{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:18:46Z","timestamp":1765826326702,"version":"3.48.0"},"reference-count":48,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"crossref","award":["NIHR133880"],"award-info":[{"award-number":["NIHR133880"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,8,30]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the UK, one in four patients are in work at the time of their hip or knee replacement surgery. These patients receive little support about their return to work (RTW). There is a need for an occupational support intervention that encourages safe and sustained RTW which can be integrated into National Health Service practice. We developed a two-arm intervention trial, based on a feasibility study, to assess whether an occupational support intervention (the OPAL (Occupational support for Patients undergoing Arthroplasty of the Lower limb) intervention) is effective in supporting a reduced time to full, sustained RTW compared with usual care in patients undergoing hip and knee replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a multicentre, individually randomised controlled superiority trial comparing the OPAL intervention to usual care. 742 working adults listed for elective primary hip or knee replacement, who intend to RTW, will be randomised to the OPAL intervention or usual care. The intervention comprises: (1) multimedia information resources; and (2) support from a designated RTW coordinator. The primary outcome is time until \u2018full\u2019 sustained RTW without sick leave for a consecutive 4-week period. Secondary outcomes are: time to any RTW, measures of functional recovery, number of \u2018sick days\u2019 between surgery and \u2018full\u2019 sustained RTW and the use of workplace modifications to facilitate their return. A health economic evaluation and a mixed methods process evaluation will assess cost-effectiveness and the implementation, fidelity and acceptability of the intervention, respectively. Outcomes will be collected at baseline, 3, 6, 9 and 12-month follow-up time points, as well as a monthly RTW questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Dissemination will focus on supporting the wider adoption and implementation of the intervention (if effective) and will target groups for whom the results will be relevant. This trial was approved by West Midlands\u2014Edgbaston REC 23\/WM\/0013.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN13694911\">ISRCTN13694911<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-085962","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T14:09:33Z","timestamp":1726495773000},"page":"e085962","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Occupational support following arthroplasty of the lower limb (OPAL): trial protocol for a UK-wide phase III randomised controlled trial"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"isrctn13694911","registry":"10.18810\/isrctn"},{"clinical-trial-number":"isrctn27426982","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7622-9109","authenticated-orcid":false,"given":"Lucy","family":"Sheehan","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amie","family":"Woodward","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Archer","sequence":"additional","affiliation":[{"name":"Patient and Public Involvement representative, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Jordan","sequence":"additional","affiliation":[{"name":"Patient and Public Involvement representative, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maisie","family":"Martland","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A","family":"McDonald","sequence":"additional","affiliation":[{"name":"Scottish Government and Social Care Directorates, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gill","family":"Parkinson","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lou","family":"Watkins","sequence":"additional","affiliation":[{"name":"University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9860-0850","authenticated-orcid":false,"given":"Joy","family":"Adamson","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1220-8354","authenticated-orcid":false,"given":"Avril","family":"Drummond","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4196-0270","authenticated-orcid":false,"given":"Ann","family":"Hewison","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ada","family":"Keding","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucksy","family":"Kottam","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ira","family":"Madan","sequence":"additional","affiliation":[{"name":"Guys And St Thomas NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3751-7260","authenticated-orcid":false,"given":"Catriona","family":"McDaid","sequence":"additional","affiliation":[{"name":"York Trials Unit, University of York, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Reed","sequence":"additional","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Shields, 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