J Occup Rehabil. 2026 Jun 19. doi: 10.1007/s10926-026-10410-x. Online ahead of print.
ABSTRACT
PURPOSE: To synthesize the evidence regarding the effectiveness of the participatory approach (PA) on return to work (RTW) of sick-listed workers compared to usual care and other interventions.
METHODS: A systematic review and meta-analysis were conducted according to the PRISMA guidelines, searching five databases for evidence from their inception until February 2025. Studies were eligible for inclusion if they included sick-listed workers, conducted a PA intervention at the workplace focused on RTW, and included a comparison group. Data on RTW, health, and economic outcomes were extracted, and the quality of the studies was appraised. Data on time until full and lasting RTW were pooled, and a meta-analysis was conducted, followed by an assessment of the certainty of the evidence.
RESULTS: Eight randomized controlled trials reported across 14 papers were included. Half of the studies had a good quality score, whereas the remaining studies were considered of poor (n = 3) or fair (n = 1) quality. While no significant overall effect of the PA on time until full and lasting RTW was found, a statistically significant effect in favor of the PA was observed among sick-listed workers with low back pain (LBP) compared to control conditions.
CONCLUSION: The evidence provides moderate certainty that the PA is effective in reducing time to full and lasting RTW for sick-listed workers with LBP compared to usual care. However, for workers sick-listed due to mental health conditions or mixed health complaints, the evidence does not support its effectiveness, and the certainty of this evidence is very low. More high-quality research and realist evaluations across different settings and populations are needed to strengthen the evidence on the PA as an RTW intervention and to explain its underlying working mechanisms.
PMID:42319608 | DOI:10.1007/s10926-026-10410-x