SEEK: Salford Environment for Expertise and Knowledge

June 2014

Work rehabilitation in inflammatory arthritis: a pilot randomised controlled trial.

Hammond, A & Prior, Y & O'Brien, R & Woodbridge, S & Radford, K 2014, 'Work rehabilitation in inflammatory arthritis: a pilot randomised controlled trial.', Annals of the Rheumatic Diseases, 73(Suppl 2), p.1209.



Background: Work problems are common in people with inflammatory arthritis (IA): with 28-40% of people with rheumatoid arthritis (RA) stopping work in 5y of diagnosis. There is little research into effectiveness of job retention vocational rehabilitation (JR-VR) for employed people with IA. Brief JR-VR led to significantly fewer job losses at 3.5 years in the USA (Allaire et al, 2003) and a UK pilot trial demonstrated 6m improvements in work instability and work satisfaction (Macedo et al, 2009).
Objectives: To conduct a pilot randomised controlled trial (RCT) evaluating a JR-VR intervention with employed people with IA, to facilitate planning a full RCT.
Method: Participants with IA were recruited from 6 Rheumatology departments and randomised to VR (delivered by Rheumatology OTs with VR training) or a control group. Both groups received written self-help information about managing work problems. The VR group could receive up to 6h JR-VR, including a work visit. Presenteeism outcomes included: RA-Work Instability Scale (RAWIS:0-23), Work Limitations Questionnaire Productivity Loss (WLQPL: %), Work Activities Limitations Scale (WALS:0-33). Health outcomes included: SF12v2 Physical component (SF12-PC), pain and fatigue VAS (0-100). Mean (SD) change scores and effect sizes were calculated.
Results: 213 eligible employed patients with IA were identified, of whom 55 (26%) participated (34 with RA): 13M, 42F; aged 49y (SD 8.8); 7.9y (SD 8.9) disease duration; 33 worked full-time; job types were professional (27%), associated professional/skilled (15%), partly skilled/admin/caring/retain (53%), unskilled (5%). Both groups were comparable at baseline.

VR 0m
VR change 9m
Control 0m
Control change 9m
Effect size
16.2 (5)
15 (5.7)
10.9 (4.9)
11.2 (5.6)
12.8 (5.3)
12.7 6.2)
32.5 (8.3)
32.6 (10.1)


SEEK Members

External Authors

S Woodbridge

K Radford

Y Prior

R O'Brien

Publication Details

Annals of the Rheumatic Diseases, 73(Suppl 2), p.1209.