Vocational rehabilitation in patients with chronic rheumatic diseases: A systematic literature review*

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Abstract

Objective: To describe the effectiveness of vocational rehabilitation programs for patients with chronic rheumatic diseases by means of a systematic review of the literature. Methods: Data were obtained by a computer-aided and manual search of the literature from 1980 until May 2001. Vocational rehabilitation programs had to be clearly defined interventions specifically aimed at having patients with rheumatic diseases reenter or remain in the work force. The vocational rehabilitation programs had to be executed by one or more health professionals. Outcome of the intervention had to be described in terms of vocational status (work disability, sick leave, job modification, paid occupation, retraining). Results: Six studies were identified. All were uncontrolled studies. Follow-up periods ranged 2-84 months. Five of six vocational rehabilitation programs consisted of multidisciplinary intervention and 15% to 69% of the patients successfully returned to work. Conclusions: Although 5 of 6 studies showed a marked positive effect of vocational rehabilitation on work status, proof of the benefit of these interventions is limited, mainly due to methodologic differences and shortcomings. Relevance: Work disability is a major consequence of the disease in patients with rheumatic conditions. More and more attention is being paid to preventing disability and promoting return to work. Knowledge regarding the effectiveness of vocational rehabilitation programs is insufficient. Semin Arthritis Rheum 32:196-203. Copyright 2002, Elsevier Science (USA). All rights reserved.

Section snippets

Search strategy

The search strategy was aimed at the selection of studies describing the outcome of vocational rehabilitation programs for patients with a chronic rheumatic disease. In cooperation with a trained librarian (JS), a search strategy was composed. Due to limited translation resources, only articles in English, Dutch, and German were considered for inclusion. The search was restricted to studies published in the last 20 years.

The initial search strategy comprised a search of electronic databases:

Search and selection of trials

The initial electronic database search provided 127 eligible citations. Eight articles were found more then once and were counted as 1. Twenty-five titles or abstracts met the initial selection criteria: description of a vocational rehabilitation program that involved patients with chronic rheumatic diseases. All 25 full text 17, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41 articles were assessed according to the more extended criteria described

Discussion

The number of published studies reporting on the results of vocational rehabilitation programs for patients with rheumatic diseases is limited. Although the results of 5 of the studies show a positive effect on vocational status, the benefit of these interventions for patients with chronic rheumatic diseases is uncertain, mainly due to methodologic differences and shortcomings in most of the studies.

Our study is the first to describe the effectiveness of vocational rehabilitation programs for

References (46)

  • K Eberhardt et al.

    Early rheumatoid arthritis-some social, economical, and psychological aspects

    Scand J Rheumatol

    (1993)
  • AJ Partridge et al.

    Risk factors for early work disability in systemic lupus erythematosus: results from a multicenter study

    Arthritis Rheum

    (1997)
  • A Boonen et al.

    van Der Linden S. Work status and its determinants among patients with ankylosing spondylitis. A systematic literature review

    J Rheumatol

    (2001)
  • F Wolfe et al.

    The longterm outcomes of rheumatoid arthritis: Work disability: a prospective 18 year study of 823 patients

    J Rheumatol

    (1998)
  • W Mau et al.

    Indicators of work incapacity in the first year of chronic polyarthritis

    Z Rheumatol

    (1996)
  • E Yelin et al.

    The work dynamics of the person with rheumatoid arthritis

    Arthritis Rheum

    (1987)
  • S Reisine et al.

    Predictors of work disability in rheumatoid arthritis patients. A five-year followup

    Arthritis Rheum

    (1995)
  • SH Allaire et al.

    Reducing work disability associated with rheumatoid arthritis: identification of additional risk factors and persons likely to benefit from intervention

    Arthritis Care Res

    (1996)
  • ST Reisine et al.

    Work disability among women with rheumatoid arthritis. The relative importance of disease, social, work, and family factors

    Arthritis Rheum

    (1989)
  • E Fex et al.

    Effect of rheumatoid arthritis on work status and social and leisure time activities in patients followed 8 years from onset

    J Rheumatol

    (1998)
  • GL Makisara et al.

    Prognosis of functional capacity and work capacity in rheumatoid arthritis

    Clin Rheumatol

    (1982)
  • B Billeter

    Functions of the Rheumatism League Advisory Service in the care of patients with polyarthritis

    Ther Umsch

    (1991)
  • AN Baanders et al.

    Work adjustments among the chronically ill

    Int J Rehabil Res

    (2001)

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    *

    Address reprint requests to Petronella D.M. de Buck, MD, Leiden University Medical Center, Department of Rheumatology, C4-R, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

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