Predicting non-return to work in patients attending cardiac rehabilitation.

Return to work (RTW) is the primary goal in the rehabilitation of patients suffering from coronary heart diseases. However, in spite of expensive rehabilitative efforts, many patients do not resume work following cardiac rehabilitation. To increase cost-effectiveness, predictive tests for non-RTW are needed to identify patients who are at risk of applying for early retirement, for reasons other than medical ones, at the beginning of the rehabilitation process, so that the necessary intervention is incorporated into the rehabilitation programme. As part of a study aiming at developing an advisory programme which can be integrated into existing rehabilitation programmes, we developed a screening instrument for the identification of persons at risk of not returning to work at the onset of the rehabilitation process. More than 65% of the participants who had not returned to work 6 and 12 months following rehabilitation had been correctly identified as risk patients at the beginning of the rehabilitation process. Seventy-five percent had been correctly identified as not being at risk. Multiple regression analysis results showed that increased age, profession, positive expectations concerning RTW and level of depression were significant predictors of RTW. Gender and anxiety were not significant predictors.