Op-292 Functional And Contextual Criteria For Sick Leave Prescription In General Practice: The Atcif Study

Letrilliart L. (Lyon), Kellou N. (Gent), Barral C. (Gent), Perez P. (Gent), Cuenot M. (Gent), Heuls B. (Gent), Verbeke M. (Gent), Falez F. (Gent)
Introduction: Sick leave prescription involves medical issues (influence possibly negative of a too short or too long sick leave on the outcome of a health problem). Our main aim was to describe the functional limitations and the contextual factors of patients prescribed a sick leave.
Methods: We conducted a cross-sectional study, between December 2007 and March 2008. The investigators were nine general practice residents in teaching practices, formerly trained to the use of a check-list derived from the International Classification of Functioning, Disability and Health (ICF). Data were collected using a questionnaire informed within the consultation.
Results: We have included 435 patients, aged 36.9 years in average, among which 54.3% men, 57.7% employees, 71.3% living in a couple, without chronic pathology for 75.4%, and 81.1% were prescribed an initial sick leave. The most frequently reported impairment was a sensation of pain (19.5%), activity limitation was focusing attention (16.6%). An environmental obstacle was identified in 41.6% of situations, mainly due to a lack of adaptation of work station (40.6%).
Discussion: ICF adapted check-list was considered quick and easy to use by the investigators (median time of 3 minutes per patient), and suited to the description of functional limitations. They were less familiar with incorporating environmental obstacles in their clinical assessment. The acceptability of this approach remains to be explored further.
Functional and contextual criteria for sick leave prescription in general practice: the ATCIF study