Background We have shown in a population-based study that the risk of permanent work disability has decreased after the turn of millennium among incident patients with rheumatoid arthritis (RA) (1), but the risk among patients with established RA is not known.
Objectives To investigate the risk for lost workdays in patients with RA in daily clinical practice.
Methods In 12 rheumatology outpatient clinics in Finland, consecutive patients filled in a questionnaire. Data on age, sex, and work status were gathered. Employed patients estimated physical demand and psychological stress associated with work in a numeric scale from 0 to 10, and they were asked to assess, whether they were felt (yes or no) they would lose workdays because of rheumatic disease during the following 6 months and whether they felt they would lose their working ability. Their physician filled in the patient’s ICD-10 code and recorded any use of biologic drugs. Data on 2220 patients were obtained. Patients with RA (codes M05 and M06) were analysed.
Results A total of 993 patients had RA diagnosis, 754 (76%) were seropositive. Of these, 529 (378 RF+ and 151 RF-) were 23 to 63 years of age and were employed during the preceding 6 months. 383 (72%) were biologic naïve. These patients had a shorter disease duration, 6.8 years (SD 8.2), compared to patients with history of biologics, 12.3 years (SD 8.3) (p<0.001). No other differences between the groups appeared. Proportion of females was 76% and 79%, age 48.0 (SD 10.3) and 47.5 (SD 10.0) years, RF present in 74% and 66%, self-assessed physical work load 5.3 (SD 2.8) and 4.9 (SD 2.9), and self-assesses work related stress 6.3 (SD 2.3) and 6.6 (SD 2.3), in Bio- and Bio+ groups, respectively.
The self-experienced risk for days off work was equal: in Bio- 42% (95% CI: 37 to 47) and in Bio+ 45% (95% CI: 37 to 53); p=0.48, adjusted for age, gender, RF, and disease duration. Neither was difference found in the experienced risk for permanent work disability: Bio- 27% (95% CI: 23 to 31), Bio+ 32% (95% CI: 24 to 39), adjusted p=0.67.
Conclusions Self-experienced risk for temporary or permanent loss of work productivity is still substantial among patients with RA seen in daily clinical practice irrespective of the use of biologic agents. The longer disease duration of Bio+ patients, however, may suggest channelling bias.
Rantalaiho V et al. Decline in work disability caused by early rheumatoid arthritis: Results from a nationwide Finnish register, 2000-8. Ann Rheum Dis in press
Disclosure of Interest None Declared