Key result
Tertiary interventions significantly increased the rate of return-to-work compared to treatment as usual or wait-list controls (HR 4.5), but did not significantly improve full return-to-work (OR 1.33).
Why the study?
Do tertiary interventions improve return-to-work in individuals with clinically significant burnout?
Meta-Analysis (n=1,192)
Do tertiary interventions improve return-to-work in individuals with clinically significant burnout?
Hazard Ratio: 4.5 (95% CI 2.15–9.45)
Tertiary interventions may be effective in facilitating return-to-work for individuals with clinical burnout, particularly when incorporating labor expert advice and workplace dialogue.
Tertiary interventions may hasten return-to-work in clinical burnout; extends meta-analytic support for rate but leaves full recovery uncertain.
Clinical burnout is one of the leading causes of work absenteeism in high- and middle-income countries. There is hence a great need for the identification of effective intervention strategies to increase return-to-work (RTW) in this population. This review aimed to assess the effectiveness of tertiary interventions for individuals with clinically significant burnout on RTW and psychological symptoms of exhaustion, depression and anxiety. Four electronic databases (Ovid MEDLINE, PsychINFO, PubMed and CINAHL Plus) were searched in April 2016 for randomized and non-randomized controlled trials of tertiary interventions in clinical burnout. Article screening and data extraction were conducted independently by two reviewers. Pooled odds ratios (ORs) and hazard ratios (HRs) were estimated with random-effects meta-analyses. Eight articles met the inclusion criteria. There was some evidence of publication bias. Included trials were of variable methodological quality. A significant effect of tertiary interventions compared with treatment as usual or wait-list controls on time until RTW was found, HR = 4.5, 95% confidence interval (CI) = 2.15-9.45; however, considerable heterogeneity was detected. The effect of tertiary interventions on full RTW was not significant, OR = 1.33, 95% CI = 0.59-2.98. No significant effects on psychological symptoms of exhaustion, depression or anxiety were observed. In conclusion, tertiary interventions for individuals with clinically significant burnout may be effective in facilitating RTW. Successful interventions incorporated advice from labor experts and enabled patients to initiate a workplace dialogue with their employers.
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Perski et al. (2017) conducted a meta-analysis in Clinical burnout (n=1,192). Tertiary psychosocial interventions vs. Treatment as usual or wait-list control was evaluated on Time until return-to-work (RTW) (HR 4.5, 95% CI 2.15-9.45). Tertiary interventions significantly increased the rate of return-to-work compared to treatment as usual or wait-list controls (HR 4.5), but did not significantly improve full return-to-work (OR 1.33).
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