Background Inflammatory arthritis strongly correlates with work disability. Treatment guidelines recommend work support but data are lacking on rheumatology clinicians' perspectives on work referral and extent of work support within current rheumatology services for this population.
Objectives To scope the need for and patterns of work referral, and examine the extent and type of work support currently available in Irish rheumatology services for people with inflammatory arthritis. To identify factors that help or hinder employment-related service provision. To explore the role of occupational therapy in addressing work with this population from the perspectives of the other members of the rheumatology team and current practices and challenges.
Methods A questionnaire concerning work support provision was distributed via online survey to doctors, nurses and physiotherapists working in clinical rheumatology in Ireland.
Results Response rate of 22% was achieved and total sample of 73 analysed. Respondents indicated that 71% of service users were of working age and the majority of respondents (95%) agreed that addressing employment retention was within the remit of rheumatology services. Over half of respondent (55%) of respondents estimated that 25–49% of their caseload had work needs. Work was usually addressed if clients raised work concerns (94%), client reports work absenteeism (83%), client's work involved manual component (75%). Barriers to addressing work included limited time in clinical setting (92%); unfamiliarity with best practice for work support (91%); lack of perceived competency to assess work complexities (82%). Occupational therapy (OT) was identified as the most appropriate profession to address work (78%). However, 51% respondents reported not routinely referring to OT for work support due to limited availability of OT (13% of responders having no access to OT); uncertainty regarding optimum timing for work intervention, and uncertainty as to what OT could offer regarding work.
Conclusions Addressing work was recognised as multifaceted and multidisciplinary. Work needs are addressed within current rheumatology services only when the client themselves initiate the issue. Opportunity exists to improve the quality of services to address work in line with guidelines by educating the multidisciplinary team about available work services and implementation of a clinical pathway for employment retention.
Disclosure of Interest None declared