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J Altern Complement Med. 2019 Apr;25(4):377-384. doi: 10.1089/acm.2018.0257. Epub 2019 Feb 26.

Exploring Sick Leave in Integrative Care-Retrospective Observations and Future Study Recommendations.

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1 Unit for Studies of Integrative Health Care, Division of Nursing, Department of Neurobiology Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
2 Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia.
3 Occupational and Environmental Medicine Unit, Department of Public Health and Community Medicine, University of Gothenburg, Göteborg, Sweden.
4 Quality Stat AB, Umeå, Sweden.



To describe and contrast the prevalence and trends of sick leave in patients with pain or stress disorders referred to inpatient care that integrates conventional and complementary therapies, that is, integrative care (IC).


County council and social insurance data were used to retrospectively observe cross-sectional sick leave prevalence at four time points: 1 year before the first registered inpatient visit with the target diagnosis, after referral at index, and at 1 and 2 years after index. To contrast the IC findings, observations of patients with similar background characteristics referred to conventional care (CC) were used.


The sick leave prevalence of IC pain patients and IC stress patients increased from the preceding year to peak at index, where after it decreased back toward preindex levels over 2 years. Overall sick leave prevalence was higher in IC than in CC, where analogous but lower prevalence trends of sick leave changes were observed.


Observed sick leave prevalences, which were higher in IC than in CC, gradually decreased over time following IC or CC referral. While natural recovery or other reasons for change of sick leave cannot be excluded, future prospective and randomized clinical trials are recommended.


integrative care; observational study; pain; prevalence; sick leave; stress

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