THU0623 Decrease in the temporary work incapacity due to musculoskeletic diseases: utility of a preventive program in valencia-la fe health area

Abstract

Background: Musculoskeletal diseases are nowadays a frequent cause of temporary work incapacity (TWI). The implementation of specific programs for the care of these patients can be an important cornerstone in the resolution of these TWI processes., Objectives: Our aim is to analyze the usefulness of an Early Intervention Program (EIP) in patients with TWI of musculoskeletal origin., Methods: Case-control study, including patients from HUP La Fe area, which were referred from Primary Care since April 2012 to April 2016 to our Early intervention program (EIP) addressed to patients with TWI of musculoskeletal origin. The patients were evaluated in our consultation within a maximum of 15 days after the start of TWI. The intervention consisted in an evaluation, including complementary tests if necessary, diagnosis and treatment by the rheumatologist in consultation. The patient was followed in consultation continuously until discharge. Patients whose disabilities were of traumatic or surgical origin were excluded. A comparative study was carried out against a control group of patients with ILT of musculoskeletal origin., Results: A total of 666 patients were recruited; 508 (76.3%) belonged to EIP group (46.1% male; 53.9% female) and 158 patients (23.7%) belonged to the control group (44.3% male; 55.7% female)., The average age was 47,6+/-10.5 years for the EIP ones and 46.7+/-10 years in the control group., The most frequent diagnoses were low back pain (23.3%), neck pain (18%) y lumbosciatica (12.3%). In EIP group, 100% of the patients received medical treatment, a 54.5% received instructions for doings physical therapy at home, an ultrasound scan was performed to the 26,4% of the patients while the 19.9% received at least one local infiltration. The longest TWI corresponded to knee meniscopathy (203 days), painful shoulder syndrome (173 days) and lumbosciatica (170.5 days). No statistically significant differences were found between the duration of the TWI attending to sex, age group, labour activity or diagnose. However, a significant association was found between TWI duration and the delay since the start of the symptons to the referral from Primary Care to our consultation, specially within the firdt 10 days (p=0.04). Furthermore, TWI duration was significantly shorter in the EIP group patients than in the control group patients (137.4+/-132.3 days vs 194.7+/-143.1 days; p<0,001).The period before relapse was longer in the EIP group, although the differences did not reach significance. In addition, an inverse relation was found between age and time to relapse (p=0,01)., Conclusions: The establishment of an early intervention program specifically addressed to patients with temporary work incapacity of musculoskeletal origin shortens the duration of this situation, allowing the patient to rejoin his work activity, with the resulting cost savings related to work incapacity., Disclosure of Interest: None declared, (C) 2017 BMJ Publishing Group Ltd and European League Against Rheumatism