Research Reports - Effective return-to-work interventions after acquired brain injury

Brain Inj. 2015 Dec 8:1-19. [Epub ahead of print]

Donker-Cools BH(1,)(2), Daams JG(1), Wind H(1,)(2), Frings-Dresen MH(1,)(2).

OBJECTIVE: To gather knowledge about effective return-to-work (RTW) interventions
for patients with acquired brain injury (ABI).
METHODS: A database search was performed in PubMed, EMBASE, PsycINFO, CINAHL and
the Cochrane Library using keywords and Medical Subject Headings. Studies were
included if they met inclusion criteria: adult patients with non-progressive ABI,
working pre-injury and an intervention principally designed to improve RTW as an
outcome. The methodological quality of included studies was determined and
evidence was assessed qualitatively.
RESULTS: Twelve studies were included, of which five were randomized controlled
trials and seven were cohort studies. Nine studies had sufficient methodological
quality. There is strong evidence that work-directed interventions in combination
with education/coaching are effective regarding RTW and there are indicative
findings for the effectiveness of work-directed interventions in combination with
skills training and education/coaching. Reported components of the most effective
interventions were tailored approach, early intervention, involvement of patient
and employer, work or workplace accommodations, work practice and training of
social and work-related skills, including coping and emotional support.
CONCLUSION AND IMPLICATIONS: Effective RTW interventions for patients with ABI
are a combination of work-directed interventions, coaching/education and/or
skills training. These interventions have the potential to facilitate sustained
RTW for patients with ABI. 

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