FOTO Rehab Outcomes Blog

Motivational Interviewing and Return to Work

Written by Selena Horner | Jul 10, 2017 10:00:00 AM

The words we use matter. We've been learning this over the past few years, in particular in the pain science world.

 This study focused on individuals and return to work. We already know that a patient who is injured at work has a characteristic that is risk adjusted for fair comparison in outcomes. These individuals may not achieve functional outcomes as high or as fast compared to other patients. Motivational interviewing may be considered within the treatment strategy to improve outcomes.

Below you will find a quick view of the abstract.

Motivational Interviewing Improves Sustainable Return to Work in Injured Workers After Rehabilitation: A Cluster Randomized Controlled Trial.

 

Abstract

OBJECTIVE:

To examine whether motivational interviewing (MI) leads to more sustainable return-to-work outcomes for injured workers undergoing rehabilitation. MI is a client-centred counselling approach that facilitates behavioural change through identifying and resolving ambivalence.

DESIGN:

A cluster randomised controlled trial was conducted with analysis at level of claimant (registration ISRCTN45748422).

SETTING:

The study was conducted at a workers' compensation rehabilitation facility in Edmonton, Canada.

PARTICIPANTS:

Data were collected on claimants undergoing rehabilitation for musculoskeletal conditions. Participants were predominantly employed (72.7%) males (63.2%) with chronic conditions (mean duration 234 days).

INTERVENTIONS:

Treating clinicians at the facility were randomised into 2 groups. One group included 6 clinicians who were trained to conduct MI interventions during the course of rehabilitation, while the control group included 6 clinicians who continued standard procedures.

MAIN OUTCOME MEASURES:

Outcomes included compensation outcomes over 1 year after discharge. This included reception of disability benefits and recurrence rates. Analysis was stratified by admission employment status and included Chi square, t tests, and multivariable regression.

RESULTS:

Participants included 728 claimants of whom 367 (50.4%) were treated with MI. Unemployed claimants in the MI group received significantly more partial disability benefits (average of 8.2 versus 0.2 days, p=0.02), indicating return to modified work duties. Employed claimants in the control group had a higher recurrence rate (9.1% versus 4.5%, p = 0.04). Adjusted odds ratio for benefit recurrence was 2.7 (1.1 - 6.5) after controlling for age, sex, and number of previous claims.

CONCLUSIONS:

Use of MI appears to lead to more sustainable return-to-work following rehabilitation, and facilitates transition to modified work duties.

Arch Phys Med Rehabil. 2017 Jun 21. pii: S0003-9993(17)30409-4. doi: 10.1016/j.apmr.2017.06.003. [Epub ahead of print]