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OP0364-PARE Work status and work barriers in patients receiving bdmards as infusions in rheumatology hospital clinics in norway. a cross-sectional study
  1. M. Klokkerud1,
  2. E. Hasselknippe2,
  3. A. Rønningen2,3,
  4. H. Haveråen3,
  5. A.-L. Sand-Svartrud1
  1. 1Rheumatology, NKRR, Diakonhjemmet Hospital, Oslo
  2. 2Rheumatology, Lillehammer Hospital for Rheumatic Diseases, Lillehammer
  3. 3Rheumatology, Diakonhjemmet hospital, Oslo, Norway


Background Preventing work disability is an important treatment goal for people with rheumatic diseases. New treatment modalities with introduction of bDMARDs have led to better control of disease activity, symptoms and improvement of functional capacity. Still, sick leave and forced retirement is common, and studies have shown that work status at start of therapy is a predictor of work ability later in the disease course.

Objectives The objective of this study was to explore work status, concerns about future work capacity and work barriers in a group of patients receiving bDMARDs as infusions in rheumatology hospitals in Norway.

Methods This is a cross-sectional study. In March and April 2017, patients at two rheumatology hospitals were invited to participate in a survey. Participation was voluntary with anonymous response. Information about background, disease, and start of bDMARD infusions was self-reported in a questionnaire. Further, respondents who were working or on sick leave (full-or part time), answered questions about work capacity and degree of concern about future work capacity on NRS-scales from 1–10 (10=best capacity and high degree of concern). They also scored their experienced barriers related to seven different topics selected from the Work Experience Survey-Rheumatic Conditions (WES-RC) on 5 point Likert scales (5=severe problems).

Results Of 343 eligible patients, 317 responded (92%). Mean (SD) age were 52.3 (14.9) years, 81% were under 67 (age of retirement in Norway). The largest diagnostic groups were rheumatoid arthritis (47%) and spondylarthritis (26%). Mean (SD) disease duration was 13.8 (10.6) years. Half of the respondents aged <67 years reported reduced work ability, of these 27% were on sick leave and 23% were on disability pension. The proportion of patients on sick leave was highest among those who started with bDMARD infusions within the last 3 months (42.3%), and lowest in the group who had started 25 to 36 months earlier (21.4%). For disability pension the numbers were oposite, with the largest amount in the group that received treatment for more than 36 months (29.7%).

There were significant differences in ratings of work capacity and concerns about future work capacity among respondents working full time and those on sick-leave. Mean (SD) scores of work capacity were 8.0 (1.7) and 5.5 (3.0) (p<0.001) in full time workers and participants on sick-leave, respectively. Corresponding scores for concerns about future work capacity were 5.2 (2.5) and 7.0 (2.7), (p<0.001). Thirty percent of respondents in full-time work scored 7 or higher on degree of concern about future work capacity. Regardless of work status, ‘physical work demands’, ‘mental work demands’ and ‘balance between work and private life’ was rated as the most severe barriers for work ability.

Conclusions This cross-sectional study shows that approximately half of the patients receiving bDMARD infusions at two hospitals in Norway report reduced work ability, and nearly one third was concerned about future work capacity. Early identification of patients who, despite optimal treatment, experience work barriers is important. Activity regulation, ergonomic advice and self-management strategies for managing work demands and imbalance between work and private life should be further tested.

Disclosure of Interest None declared

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