Biomedical subjects

N Fleten

Publications and source records attributed to N Fleten.

3 recordsLinked to original sources

PubMed2006

Reducing sick leave by minimal postal intervention: a randomised, controlled intervention study.

BACKGROUND: The lack of efficient medical interventions for combating increasing sickness absence rates has lead to the introduction of alternative measures initiated by the Norwegian National Insurance Service or at workplaces. AIM: To determine whether minimal postal intervention had any effect on the length of sick leave. METHODS: Randomised, controlled trial with a one year follow up in Northern Norway in 1997 and 1998; 990 consecutive newly sick-listed persons with musculoskeletal or mental disorders were studied. Within the intervention group, 495 eligible sick-listed persons received a general information letter and a questionnaire as their sick leave passed 14 days. Possible intervention effects were analysed by survival analysis of the probability of returning to work within one year, and logistic regressions with benefits at one year as the dependent variable. RESULTS: The overall reduction of 8.3 (95% CI -22.5 to 6.0) calendar days in mean length of sick leaves in the intervention group compared to controls, was not statistically significant. However, intervention significantly reduced length of sick leaves in subgroups with mental disorders, and with rheumatic disorders and arthritis, and overall for sick leaves lasting 12 weeks or more. Young people with low back pain showed an adverse effect to intervention. The overall relative risk of receiving benefits due to sickness after one year in the intervention group was 0.69 (95% CI 0.51 to 0.93) compared to controls. CONCLUSION: The results should encourage employers, insurance institutions, and authorities to initiate challenges as questions on the length of sick leave and possible modified work measures, during the first few weeks of sick leave, for at least some groups of sick-listed persons.

Absenteeism↗

PubMed1999

[Sick-listed persons think job adjustments might reduce sick-leave].

In the 1990's, improving the follow-up of sick-listed patients with a focus on job adjustments has been a priority in Norwegian social policy. In a study of 1,000 consecutive sick-listed patients (14 days or more) with a musculoskeletal or mental disorder as primary diagnosis, we asked 499 randomly selected sick-listed patients about their opinion on whether adjustments in their job situation might reduce their need for sick-leave in the current episode or in the future. 161 useful questionnaires were returned. Nearly 30% replied that job adjustments might bring down his or her current sick-leave, and 40% thought that job adjustments might reduce future needs for sick-leaves. One in four were of the opinion that they might return to work immediately if job adjustments were made. Among those who knew about job adjustments which had in fact been implemented at their place of work, there were no significant differences in the estimates of potential reductions by age, sex, diagnosis or occupation, with the exception that young women who worked in places where such adjustments had been made, had little belief in the potential of such adjustments. We may conclude that in the sick-listed patients' own opinion, job adjustments have a considerable potential for cutting down the number of working days lost by sickness. The Norwegian "active sick-leave" scheme is suitable and might be used more.

Adult↗

PubMed1995

[The value of C-reactive protein testing in suspected lower respiratory tract infections. A study from general practice on the effect of a rapid test on antibiotic research and course of the disease in adults].

We wanted to assess whether routine use of a rapid test for C-reactive protein (CRP) could reduce prescription of antibiotics for adults with possible lower respiratory tract infection. 239 patients were randomized into a CRP group, tested with the rapid test (n = 108) and a control group (n = 121). Before knowing to which group the patient belonged the doctors made a preliminary decision about antibacterial treatment. The C-reactive protein value was then released if the patient belonged to the CRP group, and the therapy could be adjusted in light of the result. Antibacterial courses prescribed during the consultations and in the following three weeks were registered. The clinical course was evaluated by interview after one week and again after three weeks. Antibiotics were prescribed for altogether 56% of the patients in the CRP group and 60% in the control group. The difference was not statistically significant. Prescription of antibiotics was strongly associated with the finding of crackles and wheezes, but not with cough, dyspnoea or chest pain. Slow recovery was associated with high age, absence of fever and a normal value of C-reactive protein. No significant benefit of the CRP test was demonstrated. We discuss whether the doctors made full practical use of the information provided by the test. Bronchial obstruction should probably be considered to be the problem more often in coughing patients with a normal CRP value.

Adolescent↗