Research agenda originating from knowledge gaps identified during the literature searches and confirmed by the discussion among members of the taskforce
| Research topic | Justification |
| Healthcare | |
| How to train/guide persons with RMDs to start a conversation with HCP, supervisor or employer to discuss health-related problems at work? | Employers and healthcare professionals might not always be aware of a person’s specific work limitations. Communication might be a first step towards problem recognition and solutions, but requires thoughtful preparation. |
| How can healthcare professionals accurately identify persons with RMDs at risk of adverse work outcomes? | Prediction and risk stratification tools for adverse work outcome have been developed in general working populations, but have not been validated in people with RMDs. |
| Which non-pharmacological interventions are effective in (subgroups of) persons with RMDs? | Current evidence on effectiveness of non-pharmacological interventions (including workplace and community interventions) showed high heterogeneity. Efficiency of interventions will benefit from more accurate inclusion/stratification. |
| How can we implement (and finance) work-oriented care in clinical practice? Should work-related care be a quality indicator? | Screening, risk stratification, interventions and monitoring of work participation should be implemented by general practitioners, medical specialists and other healthcare professionals. Limited resources for prevention should not hinder timely work-oriented care. |
| Workplace | |
| Which features of work constitute a healthy workplace for people with RMDs, and which features are harmful for RMD-related health outcomes? | Features of work can comprise type of work, tasks within a job (including autonomy and flexibility), physical environment, regulations (including salary, job and social security) and culture of workplaces (eg, support from colleagues, accommodations). |
| What are the needs (eg, policies, financial) and responsibilities of employers to support people with RMDs in healthy and sustainable work? | Most employers don’t have specific knowledge and skill to support people with RMDs and limited finances are in place to encourage employers to implement limited policies on this issue. |
| Outcome assessment and monitoring | |
| How do we define ‘healthy and sustainable work’ and how can we measure this? | How can we combine different perspectives on work participation outcomes (patient, caregivers, workplace and societal)? Are short-term measures appropriate surrogates for long-term outcomes? Clearly, continuation of work should not go at the expense of health. |
| How can we improve real-world data collection of work outcomes of persons with RMDs? | Measures of work participation should be routinely collected as part of (1) clinical data/information and (2) research projects which include working-age adults. Encourage the development of ‘big data’ that integrate data variables at level of the patients, their working and living environment, healthcare and social security system and national policies are required to fully understand efficiency of intervention. |
| Policies on healthcare, social security and labour organisation | |
| What is the role of intersectionality in (closing) the work participation gap? | Individuals in a society experience discrimination and disadvantage on the basis of a multitude of factors. Social inequality in employment occurs along several axes that intersect and need to be studied and acted upon appropriately. |
| Which policies support sustainable work for patients with RMDs? | Governments are interested in policies to enhance sustainable and healthy work participation, especially in an ageing population. Evidence on this issue is scarce, and methodologically challenging to generate. |
| What is the cost-effectiveness of various interventions that could help to close the work participation gap? | High-quality care is not only effective but also efficient. As one of the aims of work-related care is to reduce the financial burden of health-related productivity costs, work-oriented policies and care should be affordable. What is the return on investment of interventions including policies? |
| How can work policies be financed? | Silos in budgets between healthcare and labour policies should not hinder health-oriented policies at the workplace. |
| Collaboration | |
| How can we improve collaboration between professional organisations, policymakers, patient organisations and employers? | Shared goals, consistent communication and aligned policies/systems are essential to achieve optimal work participation. |
| How can we implement evidence-based practices, interventions and policies? | If practices/interventions have proven to be effective, (de-)implementation will be the key to achieve impact in individuals and society. |
HCP, healthcare provider; RMDs, rheumatic and musculoskeletal diseases.