359 Facilitating return to work and maintenance of employment after myocardial infarction: results of a randomised trial

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Abstract

Introduction

Cardiovascular disease is the most prevalent of life-threatening disorders in industrialised countries and is a rapidly growing problem in developing nations. Cardiac rehabilitation has been shown to reduce morbidity and mortality. One of the significant markers of recovery and an essential element in the overall well-being is the return-to-work (RTW) of cardiac patients.

Methods

In this randomised trial which spanned 2 years of follow-up, we studied 151 cardiac patients under the age of 57 who had undergone acute myocardial infarction and that had been working for at least 1 year prior to the event. Patient data was collected on three main elements: 1. Demographic, 2. Psychological and 3. Occupational parameters. Following an examination by a cardiologist, patients were randomised into intervention (n=74) and control (n=77) groups. The control group received the currently acceptable rehab program. The study group received rehabilitation program by a case manager.

Results

The study group had a significantly higher rate of RTW within 6 months than the control group (89% vs 74% respectively, p<0.05). A significantly higher return to a full-time job (80% vs 63%, p<0.05) and same position/role (98% vs 73%, p<0.001) was seen in the study vs the control group respectively. The study group exhibited a significantly higher job persistency rate compared to the control group (88% vs 72% respectively, p<0.05).

Conclusions

This study presents a novel approach for facilitating RTW and rehabilitation of cardiac patients utilising the services of occupational medicine clinics and social workers therein. The studied approach proved highly efficient with higher RTW and higher job persistency rates. We recommend the assimilation of our approach in all clinics engaging in the active rehab of cardiac patients and in the support of patient recovery and overall wellbeing.

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