Background Early morning stiffness in patients with rheumatoid arthritis (RA) may last for >1 hour in 23–49% of people.1,2 It is associated with reduced quality of life and early retirement from work.3,4 However little is known about how morning stiffness affects patients.
Objectives A survey was conducted to assess the effect of morning stiffness on quality of life and patient withdrawal from the active work force.
Methods A survey was conducted among working age patients (18 years to state retirement age) in 11 European countries (Belgium, Denmark, Finland, France, Germany, Italy, Norway, Poland, Spain, Sweden, UK). Patients with RA for ≥6 months and RA-related morning stiffness were interviewed by telephone using a structured questionnaire, translated into the appropriate language.
Results A total of 1061 patients (55 from Norway and approximately 100 from all other countries; 78% female) completed the questionnaires. Mean duration of morning stiffness was 1h 21 mins/day. Approximately seven in ten respondents reported that morning stiffness has a significant impact on their ability to work or do household tasks (69%) and limits the types of home/work jobs they can do (72%). More than four in ten respondents (42%) reported that morning stiffness has a major impact (score 7–10 on a scale of 1–10) on their daily lives, with a similar proportion (45%) reporting that a 30-min reduction in morning stiffness would significantly improve their quality of life. On average, respondents were willing to pay £4.35/day for a 30-min reduction in morning stiffness. Of the total respondents, 440 (41%) were not in full time work (part time work: 129; unemployed: 48; sick leave: 39; retired: 204; semi-retired: 20); for 53% of these respondents, this was directly due to RA. Seven in ten of the 224 retired/semi-retired respondents (71%) retired early, with morning stiffness playing a role in the decision for 64% of these patients.For more than half of the retired respondents, morning stiffness shortened their career (52%)and specifically lowered the age for retirement (56%). A quarter (23%) of retired/semi-retired respondents reported that better management of morning stiffness would allow them to return to work. Among the 621 respondents not currently completely retired or homemakers, 116 (19%) anticipated retiring early, with morning stiffness a factor in the decision for 61% of these patients.
Conclusions The survey confirms the impact of morning stiffness on quality of life and the considerable contribution that the symptom makes to early retirement among patients with RA.
The survey was conducted by Ipsos MORI and sponsored by an educational grant from Mundipharma International Limited
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Disclosure of Interest R. Tuominen Consultant for: Mundipharma International Limited, Speakers Bureau: Mundipharma International Limited, F. Buttgereit Grant/Research support from: Merck Serono, Horizon Pharma, Consultant for: Merck Serono, Horizon Pharma, Mundipharma International Limited, Speakers Bureau: Merck Serono, Horizon Pharma, Mundipharma International Limited