Early vocational rehabilitation and psychological support for trauma patients to improve return to work (the ROWTATE trial): study protocol for an individually randomised controlled multicentre pragmatic trial

Trials, 2024 · DOI: https://doi.org/10.1186/s13063-024-08183-w · Published: May 17, 2024

Simple Explanation

This study investigates whether providing early vocational rehabilitation (VR) and psychological support can help trauma patients return to work or education. The study will compare patients who receive VR and psychological support in addition to usual care, with those who only receive usual care. The main goal is to see if the VR intervention improves patients' ability to return to work or education for at least 80% of their pre-injury hours, 12 months after the start of the study.

Study Duration

12 months intervention, 30 months recruitment period

Participants

722 participants with ISS > 8

Evidence Level

Level 1: Individually randomised controlled multicentre pragmatic trial

Key Findings

1
The primary objective is to establish whether the ROWTATE VR intervention plus usual care is more effective than usual care alone for improving participants’ self-reported return to work/education for at least 80% of pre-injury hours at 12 months post-randomisation.
2
The ROWTATE VR intervention is individually tailored specialist VR that aims to lessen the impact of injury on work/education demands by assessing the participant’s role as an employee/student to find acceptable strategies to overcome problems.
3
This trial will provide robust evidence regarding a VR intervention for a major trauma population.

Research Summary

The ROWTATE trial is designed to evaluate the effectiveness of early vocational rehabilitation (VR) and psychological support for trauma patients to improve their return to work or education. The trial includes an individually randomised controlled multicentre pragmatic trial, an internal pilot, economic evaluation, a process evaluation, and an implementation study. The study aims to provide robust evidence for commissioners and providers to adopt VR services for trauma patients within the NHS, if the intervention proves clinically and cost-effective.

Practical Implications

Clinical Practice

Evidence-based VR intervention can be integrated into trauma care pathways to improve return-to-work outcomes.

Healthcare Policy

Findings can inform the commissioning and provision of VR services within the NHS for major trauma patients.

Future Research

Further studies can explore the long-term impact of VR interventions and identify factors that moderate treatment effects.

Study Limitations

1
Slower than anticipated recruitment due to site set-up delays and staff absences.
2
Potential for contamination, where control arm participants receive the intervention.
3
Limited capacity of occupational therapists delivering the intervention.

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