Affecting patients with work-related problems by educational training of their GPs: a cost-effectiveness study

• Published in: BMC family practice Vol. 20; no. 1; pp. 38 - 10
• Main Authors: de Kock, Cornelis, Noben, Cindy, Lagro-Janssen, Antoine, Lucassen, Peter, Knottnerus, André, de Rijk, Angelique, Nijhuis, Frans, Steenbeek, Romy, Evers, Silvia
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.03.2019; BioMed Central; BMC
• Subjects: Adult; Analysis; Clinical trials; Collaboration; Cost analysis; Cost-Benefit Analysis; Efficiency; Employees; Female; Gender; General practitioners; General Practitioners - education; Health Care Costs; Health care expenditures; Health economics; Humans; Intervention; Male; Medical practice; Medical research; Middle Aged; Netherlands; Occupational Health - education; Occupational/environmental medicine; Patient care; Patients; Primary care; Production management; Productivity; Quality of Life; Questionnaires; Randomized controlled trial; Rehabilitation/disabilities; Return to Work; Self Efficacy; Sick leave; Training; Workers with disabilities; Workshops (Educational programs); Netherlands; Rehabilitation/disabilities; Health economics; Occupational/environmental medicine; Primary care; Randomized controlled trial
• ISSN: 1471-2296; 1471-2296
• DOI: 10.1186/s12875-019-0924-9

Assessing the cost effectiveness of training aimed at increasing general practitioners' (GP) work awareness and patients' work-related self-efficacy and quality of life. A cluster randomized controlled trial in twenty-six GP practices in the southeast of the Netherlands with 32 participating GPs. GPs working in an intervention group practice received training and GPs working in a control group practice delivered usual care. The training intervention consisted of lectures and workshops aimed at increasing GPs' work awareness and more proactive counseling for patients with work-related problems (WRP). Subjects were working age patients with paid work for at least 12 h per week, who visited one of the participating GPs during the study period. As outcome measures we used the Return to Work Self Efficacy scale to assess patients' work-related self-efficacy and the Euroquol to assess quality of life. We also measured health care costs and productivity costs. With a 4-item questionnaire we asked patients to assess their GPs' work awareness. Data were collected at baseline, after 6 and 12 months. Data of 280 patients could be analyzed. The patient related outcomes did not improve after GP training. The change in GP work awareness and the overall mean cost difference (of €770) in favor of the intervention group were not significant. The training intervention presented in this paper was not cost-effective. Training which is further personalized and targeted at high risk groups with respect to WRP, is more likely to be cost effective.