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.(Full table at doi).
Annals of the Rheumatic Diseases, 73(Suppl 2), p.1209.