Affiliations: [a] Primary Health Care/Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| [b] Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
| [c] School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| [d] Center for Clinical Research Dalarna, Uppsala University, Uppsala, Sweden
Correspondence:
[*]
Address for correspondence: Irene Svenningsson, FoU primärvård Fyrbodal, Västra Götalandsregionen, Vänerparken 15, 462 35 Vänersborg, Sweden. E-mail: [email protected].
Abstract: BACKGROUND:Collaborative care with a care manager in primary care improves care. OBJECTIVE:To study whether care manager support leads to improved work ability, decreased job strain and reduced time of sick leave among primary care patients with depression. METHODS:A clinical effectiveness study of care managers for depression patients seeking care in primary care was conducted in a RCT 2014 –2016. Patients in the intervention group were assigned a care manager. In the 12-month follow-up, patients with employment (n = 269; intervention n = 142, control n = 127) were studied concerning work ability, job strain and sick leave. RESULTS:An association was shown between reduction of depressive symptoms and improved work ability for the entire group. At 12-month follow-up a statistically significant difference of reduction of depressive symptoms was seen between the groups (MADRS-S: intervention 10.8 vs control 13.1, p = 0.05) as well as increased quality of life (EQ-5D: intervention 0.77 vs control 0.70, p = 0.04). In the intervention group, a concordance was found between the patient’s prediction of return to work and the actual return to work (91%for intervention and 68 %for control group, p = 0.047). CONCLUSIONS:Compared to usual care, the care manager does not seem to further improve perception of work ability, job strain or perception of social support per se among the patients despite a long-term effect on depression symptoms. The lack of a long-term effect regarding these aspects may be due to the fact that care manager support was only provided during the first three months.
Keywords: Primary health care, job strain, work ability index, return to work, depression
