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FRI0592-HPR Work rehabilitation in inflammatory arthritis: A pilot randomised controlled trial

Hammond, A; Prior, Y; O'Brien, R.; Woodbridge, S.; Radford, K.


R. O'Brien

S. Woodbridge

K. Radford


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 (JRVR)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.

Methods: 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). Absenteeism was measured using monthly work diaries. Health outcomes included: SF12v2 Physical component(SF12-PC), pain, fatigue and perceived health status 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 (see Table). At 9m: effect sizes were moderate to large for changes in work and health outcomes in the JR-VR group and none to small in the control group; %working days lost due to sickness: JR-VR =9.6% (SD 13.6); control = 20% (SD 27.1). JR-VR lasted on average 3.08 (SD 1.8)hours and cost £74.98 (SD £46.80) per patient.

Conclusions: This pilot suggests brief JR-VR provided by Rheumatology OTs can improve presenteeism, absenteeism and health status, indicating a RCT is warranted. Recruitment was problematic, with many not consenting. Potential reasons include: fear about employers (in a recession) learning they have arthritis; concerns about time out of work attending VR; and not perceiving VR is needed as yet. JR-VR intends to prevent work problems. Support is needed to enable employed people with IA and work problems
to attend JR-VR.


Hammond, A., Prior, Y., O'Brien, R., Woodbridge, S., & Radford, K. (2014). FRI0592-HPR Work rehabilitation in inflammatory arthritis: A pilot randomised controlled trial. Annals of the Rheumatic Diseases, 73(Suppl), 1209-1209.

Journal Article Type Article
Online Publication Date Jun 10, 2014
Publication Date Jun 10, 2014
Deposit Date Jan 28, 2015
Publicly Available Date Jan 28, 2015
Journal Annals of the Rheumatic Diseases (ARD)
Print ISSN 0003-4967
Electronic ISSN 1468-2060
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 73
Issue Suppl
Pages 1209-1209
Publisher URL
Related Public URLs


Hammond A abstract WORK-IA feasibility trial ARD 2014.pdf (163 Kb)


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