Purpose There is a lack of results on long-term effects of return to work interventions. We previously reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective in reducing sickness absence and facilitating return to work (RTW) at 12 months follow-up compared to an outpatient program that consisted mainly of Acceptance and Commitment Therapy (O-ACT). We now report the 2-year outcome data. Methods A randomized clinical trial with parallel groups. Participants were 18–60 years old, sick listed with musculoskeletal, common mental or general/unspecified disorders. I-MORE lasted 3.5 weeks and consisted of ACT, physical training and work-related problem solving. O-ACT consisted mainly of 6 weekly sessions (2.5 h. each) of ACT in groups. Outcomes were cumulated number of days on medical benefits and time until sustainable RTW (1 month without medical benefits) during 2-years of follow-up, measured by registry data. Results For the 166 randomized participants, the median number of days on medical benefits was 159 (IQR 59–342) for I-MORE vs 249 days (IQR 103–379; Mann–Whitney U test, p = 0.07), for O-ACT. At 2 years, 40% in I-MORE received long-term benefits (work assessment allowance) vs 51% in O-ACT. The crude hazard ratio (HR) for sustainable RTW was 1.59 (95% CI 1.04–2.42, p = 0.03) and the adjusted HR 1.77 (95% CI 1.14–2.75, p = 0.01), in favor of I-MORE. Conclusions The 2-year outcomes show that I-MORE had long-term positive effects on increasing work participation for individuals sick listed with musculoskeletal and mental disorders. Further follow-up and economic evaluations should be performed.

目的缺乏关于重返工作岗位干预的长期影响的结果。我们之前曾报道，与主要包括接受和承诺治疗的门诊计划相比，住院多模式职业康复计划 (I-MORE) 在减少病假和促进 12 个月随访时重返工作岗位 (RTW) 方面更有效。 O-ACT）。我们现在报告 2 年结果数据。方法具有平行组的随机临床试验。参与者年龄在 18-60 岁之间，患有肌肉骨骼疾病、常见的精神疾病或一般/未指明的疾病。I-MORE 历时 3.5 周，包括 ACT、体能训练和与工作相关的问题解决。O-ACT 主要包括每周 6 次的 ACT 课程（每次 2.5 小时）。结果是通过注册数据衡量的 2 年随访期间，医疗福利的累积天数和可持续 RTW（没有医疗福利的 1 个月）的时间。结果对于 166 名随机参与者，I-MORE 的中位医疗福利天数为 159（IQR 59-342），而 O-ACT 为 249 天（IQR 103-379；Mann-Whitney U 检验，p = 0.07） . 在 2 年时，I-MORE 中 40% 的人获得了长期福利（工作评估津贴），而 O-ACT 中为 51%。可持续 RTW 的粗略风险比 (HR) 为 1.59 (95% CI 1.04–2.42, p = 0.03)，调整后的 HR 为 1.77 (95% CI 1.14–2.75, p = 0.01)，支持 I-MORE。结论2 年的结果表明，I-MORE 对增加患有肌肉骨骼和精神障碍的患者的工作参与度具有长期的积极影响。应进行进一步的随访和经济评估。