4 research outputs found
Job retention vocational rehabilitation for employed people with inflammatory arthritis: adaptations to the WORKWELL trial due to the impact of the COVID-19 pandemic
There are high levels of work disability, absenteeism (sick leave) and presenteeism (reduced productivity) amongst people with inflammatory arthritis. WORKWELL is a multi-centre, randomised controlled trial of job retention vocational rehabilitation for employed people with inflammatory arthritis. The trial tested the effectiveness and cost-effectiveness of the WORKWELL programme compared to the receipt of written self-help information only. Both arms continued to receive usual care. In March 2020, due to the COVID-19 pandemic, the WORKWELL trial paused to recruitment and intervention delivery. To successfully re-start, protocol amendments were rapidly submitted and changes to existing trial procedures were made. The WORKWELL protocol was adapted in response to both the practical issues likely faced by many clinical research studies active across NHS sites during the pandemic and additional trial-specific challenges. A key eligibility criterion for the trial required participants to be in paid work for at least 15 h per week. However, UK national lockdowns led to a substantial proportion of the workforce suddenly being furloughed or unable to work, and many people with arthritis taking immunosuppressive medications were asked to shield themselves. Thus, the number of eligible participants was reduced. Those continuing to work were harder to identify, as hospital clinics moved to remote delivery, and also to then screen, consent and treat, as the hospital research staff and clinical therapists were re-deployed. New recruitment and consent strategies were applied, and where sites had reduced capacity, responsibilities were absorbed by the trial management team. Remote intervention delivery and electronic data capture were also implemented. By rapidly adapting the WORKWELL protocol and procedures, the trial successfully reopened to recruitment in July 2020, only 4 months after the trial pause. We were able to achieve recruitment figures above the pre-COVID target and maintain a high retention rate. In addition, we found many of the protocol changes beneficial, as these streamlined trial procedures, thus improving efficiency. It is likely that many strategies implemented in response to the pandemic may become standard practice in future research within trials of a similar design and methodology. Trial registration: ClinicalTrials.gov NCT03942783. Retrospectively registered on 08 May 2019. ISRCTN Registry ISRCTN61762297. Retrospectively registered on 13 May 2019
The development and evaluation of a vocational rehabilitation training programme for rheumatology occupational therapists
People with inflammatory arthritis rapidly develop work disability, yet there is limited provision of vocational
rehabilitation (VR) in rheumatology departments. As part of a randomized, controlled trial, ten occupational
therapists (OTs) were surveyed to identify their current VR provision and training needs. As a result, a VR training course
for OTs was developed which included both taught and self-directed learning. The course included: employment and
health and safety legislation, work assessment and practical application of ergonomic principles at work.
Pre-, immediately post- and two months post-training, the ten OTs completed a questionnaire about their VR
knowledge and confidence On completion, they reported a significant increase (p<0.01)in their knowledge and
confidence when delivering vocational rehabilitation. They rated the course as very or extremely relevant, although
seven recommended more practical sessions. The preference for practical sessions was highlighted, in that the aspects
they felt most beneficial were role-playing assessments and sharing ideas through discussion and presentations.
In conclusion, the course was considered effective in increasing both knowledge and confidence in using VR as an
intervention, but, due to time constraints within the working day, some of the self-directed learning should be
incorporated into the training days
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