Background Rheumatic conditions can impact significantly on patients’ working lives as highlighted by previous national and international surveys.1,2 Since these studies the economic climate has worsened, with growing pressures on maintaining employment. It is important to understand how patients perceive their condition to affect work in the current climate, and what they feel rheumatologists can do to help.
Objectives We sought to assess the impact of rheumatic diseases on working life in our patient population four years since the last national survey. We aimed to characterise patients’ perspectives on the current key obstacles and perceived solutions.
Methods Anonymous questionnaires were sent to all patients on our departmental DMARD monitoring database. Data was compared using the chi-square test.
Results Of 1455 patients invited, 504 responded (35%). Median age was 65 years. 319 (63%) had RA, 58 (12%) PsA, 14 (3%) ankylosing spondylitis and 34 (7%) other rheumatic diseases. 79 (16%) did not give their diagnosis. 165 patients (33%) were in paid employment. Of the 339 patients not working, 237 were retired (70%); 66 (19%) were not working due to their rheumatic condition. Of those working 53% thought they would still be in their current job in 3 years. 25% of working patients reported their condition had both caused them to change work and hindered career progression. 71% had told their employer about their diagnosis and 37% felt their employer did not understand their condition. More working patients felt their employer had assisted them sufficiently in making changes to their working conditions than those not working (43% vs 22%, p<0.05). More working patients listed urgent access to the rheumatology team than any other factor in helping them to continue at work (38%). Better government schemes and employer flexibility were also considered important in enabling patients to stay in work (35% and 26% of respondents respectively). Physical limitation, pain and fatigue were the commonest factors perceived to prevent work in all patients. Impact of their condition on personal relationships (13%), social activities (28%) and finances (20%) was independent of work status. Of those not working, 20% of respondents said they would like to return to work if they could find a job that would accommodate their condition and 23% were on disability living allowance. Working patients with PsA felt their condition impacted more on finances than working RA patients (p<0.05). Of those who stopped work due to their condition, more PsA patients stopped within a year of diagnosis than RA patients (p<0.05).
Conclusions Working patients with rheumatic diseases feel urgent access to rheumatology services is important in keeping them at work. 37% feel their condition is not understood by their employer. A significant proportion of patients not working attribute this to their condition, and would like to return to work. PsA patients perceive a greater impact on finances and stop work earlier after diagnosis than RA patients.
“I Want to Work”; NRAS survey 2007. www.nras.org.uk
Let’s Work Together survey, World Arthritis Day 2009
Disclosure of Interest None Declared