Background Current treatment options and timely care should ensure patients with RA to lead normal life including full ability to continue in work force. However, in a multinational review of patients in usual rheumatology care, third of those who were diagnosed with RA in early 2000’s became work disabled within 5 years. Therefore, discrepancy between improved treatment options for RA and patient’s tendency to fall out of work force still requires attention.
Objectives To study patient self-assessed risk of work disability and factors that may be associated with it.
Methods From Sept 2012 through Jan 2013, patients with RA completed a questionnaire which queried physical load and psychological stress associated with their work on a numeric scale (0-10) and whether they felt they might lose their working ability (yes, no). Questionnaire data were analyzed together with the clinical database including demographic and clinical variables, medications, and patient self reported outcomes. Multivariate logistic regression was performed for patient self-perceived risk of work disability.
Over a 4-month period, 778 patients with RA had an outpatient visit including 480 who were at “working age” of 18-65 years. Among the 480, 137(29%) were not in work force due to age- or disability-related pension. Among 343(mean age 48, disease duration 8years, 70%females 72%RF/CCP+) in work force, 201(59%) completed the questionnaire. Among 201 respondents, 51(25%) reported perceived risk of work disability including 36(22%) of 167 patients who were full/part time working, 4(29%) of 14 jobseekers/unemployed patients and 11(55%) of 20 patients who were on sick leave or rehabilitation As sick leave/rehabilitation is a strong predictor of work disability, following analyses included 181 patients who were working or unemployed. Patients who perceived/did not perceive risk of work disability were comparable in all variables (Table1) except HAQ, work-related physical load and psychological stress. In multivariate regression analysis (including variables in Table1), only the three variables were independently associated with perceived risk of work disability: Odds Ratio with 95%CI HAQ 6.1(2.5 to 15), psychological stress 1.3 (1.1 to 1.6), and physical work load 1.2(1.0 to 1.4) (area under ROC curve=0.85). Furthermore, DAS28_esr3<2.6 (remission) was met by 78% of patients regardless of perceived risk of work disability.
Conclusions Perceived function and psychological factors rather than disease activity are determinants of perceived risk of work disability in employed and jobseeker patients with RA.
Disclosure of Interest None Declared