did not differ significantly from each other in the duration until full RTW. Adherence to the collaborative care intervention was low.

Conclusions These results do not justify a widespread implementation of collaborative care in occupational healthcare, as it was operationalised in this study. However, since the study might have been underpowered for RTW and because treatment integrity was low, further research, with larger sample sizes, is needed to develop the best fitting (collaborative care) model for addressing RTW in depressed sick-listed workers.

Trial registration: ISRCTN78462860

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