TY - JOUR

T1 - Work ability in rheumatoid arthritis patients

T2 - a register study on the prospective risk of exclusion and probability of returning to work

AU - Hansen, Sofie M

AU - Hetland, Merete Lund

AU - Pedersen, Jacob

AU - Østergaard, Mikkel

AU - Rubak, Tine Steen

AU - Bjorner, Jakob Bue

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objectives: The aim was to study work ability in patients with RA compared with the general population by investigating the rates and risks of long-term sickness absence, unemployment and disability pension, and the chance of returning to work and the changes in these risks over time (1994-2011).Methods: This was a cohort study with up to 17 years of follow-up (mean 6.95 years/person) including 6677 RA patients of working age (identified in the nationwide DANBIO registry) and 56 955 matched controls from the general population. A multi-state model was used to analyse all shifts between the work-related states (long-term sickness absence, unemployment and disability pension, as well as the chance of returning to work) and calculate hazard rates (HRs). Analyses were stratified by disease duration and controlled for socio-demographic factors, physical job exposure and somatic and psychiatric co-morbidities.Results: RA patients had increased risk of long-term sickness absence (e.g. early RA: HR = 4.00, 95% CI: 3.64, 4.30) and disability pension (e.g. established RA: HR = 2.75, 95% CI: 2.54, 2.98) relative to controls. From 1994-99 to 2006-11, a decrease in the effect of established RA was observed [long-term sickness absence: from HR = 2.25 (95% CI: 1.99, 2.54) to 1.63 (95% CI: 1.51, 1.75); and disability pension: from HR = 3.49 (95% CI: 2.83, 4.32) to 2.40 (95% CI: 2.15, 2.69)]. RA patients had a lower chance of returning to work from long-term sickness absence or unemployment (HR = 0.60, HR=0.80), and this did not change over time.Conclusion: RA patients remain at high risk for long-term sickness absence and disability pension, despite a positive development between 1996-99 and 2006-11. Returning to work after sick leave or unemployment remains a challenge for RA patients.

AB - Objectives: The aim was to study work ability in patients with RA compared with the general population by investigating the rates and risks of long-term sickness absence, unemployment and disability pension, and the chance of returning to work and the changes in these risks over time (1994-2011).Methods: This was a cohort study with up to 17 years of follow-up (mean 6.95 years/person) including 6677 RA patients of working age (identified in the nationwide DANBIO registry) and 56 955 matched controls from the general population. A multi-state model was used to analyse all shifts between the work-related states (long-term sickness absence, unemployment and disability pension, as well as the chance of returning to work) and calculate hazard rates (HRs). Analyses were stratified by disease duration and controlled for socio-demographic factors, physical job exposure and somatic and psychiatric co-morbidities.Results: RA patients had increased risk of long-term sickness absence (e.g. early RA: HR = 4.00, 95% CI: 3.64, 4.30) and disability pension (e.g. established RA: HR = 2.75, 95% CI: 2.54, 2.98) relative to controls. From 1994-99 to 2006-11, a decrease in the effect of established RA was observed [long-term sickness absence: from HR = 2.25 (95% CI: 1.99, 2.54) to 1.63 (95% CI: 1.51, 1.75); and disability pension: from HR = 3.49 (95% CI: 2.83, 4.32) to 2.40 (95% CI: 2.15, 2.69)]. RA patients had a lower chance of returning to work from long-term sickness absence or unemployment (HR = 0.60, HR=0.80), and this did not change over time.Conclusion: RA patients remain at high risk for long-term sickness absence and disability pension, despite a positive development between 1996-99 and 2006-11. Returning to work after sick leave or unemployment remains a challenge for RA patients.

KW - Adult

KW - Arthritis, Rheumatoid

KW - Case-Control Studies

KW - Cohort Studies

KW - Denmark

KW - Disability Evaluation

KW - Employment

KW - Female

KW - Humans

KW - Insurance, Disability

KW - Male

KW - Middle Aged

KW - Occupational Health

KW - Predictive Value of Tests

KW - Reference Values

KW - Registries

KW - Retrospective Studies

KW - Return to Work

KW - Risk Assessment

KW - Sick Leave

KW - Sickness Impact Profile

KW - Task Performance and Analysis

KW - Unemployment

KW - Journal Article

U2 - 10.1093/rheumatology/kex064

DO - 10.1093/rheumatology/kex064

M3 - Journal article

C2 - 28371921

VL - 56

SP - 1135

EP - 1143

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 7

ER -