Workplace Accommodation Among Persons with Disabilities: A Systematic Review of Its Effectiveness and Barriers or Facilitators

Purpose A systematic review was conducted to review the effectiveness of workplace accommodation (WA) regarding employment, work ability, and cost-benefit among disabled people. It also describes the evidence gained on the barriers and facilitators of WA process to sustain employment. Methods We reviewed systematically current scientific evidence about effectiveness of WA among disabled persons. The outcomes were employment, work ability, and cost-benefit. Qualitative studies of employment facilitators and barriers were also included. The population comprised people with physical disability, visual impairment, hearing impairment, cognitive disability, or mental disability, aged 18-68 years. CINAHL, the Cochrane Library, Embase, Medic, OTseeker, PEDro, PsycInfo, PubMed, Scopus, and Web of Science were searched for peer-reviewed articles published in English from January 1990 to November 2012. Results Three quantitative (one randomized controlled, one concurrently controlled, and one cohort) and eight qualitative studies met the inclusion criteria. There was moderate evidence that specific types of WA (vocational counselling and guidance, education and self-advocacy, help of others, changes in work schedules, work organization, and special transportation) promote employment among physically disabled persons and reduce costs. There was low evidence that WA (liaison, education, work aids, and work techniques) coordinated by case managers increases return to work and is cost-effective when compared with the usual care of persons with physical and cognitive disabilities. The key facilitators and barriers of employment were self-advocacy, support of the employer and community, amount of training and counselling, and flexibility of work schedules and work organization. Conclusions More high-quality studies using validated measures of the work ability and functioning of disabled persons are needed. The identified barriers and facilitators found in the qualitative studies should be used to develop quantitative study designs.