Trajectories of work absence in England due to a musculoskeletal or mental health condition: an electronic health record study

Legha, Amardeep Singh

Abstract

Introduction
Long-term sickness absence has recently been rising in the UK, causing a record number of economically inactive individuals and prompting concern from the Government. The aim of this thesis is to derive trajectories of absence over time due to a musculoskeletal (MSK) or mental health (MH) condition in an English population and explore association of these absence trajectories with health and sociodemographic characteristics.

Methods
A national primary care dataset, the Clinical Practice Research Datalink Aurum, was used to uncover trajectories of absence through issuance of fit notes. Different trajectory derivation methods were tested based on latent class analysis, alongside different approaches to specifying time intervals and follow-up periods. Trajectory-covariate association analysis was performed through multivariable multinomial logistic regression.

Results
The optimal chosen models contained n=43,130 and n=62,355 individuals with an incident fit note due to a MSK or MH condition, respectively. Five common trajectories were uncovered for both the MSK and MH condition fit note cohorts, using latent class growth analysis and based on two-monthly intervals over a one-year follow-up post index fit note. The two most common trajectories consisted of low absence (a ‘Single’ fit note and ‘Short Term’ absence), whilst the two least common trajectories were characterised by longer-term absence (‘Chronic Sustained’ and ‘Chronic Fast Decreasing’), and the fifth by intermittent absence. Individuals associated with the most severe absence trajectories were: older, living in the North or Midlands or most deprived areas of England, prescribed opioids, and current smokers.

Conclusions
This thesis has highlighted different patterns of sickness absence due to a MSK or MH condition and profiles of individuals associated with intermittent and longer-term absence. Earlier and more targeted health and work intervention towards these high-risk subgroups, alongside policy interventions to reduce health inequalities, could help alleviate Britain’s missing worker problem.

Citation

Legha, A. S. Trajectories of work absence in England due to a musculoskeletal or mental health condition: an electronic health record study. (Thesis). Keele University. Retrieved from https://keele-repository.worktribe.com/output/956328

• Thesis Type: Thesis
• Deposit Date: Oct 28, 2024
• Publicly Available Date: Oct 28, 2024
• Public URL: https://keele-repository.worktribe.com/output/956328
• Award Date: 2024-10