Background Rheumatoid arthritis (RA) and other rheumatic conditions can lead to work disability, and temporary or permanent exit from the labour market. The indirect costs related to work disability, are higher than direct treatment costs, and pose an economic burden on patients and society. Workability in RA is influenced by many factors, including symptoms, such as pain, swelling and stiffness, muscle strength, or physical or mental exhaustion, which are components of the frailty syndrome.
Objectives This study aimed to determine the association of workability with disease activity, pain, functional disability and frailty in patients with seropositive rheumatoid arthritis.
Methods We conducted a monocentric cross-sectional study at a rheumatologic outpatient clinic and day hospital including 100 seropositive RA patients (according to 2010 EULAR classification) in the working age (<65 years). Workability was assessed with the self-administered Work Ability Index questionnaire. For disease activity, we used the Clinical Disease Activity Index (CDAI), a Visual analogue scale for pain assessment, for functional disability the self-administered Health Assessment Questionnaire Disability Index (HAQ-DI) and for the degree of frailty the SHARE Frailty Instrument (SHARE-FI). After testing for normal distribution, bivariate correlations between workability and associated variables were calculated using Spearman's correlation coefficients.
Results Of 100 patients for 58 the workability index could be assessed. The remaining 42 were either unemployed, on disability pension, or employed but currently not working. These 58 patients, 37 women and 21 men, had an average age of 64.8 years (min-max=22–59, SD=9.3) and an average disease duration of 93.9 months (min-max=3–360, SD=86.7). 8 patients reported excellent workability, 27 good workability, 16 moderate workability and 7 poor workability. The workability was weakly correlated with age (r s= -0.37, p<0.004), and moderately correlated with pain intensity (r s=0.42, p<0.001), disease activity (r s=0.40, p<0.002), functional disability (r s=0.64, p<0.000) and frailty (r s=0.623, p<0.000).
Conclusions A considerable portion of employed RA patients reported poor or moderate workability, which is significantly associated with disease activity but also with the other parameters assessed. An adequate therapy may therefore not only improve well-being and state of health in RA patients but also provide socioeconomically advantage by maintaining patients' workability.
Disclosure of Interest None declared