Costly intervention programme has no measurable effect on early retirement

Effect of a multidisciplinary rehabilitation programme on perceived health among employees at increased risk of incapacity for work: A controlled study 

From Clinical Rehabilitation

Most of us would agree that prevention is better than cure. However this study indicates that a costly intervention programme designed to reduce early retirement on health grounds in Finland had no measurable effect. The research was a large scale evaluative study of vocational rehabilitation, which followed 872 participants and their 2440 matched controls for up to nine years. The participants went through a four-week prevention programme incorporating physical and psychological health education and support. It aimed to help participants adopt a healthier lifestyle, and to achieve greater aerobic capacity, muscle strength and endurance, and to better manage their own stress. The four week programme is widely used in Finland but this study suggests that the programme had little effect, either in the short or long term, on how those who took part perceived their health. Although the authors stress that their findings may not hold true beyond Finland, the study shines a spotlight on similar, work-related interventions. They conclude that future research is needed to examine the reasons for the ineffectiveness of this costly early intervention and to identify more effective preventive measures to improve subjective health in working populations.

Abstract

Objective: To evaluate the effect of a four-week primary prevention programme on change in perceived health among employees at increased risk of incapacity for work.

Design: A follow-up controlled study.

Settings: The data were collected from survey responses and registered data on demographic, work and health characteristics, and health-related behaviours.

Subjects: Eight hundred and seventy-two participants and their 2440 propensity score-matched controls.

Intervention: Multidisciplinary preventive programme of physical training and psychological education to adopt a healthier lifestyle, and to achieve greater aerobic capacity, muscle strength and endurance, as well as better self-management of stress.

Main measures: Psychological distress, anxiety and suboptimal self-rated health.

Results: The prevalence of suboptimal self-rated health, psychological distress and anxiety did not differ between the participants and controls before the intervention (22.6% vs. 22.8%, 26.6% vs. 29.0%, and 33.0% vs. 33.8%, respectively). Similarly, after the intervention, there were no group differences in the prevalence of self-rated health problems at the time of the short-term (mean 1.7 years, up to 4.6 years) or long-term (mean 5.8 years, up to 9.2 years) follow-up. Figures for prevalence of suboptimal self-rated health, psychological distress and anxiety in participants and controls at the time of the long-term follow-up were 33.8% vs. 28.9%, 25.1% vs. 24.9%, and 34.7% vs. 33.2%, respectively.

Conclusions: No beneficial effects on perceived health were observed for a four-week primary prevention programme widely used in Finland to reduce early retirement on health grounds

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Article details
Saltychev, M., Laimi, K., Oksanen, T., Pentti, J., Virtanen, M., Kivimaki, M., & Vahtera, J. (2011). Effect of a multidisciplinary rehabilitation programme on perceived health among employees at increased risk of incapacity for work: a controlled study Clinical Rehabilitation DOI: 10.1177/0269215511425963

Tags: anxiety, distress, propensity score, Self-rated health, work-related stress