An 18-month return-to-work aftercare programme did not raise sustained return to work

Design

Multicentre randomised controlled trial, intention-to-treat

Population

484 sick-listed employees with a diagnosed mental disorder, treated in psychiatric outpatient clinics in Germany

Primary outcome

Self-reported sustained return to work, no more than 6 weeks sickness absence within 12 months after full return

Effect

OR 1.38 (95% CI 0.89 to 2.12), not significant

A German multicentre trial randomised 484 sick-listed employees with a diagnosed mental disorder to usual care or usual care plus an 18-month aftercare programme that combined medical-psychotherapeutic and work-focused elements.

Self-reported sustained return to work, defined as no more than six weeks of sickness absence in the 12 months after full return, was not significantly different (OR 1.38, 95% CI 0.89 to 2.12). Secondary outcomes also showed no significant effects, though they leaned slightly towards the programme.

Subgroup analyses suggested possible benefit in recurrent depressive disorder, in people without a recognised disability degree and in those with low workplace support. After adjustment for multiple testing only the recurrent depression finding on work ability held. These are hypotheses for future trials. The outcome was self-reported, which is a limitation.

• Ask about workplace support and recurrence history when planning a return to work.
• Do not expect an intensive aftercare model alone to change sustained return rates.
• Treat subgroup benefits, including in recurrent depression, as unproven.
• Document work-related goals alongside clinical recovery at follow-up.

Why it matters

More aftercare time does not automatically translate into more people back at work.

Don't overread it

Outcomes were self-reported, and the subgroup signals were exploratory.

The statistics, in plain English

An odds ratio of 1.38 with an interval from 0.89 to 2.12 includes no effect and a sizeable benefit, so the trial was inconclusive on the question rather than clearly negative. Subgroup findings are weaker than the main result.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.