Job retention vocational rehabilitation for
employed people with inflammatory
arthritis (WORK-IA) : a feasibility randomized
controlled trial

Hammond, A; O'Brien, R; Woodbridge, S; Bradshaw, L; Prior, Y; Radford, K; Culley, J; Whitham, D; Pulikottil-Jacob, R

Abstract

Background: Inflammatory arthritis leads to work disability, absenteeism and presenteeism (i.e. at-work productivity loss) at high cost to individuals, employers and society. A trial of job retention vocational rehabilitation (VR) in the United States identified this helped people keep working. The effectiveness of this VR in countries with different socioeconomic policies and conditions, and its impact on absenteeism, presenteeism and health, are unknown. This feasibility study tested the acceptability of this VR, modified for the United Kingdom, compared to written advice about managing work problems. To help plan a randomized controlled trial, we tested screening, recruitment, intervention delivery, response rates, applicability of the control intervention and identified the relevant primary outcome.
Methods: A feasibility randomized controlled trial with rheumatoid, psoriatic or inflammatory arthritis patients randomized to receive either job retention VR or written information only (the WORK-IA trial). Following three days VR training, rheumatology occupational therapists provided individualised VR on a one to one basis. VR included work assessment, activity diaries and action planning, and (as applicable) arthritis self-management in the workplace, ergonomics, fatigue and stress management, orthoses, employment rights and support services, assistive technology, work modifications, psychological and disclosure support, workplace visits and employer liaison.
Results: Fifty five (10%) people were recruited from 539 screened. Follow-up response rates were acceptable at 80%. VR was delivered with fidelity. VR was more acceptable than written advice only (7.8 versus 6.7). VR took on average 4 hours at a cost of £135 per person. Outcome assessment indicated VR was better than written advice in reducing presenteeism (Work Limitations Questionnaire (WLQ) change score mean: VR = -12.4 (SD 13.2); control = -2.5 (SD 15.9), absenteeism, perceived risk of job loss and improving pain and health status, indicating proof of concept. The preferred primary outcome measure was the WLQ, a presenteeism measure.
Conclusions: This brief job retention VR is a credible and acceptable intervention for people with inflammatory arthritis with concerns about continuing to work due to arthritis.

Citation

controlled trial. BMC Musculoskeletal Disorders, 18, 315. https://doi.org/10.1186/s12891-017-1671-5

• Journal Article Type: Article
• Acceptance Date: Jul 12, 2017
• Online Publication Date: Jul 21, 2017
• Publication Date: Jul 21, 2017
• Deposit Date: Jul 28, 2017
• Publicly Available Date: Jul 28, 2017
• Journal: BMC Musculoskeletal Disorders
• Electronic ISSN: 1471-2474
• Publisher: Springer Verlag
• Volume: 18
• Pages: 315
• DOI: https://doi.org/10.1186/s12891-017-1671-5
• Publisher URL: http://dx.doi.org/10.1186/s12891-017-1671-5
• Related Public URLs: https://bmcmusculoskeletdisord.biomedcentral.com/
• Additional Information: Projects : Work Rehabilitation in Inflammatory Arthritis. Effectiveness and cost effectiveness of an occupational therapy (OT) job retention intervention: a pilot randomised controlled trial.