Musculoskeletal disorders is the leading cause of disability worldwide and generates substantial societal costs, particularly through productivity loss. Within occupational health, large practice variation persists in the management of employees with back pain.
Occupational Health Service Arbo Unie has developed the digital musculoskeletal recovery pathway, which integrates the new evidence-based guideline for musculoskeletal disorders for occupational and insurance physicians. The pathway provides a structured stepped-care approach focused on rapid return-to-work, self-management, and coordination between curative and occupational care. The main goal of the recovery pathway is to help professionals better implement evidence-based guidelines by reducing practice variation.
This implementation study uses a non-randomized controlled trial including with primary outcome sustainable employability (time to full return-to-work), and secondary outcomes such as pain, disability, work productivity, and daily functioning. Implementation indicators will be extracted from the Arbo Unie database. A full economic evaluation assesses cost-effectiveness, cost-benefit, and cost-utility from healthcare and societal perspectives. A mixed-methods realist process evaluation explores what works, for whom, and under which circumstances, supported by focus group interviews with employees and key stakeholders. The overarching aim is to develop a blueprint for implementing occupational health guidelines within and beyond Arbo Unie.