Predictors of sick leave and improved worker productivity after 52 weeks of intensive treatment in patients with early rheumatoid arthritis

Abstract

Objective: To identify predictors of sick leave and improved worker productivity in patients with early rheumatoid arthritis (RA) treated for 52 weeks with intensive combination strategies. Methods: Patients with early RA were included in the COmbinatietherapie Bij Reumatoïde Artritis (COBRA)-light trial and followed for 52 weeks. As the COBRA-light strategy proved to be non-inferior to the COBRA strategy, all patients were pooled. Predictors for sick leave and improved worker productivity were assessed through a 3 month time-lag multivariable logistic generalized estimating equations model. Results: At baseline, 97 patients had a paid job, 59 had no job, and for six patients the work status was unknown. During the trial, 13 patients stopped working (8%) and six started working (4%). Only sick leave in the past 3 months predicted sick leave. By excluding this variable, patient global assessment and actual hours of sick leave became predictors. Increased worker productivity was predicted by higher patient global assessment levels, Sharp van der Heijde score ≥ 1, actual hours on sick leave, and higher worker productivity in the past 3 months. Conclusion: Sick leave and improved worker productivity were mainly predicted by non-disease-specific variables. Both outcomes can be predicted on a 3 month basis, using the outcome over the past 3 months for the next 3 months. By applying this model in daily practice, decisions for therapy change could be based not solely on disease activity but also taking into account a possible high risk for sick leave in the upcoming 3 months.

The role of support from significant others in the association between disease-related factors and sickness absence in early rheumatoid arthritis: a longitudinal study

“…In addition, reduced pain intensity has been reported to significantly correlate with improved work productivity (35), and improved grip force has been connected to improved work ability (36). Previous research also shows that a strong predictor for sickness absence is earlier sickness absence (12,37). Furthermore, the earlier biological treatment starts, the greater the possibility of returning to work (38).…”

“…Previous research reports that disease activity (8,9) and activity limitation (10,11) are connected to a patient's ability to continue working. However, Blomjous et al (12) reported that sickness absence and worker productivity of people diagnosed with early RA are mainly predicted by nondisease-specific variables. That is, sickness absence due to RA is multifactorial.…”

Desire to have children and preferences regarding to pre-pregnancy counselling in women with SLE

“…The following demographic data were collected as assessed for the Amsterdam SLE cohort: age, ethnicity and highest attained educational level, stratified into low (<12 years), intermediate (12–16 years) and high (≥17 years) [ 24 , 26 ]. Disease-related variables collected were disease duration (at the time of completing the questionnaire), Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) and history of lupus nephritis.…”