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A systematic review and meta-analysis of tertiary interventions in clinical burnout

Perski, O; Grossi, G; Perski, A; Niemi, M; (2017) A systematic review and meta-analysis of tertiary interventions in clinical burnout. Scandinavian Journal of Psychology , 58 pp. 551-561. 10.1111/sjop.12398. Green open access

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Abstract

Clinical burnout is one of the leading causes of work absenteeism in high- and middle-income countries. There is hence a great need for the identificationof effective intervention strategies to increase return-to-work (RTW) in this population. This review aimed to assess the effectiveness of tertiary interventions for individuals with clinically significant burnout on RTW and psychological symptoms of exhaustion, depression and anxiety. Four electronic databases (Ovid MEDLINE, PsychINFO, PubMed and CINAHL Plus) were searched in April 2016 for randomized and non-randomized controlled trials of tertiary interventions in clinical burnout. Article screening and data extraction were conducted independently by two reviewers. Pooled odds ratios (ORs) and hazard ratios (HRs) were estimated with random-effects meta-analyses. Eight articles met the inclusion criteria. There was some evidence of publication bias. Included trials were of variable methodological quality. A significant effect of tertiary interventions compared with treatment as usual or wait-list controls on time until RTW was found, HR = 4.5, 95% confidence interval (CI) = 2.15–9.45; however, considerable heterogeneity was detected. The effect of tertiary interventions on full RTW was not significant, OR = 1.33, 95% CI = 0.59–2.98. No significant effects on psychological symptoms of exhaustion, depression or anxiety were observed. In conclusion, tertiary interventions for individuals with clinically significant burnout may be effective in facilitating RTW. Successful interventions incorporated advice from labor experts and enabled patients to initiate a workplace dialogue with their employers.

Type: Article
Title: A systematic review and meta-analysis of tertiary interventions in clinical burnout
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/sjop.12398
Publisher version: http://dx.doi.org/10.1111/sjop.12398
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Clinical burnout, exhaustion, tertiary interventions, return-to-work, systematic review, meta-analysis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10028644
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