%0 Journal Article
%T 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.
%A Kendrick D
%A Lindley R
%A Blackburn L
%A Roadevin C
%A Thompson E
%A Andrews I
%A Anwar F
%A Brooks A
%A Carlton E
%A Crouch R
%A Day F
%A Fallon S
%A Farrin A
%A Graham L
%A Hoffman K
%A Howell R
%A Holmes J
%A James M
%A Jones T
%A Kellezi B
%A Kettlewell J
%A Morriss R
%A das Nair R
%A Richardson D
%A Smith M
%A Timmons S
%A Wright-Hughes A
%A Radford K
%J Trials
%V 25
%N 1
%D 2024 Jul 2
%M 38956682
%F 2.728
%R 10.1186/s13063-024-08183-w
%X <B>BACKGROUND: </B>Moderately severe or major trauma (injury severity score (ISS) > 8) is common, often resulting in physical and psychological problems and leading to difficulties in returning to work. Vocational rehabilitation (VR) can improve return to work/education in some injuries (e.g. traumatic brain and spinal cord injury), but evidence is lacking for other moderately severe or major trauma.<BR><B>METHODS: </B>ROWTATE is an individually randomised controlled multicentre pragmatic trial of early VR and psychological support in trauma patients. It includes an internal pilot, economic evaluation, a process evaluation and an implementation study. Participants will be screened for eligibility and recruited within 12 weeks of admission to eight major trauma centres in England. A total of 722 participants with ISS > 8 will be randomised 1:1 to VR and psychological support (where needed, following psychological screening) plus usual care or to usual care alone. The ROWTATE VR intervention will be provided within 2 weeks of study recruitment by occupational therapists and where needed, by clinical psychologists. It will be individually tailored and provided for ≤ 12 months, dependent on participant need. Baseline assessment will collect data on demographics, injury details, work/education status, cognitive impairment, anxiety, depression, post-traumatic distress, disability, recovery expectations, financial stress and health-related quality of life. Participants will be followed up by postal/telephone/online questionnaires at 3, 6 and 12 months post-randomisation. 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. Secondary outcomes include other work outcomes (e.g. hours of work/education, time to return to work/education, sickness absence), depression, anxiety, post-traumatic distress, work self-efficacy, financial stress, purpose in life, health-related quality of life and healthcare/personal resource use. The process evaluation and implementation study will be described elsewhere.<BR><B>CONCLUSIONS: </B>This trial will provide robust evidence regarding a VR intervention for a major trauma population. Evidence of a clinically and cost-effective VR intervention will be important for commissioners and providers to enable adoption of VR services for this large and important group of patients within the NHS.<BR><B>BACKGROUND: </B>ISRCTN: 43115471. Registered 27/07/2021.