Non-Pharmacologic Management
Abstract# 2001 - Contemporary Data on Work Disability Associated with Rheumatoid Arthritis (RA)
Authors: S. Alliare et al.
Background: Data on work disability due to rheumatoid arthritis (RA) suggests a prevalence ranging from 32 to 50%. However, these data are at least 10 years old and thereby, do not account for recent developments in treating RA. In this study, Alliare and colleagues, using data from a large US cohort of persons diagnosed with RA, examined the prevalence of RA-related work loss and estimated the annual incidence of the work loss.
Methods: Data were from respondents, aged 18-64 years, who completed at least one of 7 six month surveys conducted in the years 2002-2005. Work loss was examined as a function of RA disease duration (categorized into 6 groups with a duration ranging from 1 to 31 years). The average incidence of work loss was calculated for a 3-year period by counting respondents who were employed during a 6-month survey but who had stopped working in the subsequent survey, and dividing this value by the number of respondents at risk for work loss. The overall rate of re-employment was also derived.
Results: A total of 7,274 respondents were available for analysis. The average age of respondents was 52 ± 9 years, 81% were female, 89% were white, and 61% had at least a high school education. Average RA disease duration was 13 ± 9 years. Work loss prevalence increased as a function of disease duration (19% with 2 years of disease to 49% with ≥ 20 years of disease). These results were not altered when the analysis adjusted for age and functional limitation. The annual incidence of work loss was about 7%, and 36% of respondents who stopped working later returned to work.
Conclusions: The prevalence of work loss due to RA between the years 2002 to 2005 was not substantially different from the prevalence observed in previous surveys. However, over 1/3 of RA sufferers were able to return to work.
Editorial Comments: RA is a devastating disease that imposes a considerable health, function, and quality of life burden. Results of this recent survey of a large cohort of adults with rheumatologist diagnosed RA indicates that work loss remains highly prevalent. Nearly 40% of RA sufferers at 10 years of disease were unable to remain employed. However, on the bright side, about one-third of persons with RA who experienced work loss were able to eventually return to work. This implies that the advent of newer treatments for RA (i.e., the “biologics”) might enable patients to better manage their disease to such an extent that they can return to work. Undoubtedly, the ability to return to the work force markedly improves quality of life and likely has beneficial effects on general health and emotional well-being. As such, the results of this analysis underscore the importance of continuing to develop and refine RA treatments, as well as to identify persons with RA earlier in their disease course to minimize progression and joint destruction.