Training GPs to improve their management of work-related problems: results of a cluster randomized controlled trial

Eur J Gen Pract. 2018 Dec;24(1):258-265. doi: 10.1080/13814788.2018.1517153.

Abstract

Background: Paying attention to their patients' work and recognizing work-related problems is challenging for many general practitioners (GPs).

Objectives: To assess the effect of training designed to improve the care for patients with work-related problems in general practice.

Methods: A cluster randomized controlled trial among 32 Dutch GPs. GPs in the intervention group received five-hour training. GPs in the control group were not trained. Included patients (age 18-63, working ≥12 h per week) completed baseline questionnaires and follow-up questionnaires planned after one year. Primary outcome at patient level was patients' expectations about their ability to work, measured using the return-to-work self-efficacy scale (RTW-SE). Primary outcomes on GP level were their use of ICPC-code Z05 ('work-related problem') per 1000 working-age patients and percentage of the electronic medical files of working-age patients in which information about occupation had been recorded.

Results: A total of 640 patients completed the baseline questionnaire and 281 the follow-up questionnaire. We found no statistically significant differences in patients' RTW-SE scores: intervention 4.6 (95%CI: 4.2-5.0); control 4.5 (95%CI: 4.1-4.9). Twenty-nine GPs provided data about the GP-level outcomes, which showed no statistically significant differences: use of ICPC code Z05 11.6 (95%CI: 4.7-18.6) versus 6.0 (95%CI: -1.2 to 13.2) per 1000 working-age patients; recording of occupation 28.8% (95%CI: 25.8-31.7) versus 28.6% (95%CI: 25.6-31.6).

Conclusion: Training GPs did not improve patients' work-related self-efficacy or GPs' registration of work-related problems and occupation.

Keywords: Work-related problems; educational training; general practitioners; randomized controlled trial; return-to-work self-efficacy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Cluster Analysis
  • Employment / psychology
  • Female
  • General Practice / organization & administration*
  • General Practice / standards
  • General Practitioners / education
  • General Practitioners / organization & administration*
  • General Practitioners / standards
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Occupations
  • Practice Patterns, Physicians' / standards*
  • Quality of Health Care
  • Return to Work / psychology*
  • Self Efficacy
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

Foundation Institute Gak [grant number 2008-762].