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Region Hovedstaden - en del af Københavns Universitetshospital

Integreret Behandlings- og BeskæftigelsesIndsats til Sygedagpengemodtagere med depression, angst og stress (IBBIS)

Projekt: Typer af projekterProjekt

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Introduction
Common mental disorders (CMDs) like anxiety, depression, and stress are highly prevalent and cause decline in functioning. Therefore, CMDs can lead to long term sick leave which is a substantial challenge for both individuals and society. Thus, it has been recommended that society should improve support to individuals on sick leave because of CMDs. However, there is still relatively little evidence on how to best support persons on sick leave due to CMDs. Though treatment from the health care system is expected to be pivotal to (vocational) recovery, the health care system is not the only important support system: the workplace, the insurance system and the patients’ social system also affects vocational recovery. Recent research shows that a combination of workdirected interventions and health care interventions shortens the sick leave duration compared to service as usual. Furthermore, some research points to that integration of vocational and health care interventions might be beneficial for persons with mental disorders. However, integrated service models are difficult to implement, and few specific integrated service models have yet shown improvements on return to work for persons with CMDs.

The IBBIS project aimed to develop an integrated mental health care and vocational rehabilitation inter-vention for persons on sick leave due to CMDs (the IBBIS intervention). The IBBIS intervention aimed to both improve the recovery and return to work process for the person on sick leave. Furthermore, the IBBIS project aimed to investigate:
1.The effectiveness in terms of vocational, symptom, and functional level, quality of life, satisfaction with intervention, and selfefficacy of the IBBIS intervention
2.The effectiveness of a clinical interview assessing eligibility for the IBBIS intervention
3.The implementation and functioning of core activities in the IBBIS intervention
4.The predictors for return to work for persons with CMDs
5.The cost-effectiveness of the IBBIS intervention
6.Possible clusters of trajectories in terms of vocational, symptom, and functional level in the target group

Method
The IBBIS project took a starting point in the investigation of the IBBBIS intervention’s effectiveness (aim 1) which was tested in a randomized, three-arm, multicenter, parallelgroup, superiority trial. However, aim 2-6 were fulfilled by five separate studies (studies 2-6). For studies 1-2 and 4-6, the primary focus was on the outcomes of the service users of the IBBIS intervention and the diagnostic subgroups: persons diagnosed with anxiety, depression and different types of stress. But other stakeholders (e.g. profes-sionals and managers) were investigated in the study 2 addressing implementation and functioning of the intervention through a process evaluation and fidelity reviews. The IBBIS research project had a multi-method approach and built on both register data, questionnaire data, clinical data, management data, semi-structured interviews, fieldnotes from observations, and project documents.
To get an overview of the full design of the studies in the IBBIS project, please see (https://www.psykiatri-regionh.dk/Kvalitet-og-udvikling/udvikling/ibbis/Sider/IBBIS-forskning.aspx).

Results
The results from studies 1-2 and 4-6 are not yet finalized.
Study 3 showed that the IBBIS intervention was not implemented as intended for the IBBIS trial. Though implementation degree improved throughout the trial, the implementation failure precludes making solid conclusion from the findings of study 1. Study 3 also showed that the implementation of integration between services was supported by the establishment of shared goals and personal relationships between professionals and personal trust between professionals and service users.

Discussion and impact
Study 1-3 and 5 will contribute with knowledge about the feasibility and effect of the complex IBBIS intervention and thereby add to the international as well as the national knowledge base of interventions for persons on sick leave due to CMDs. Furthermore, by looking at the predictors for return to work, study 4 will illuminate factors that affect a speedy or slow vocational recovery. Study 6 will add to that knowledge by identifying common patterns in vocational, functional, and symptom trajectories for persons on sick leave due to common mental disorders.


StatusIgangværende
Periode01/07/201531/12/2021

    Forskningsområder

  • Sundhedsvidenskab - Anxiety Disorders, Psychosocial Interventions, Randomized Controlled Clinical Trial, Mood Disorders, Integration of services

ID: 48999573