Background: Common mental disorders are strongly associated with long-term sickness absence, which has negative consequences\nfor the individual employeeââ?¬â?¢s quality of life and leads to substantial costs for society. It is important to focus on return to work\n(RTW) during treatment of sick-listed employees with common mental disorders. Factors such as self-efficacy and the intention\nto resume work despite having symptoms are important in the RTW process. We developed ââ?¬Å?E-health module embedded in\nCollaborative Occupational health careââ?¬Â (ECO) as a blended Web-based intervention with 2 parts: an eHealth module\n(Return@Work) for the employee aimed at changing cognitions of the employee regarding RTW and a decision aid via email\nsupporting the occupational physician with advice regarding treatment and referral options based on monitoring the employeeââ?¬â?¢s\nprogress during treatment.\nObjective: This study evaluated the effect of a blended eHealth intervention (ECO) versus care as usual on time to RTW of\nsick-listed employees with common mental disorders.\nMethods: The study was a 2-armed cluster randomized controlled trial. Employees sick-listed between 4 and 26 weeks with\ncommon mental disorder symptoms were recruited by their occupational health service or employer. The employees were followed\nup to 12 months. The primary outcome measures were time to first RTW (partial or full) and time to full RTW. Secondary\noutcomes were response and remission of the common mental disorder symptoms (self-assessed).\nResults: A total of 220 employees were included: 131 participants were randomized to the ECO intervention and 89 to care as\nusual (CAU). The duration until first RTW differed significantly between the groups. The median duration was 77.0 (IQR\n29.0-152.3) days in the CAU group and 50.0 (IQR 20.8-99.0) days in the ECO group (hazard ratio [HR] 1.390, 95% CI 1.034-1.870,\nP=.03). No significant difference was found for duration until full RTW. Treatment response of common mental disorder symptoms\ndid not differ significantly between the groups, but at 9 months after baseline significantly more participants in the ECO group\nachieved remission than in the CAU group (OR 2.228, 95% CI 1.115-4.453, P=.02). Conclusions: The results of this study showed that in a group of sick-listed employees with common mental disorders, applying\nthe blended eHealth ECO intervention led to faster first RTW and more remission of common mental disorder symptoms than\nCAU.
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