Presentation M O18

M O18 (Oral Presentation):
Effectiveness of a training to enhance guideline adherence for occupational physicians on RTW in workers sick-listed with common mental disorders

Presented by: Karlijn Marieke van Beurden


Van Beurden KM1, Brouwers EPM1, Joosen MCW1, Van Weeghel J1,2,3, Terluin B4, Van der Klink JJL5

  1. Tilburg University, Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, PO Box 90153, 5000 LE Tilburg. The Netherlands.
  2. Phrenos Centre of Expertise, PO Box 1203, 3500 BE Utrecht. The Netherlands.
  3. Parnassia Group, Dijk en Duin Mental Health Center, PO Box 305, 1900 AH Castricum. The Netherlands.
  4. VU University Medical Center Amsterdam, EMGO Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine, PO Box 7057, 1007 MB Amsterdam. The Netherlands.
  5. University Medical Center Groningen, University of Groningen, Department of Health Sciences, Division of Community and Occupational Medicine, A. Deusinglaan 1, 9713 AV Groningen. The Netherlands.



In an occupational health care setting, evidence-based guidelines are considered effective tools to improve work participation of sick-listed workers. However, implementation of guidelines into practice is challenging. To improve adherence to a Dutch occupational health guideline for the management of mental health problems, we have developed a tailored implementation strategy. The aim of this study is to evaluate if this guideline adherence training for occupational physicians (OPs) leads to earlier and sustainable recovery and RTW in workers sick-listed with common mental disorders.


The 66 participating OPs were allocated to an intervention and to a control group. The intervention group received an 8-session guideline adherence training spread out over a 1-year period. In this training OPs discussed their knowledge, attitude and perceived barriers that hinder them from using the guideline, found solutions to overcome these barriers, and practiced solutions in daily practice. Participating workers were sick-listed with common mental disorders diagnosed and guided by an OP. In these workers data on RTW were collected during 1-year after the start of their sickness absence. Survival analysis was used to compare groups for the outcome time to full and sustainable RTW. Linear mixed model analysis was used to compare groups for the total number of days of sickness absence and the total number of recurrence of sickness absence.


The guideline adherence training was successfully carried out and contributed positively to the OPs’ knowledge, attitudes, and skills in using the guideline. At workers level the actual time to full and sustainable RTW and total days of sickness absence and total number of recurrence of sickness absence are currently evaluated by analyzing the RTW data of the 1-year period, and will be available in May 2014.


The guideline adherence training we developed is innovative as the target users themselves find solutions to overcome barriers they perceive, and test and evaluate these solutions in their daily practice. The results contribute to the development of evidence-based guidelines and effective occupational health care. Importantly, this method may be a useful approach to implementation of other (occupational) guidelines.

Schedule Details

Monday September 29
13:45 - 15:15 Afternoon Concurrent Sessions (M O13 - M O24 and Seminar 2)
Session: Healthcare providers’ interventions I
Room B