Coronary Heart Disease and Return to Work

After a cardiac event, up to 80% of the employees return to work within one year. Cardiac rehabilitation (CR), which focuses on the physical, psychological, and social functioning, contributes to faster return to work (RTW). Specific attention for work-related issues might improve the RTW rate. Three systematic reviews were done on: (1) risk factors in the workplace for cardiac patients; (2) factors that prolonged sickness absence in cardiac patients; and (3) the effectiveness of RTW interventions for cardiac patients. Existing guidelines, expert knowledge of representatives of 11 different health professions, and a working group of psychologists were additionally used to select risk factors and management to promote RTW in cardiac patients as part of CR. The reviews, guidelines, and expert knowledge identified four groups of risk factors for RTW: eight cardiac risk factors; four psychosocial job-related risk factors; six physical risk factors; and 17 psychosocial risk factors (barriers to a successful RTW). Positive effects of interventions were found for the more comprehensive interventions. Key recommendations based on scientific evidence and expert advice are targeting via a short intake that eliminates those patients that do not need RTW support; early start of (part-time) RTW during CR; tailor-made RTW support based on individual risk assessment and interventions within and outside CR that address the individual risks; and frequent communication between the CR team and the workplace (occupational physician), upon patient agreement.