Background Few studies have analyzed the impact of rheumatoid arthritis (RA) on workplace insertion and occupation of patients in France. However, the overall negative impact of RA on work capacity has been shown previously.
Objectives To investigate the contribution of different socio-economic and clinical factors to absenteeism and loss of work capacity in a population of RA patients below 60 years of age in France in 2012.
Methods A national retrospective survey was conducted in a population of patients recruited by rheumatologists practising in hospitals or private practices during a visit, and/or were members of a patients association (ANDAR). The patients responded to a structured telephone interview with an investigator. The data collected included the current employment situation and its history, the functional impact of RA (Health Assessment Questionnaire [HAQ] score), the frequency of flares, work stoppages and disability allowance.
Results 503 patients agreed to participate, and 488 were interviewed (97%). In this study population (mean age 49.5±7.7 years and 84.4% women), the disease duration of RA was 12.2 (±9.2) years. 364 patients (74.6%) were employed, 31 (6.4%) unemployed and 93 (19.1%) were out of the labor market. For the 31 unemployed patients, the impact of RA occured as a factor of loss of employment and restriction of access to the labor market. For the 93 patients out of the labor market, discontinuation of professional activity was due to RA for three quarters of them (73%), explained by fatigue (75%), pain or stiffness (25%), or difficulty in moving (25%). The main results of the group of 364 patients in employment according to the HAQ score are shown below. The mean HAQ score was low (0.8) and the mean disease duration was 11.6 years. The proportion of patients receiving biological treatment was very high (60.4%), compared with 24.8% of patients under 60 years of age in the French national representative claims database (“Echantillon Généraliste des Bénéficiaires”) in 2011. This high proportion may also explain the low HAQ. With a HAQ score equal or greater than 1.5, 68.4% of patients reported at least one work stoppage in the last 12 months for an average of 91.6 days; this proportion was 48.3% for all active employees (p<0.0001). Regression analyses suggest that the HAQ score is the major factor contributing to absenteeism, regardless of patients' socio-economic characteristics.
Conclusions The impact of RA on work capacity is important, affecting work stoppages, loss of employment and part-time work. Lost productivity associated with RA is related to the level of HAQ, which suggests that better control of the disease would reduce this loss of productivity.
Acknowledgements The authors acknowledge Costello Medical Consulting for editorial assistance which was funded by UCB Pharma.
Disclosure of Interest P. Bertin: None declared, F. Fagnani Grant/research support: UCB Pharma, Consultant for: CEMKA-EVAL, A. Duburcq Grant/research support: UCB Pharma, Consultant for: CEMKA-EVAL, A. Woronoff: None declared, P. Chauvin: None declared, G. Cukierman Employee of: UCB Pharma, S. Tropé-Chirol: None declared, J.-M. Joubert Employee of: UCB Pharma, G. Kobelt: None declared