Update on work disability in rheumatic diseases

Abstract

Two recent studies suggest the prevalence of rheumatic condition-related work disability is considerably lower than was suggested in previous studies. However, the samples in the recent studies did not include older workers and included persons who gained employment after disease onset. In other recent studies, the rate of work disability among persons employed at disease onset is still high; a fair amount of work disability occurs in the early years of disease. There is no clear evidence yet that treatment improvements have altered the rates of work disability. Because work characteristics, like level of physical demand, influence risk for work disability and are potentially amenable, other interventions are needed to reduce rheumatic disease-associated work disability. Accommodation provided to alleviate problems in doing work and outside of work activities is the most promising intervention, followed by job/career change. Assessment tools are just now becoming available to help clinicians identify patients in need of assistance.

Work dynamics among persons with systemic lupus erythematosus

“…In rheumatoid arthritis, several analysts have observed reductions in work disability rates over time (4,25), with some evidence that this may be associated with emerging treatments (26), although it also may be an artifact of methods of analysis or of differences among nations in employment (4). The amount of literature on work disability in persons with SLE is much smaller and, with the exception of 2 of the studies (14,16), the sample sizes of these studies were relatively small and the populations studied were relatively homogeneous.…”

“…In the rheumatic diseases, work loss accounts for the majority of the economic costs of illness (1). Most of the research on work disability in the rheumatic diseases has focused on rheumatoid arthritis (2)(3)(4)(5)(6)(7)(8). Despite onset at a young age and the potential severity of systemic lupus erythematosus (SLE), there have been relatively few studies of employment among persons with SLE.…”

Longitudinal study of negative workplace events among employed rheumatoid arthritis patients and healthy controls

“…Many studies have highlighted the devastating emotional and economic consequences of unemployment in patients with rheumatoid arthritis (RA) (1)(2)(3)(4)(5). Most studies have focused on job loss and vocational rehabilitation and have identified predictors of adverse work outcomes, including older age, less education, less social support, not wanting to work, multiple social roles, and more depressive symptoms (3)(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

Work disability in systemic lupus erythematosus

“…Similar findings have also been described in patients with RA (13,27), and highlight that early detection of patients at risk of work disability is important. Evidence is emerging that interventions aimed at preventing work disability may be more effective than job accommodations or changing jobs (28,29). In particular, it may be difficult to get people back to work once they have left the job market (28).…”

“…Evidence is emerging that interventions aimed at preventing work disability may be more effective than job accommodations or changing jobs (28,29). In particular, it may be difficult to get people back to work once they have left the job market (28). Methods anticipated to prevent work disability should be multifaceted.…”