Prolonging working careers is a key policy goal in ageing populations in Europe, but reaching this goal is complex. Occupational health services are in the best position to contribute towards prolonging working careers through preventing illnesses that cause work disability and early retirement. However, impacting on the trajectory between illness and work disability requires continuity of care and follow up, enabled through identifying patients at risk. We aimed to determine whether a combined educational and electronic reminder system in occupational health care could improve the recording and follow up of primary care visits made by patients at risk of work disability, and whether the system could impact on sickness absence rates. This study is a pragmatic, cluster-randomized controlled trial using medical record data. Twenty-two Pihlajalinna Työterveys units were randomized into an intervention group receiving education and electronic reminders or a group receiving usual care through minimization methods. Patient consultation data were extracted from routine Pihlajalinna Työterveys patient registers from 2015 to 2017. In addition, process indicators were collected from the electronic system. Data were cleaned and analysed on an intention-to-treat basis using analysis of covariance. There was no significant difference between intervention and control units in terms of sickness absences of different duration. Process indicators suggested that there was a change in physicians’ practice of recording patients’ risk of work disability and work-relatedness of visits following the educational intervention. Education with an electronic reminder can change physicians’ practice, but long-term follow up is needed to determine whether this impacts on patients’ sickness absences. ISRCTN Registry: ISRCTN45728263. Registered on 12 April 2016.

中文翻译：

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改善职业基础卫生保健患者咨询期间工作相关性的记录：使用常规数据进行的一项随机对照试验

延长职业生涯是欧洲人口老龄化的关键政策目标，但要实现这一目标却很复杂。职业卫生服务最适合通过预防导致工作残疾和提早退休的疾病，为延长职业生涯做出贡献。但是，影响疾病和工作残疾之间的关系需要持续的护理和后续行动，这可以通过识别有风险的患者来实现。我们旨在确定职业卫生保健中的教育和电子提示结合系统是否可以改善有工作残障风险的患者对初级保健就诊的记录和随访，以及该系统是否会影响疾病缺席率。这项研究是使用病历数据的实用，整群随机对照试验。将22个PihlajalinnaTyöterveys单位随机分为接受教育和电子提醒的干预组，或通过最小化方法接受常规护理的组。从2015年至2017年从PihlajalinnaTyöterveys的常规患者登记册中提取了患者咨询数据。此外，还从电子系统中收集了过程指标。使用协方差分析对数据进行清理并按意向进行分析。就不同时期的疾病缺勤而言，干预单位与控制单位之间没有显着差异。过程指标表明，在进行教育干预后，记录患者的工作残疾风险和就诊相关性的医生做法发生了变化。带有电子提醒的教育可以改变医生的执业方式，但是需要进行长期随访以确定这是否会影响患者的病假。ISRCTN注册中心：ISRCTN45728263。2016年4月12日注册。