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Work instability in rheumatoid arthritis patients from Argentina: prevalence and associated factors

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Abstract

To determine the prevalence of and associated factors to work instability (WI) in rheumatoid arthritis (RA) Argentinean patients. Observational cross-sectional study that assessing employment status in currently working RA patients. They answered the validated version of RA work instability scale (RA-WIS). High-risk WI was considered when RA-WIS was ≥17. Factors associated with high-risk WI were examined by univariable and multivariable analysis. Four-hundred and fifty RA patients were enrolled; of these, 205 patients were currently employed, but only 172 have completed questionnaires required [RA-WIS and health assessment questionnaire (HAQ-A)]. Their mean age was 49.3 ± 10.8 years; 81.3 % were female; and their mean disease duration was 8.1 ± 7.2 years. Fifty-two percent of patients were doing manual work. The mean RA-WIS score was 11.4 ± 6.8, and 41 % of patients had a high-risk WI. High-risk WI was associated with radiographic erosions (p < 0.001) and HAQ-A >0.87 (p < 0.001) in the univariable analysis, whereas in the multivariable logistic regression analysis the variables associated with a high-risk WI were as follows: HAQ-A >0.87 [odds ratio (OR) 12.31; 95 % CI 5.38–28.18] and the presence of radiographic erosions (OR 4.848; 95 % CI 2.22–10.5). In this model, having a higher monthly income (OR 0.301; 95 % CI 0.096–0.943) and a better functional class (OR 0.151; 95 % CI 0.036–0.632) were protective. Forty-one percent of RA working patients had high-risk WI. The predictors of high RA-WIS were HAQ-A ≥0.87 and radiographic erosions, whereas having a better functional class and have higher incomes were protective.

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References

  1. Croon EM, Sluiter JK, Nijssen TF, Dijkmans BAC (2004) Predictive factors of work disability in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 63:1362–1367

    Article  PubMed Central  PubMed  Google Scholar 

  2. Allaire S (2001) Update on work disability in rheumatic diseases. Curr Opin Rheumatol 13:93–98

    Article  CAS  PubMed  Google Scholar 

  3. Katz P, Morris A, Yelin E (2008) Subclinical disability in valued life activities among individuals with rheumatoid arthritis. Arthritis Rheum 59:1416–1423

    Article  PubMed Central  PubMed  Google Scholar 

  4. Wolfe F, Michaud K (2009) Predicting depression in rheumatoid arthritis: the signal importance of pain extent and fatigue, and comorbidity. Arthritis Rheum 61:667–673

    Article  PubMed  Google Scholar 

  5. Sokka T (2003) Work disability in early rheumatoid arthritis. Clin Exp Rheumatol 21:S71–S74

    CAS  PubMed  Google Scholar 

  6. Zirkzee E, Sneep A, Buck P, Allaart C (2008) Sick leave and work disability in patients with early arthritis. Clin Rheumatol 27:11–19

    Article  PubMed Central  PubMed  Google Scholar 

  7. Plant MJ, O´Sullivan MO, Lewis PA (2005) What factors influence functional ability in patients with rheumatoid arthritis. Do they alter over time? Rheumatol 44:1181–1185

    Article  CAS  Google Scholar 

  8. Allaire S, Wolfe F, Niu J (2009) Current risk factors for work disability associated with rheumatoid arthritis: recent data from a US National cohort. Arthritis Rheum 61:321–328

    Article  PubMed Central  PubMed  Google Scholar 

  9. Puolakka K, Kautiainen H, Mottonen T et al (2005) Predictors of productivity loss in early rheumatoid arthritis: 5 year follow up study. Ann Rheum Dis 64:130–133

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Schneeberger E, Citera G, Maldonado Coco J et al (2010) Factors associated with disability in patients with rheumatoid arthritis. J Clin Rheumatol 16:215–218

    Article  PubMed  Google Scholar 

  11. Brekke M, Hjortdahl, Thelle D, Kvien T (1999) Disease activity and severity in patients with rheumatoid arthritis: relations to socioeconomic inequality. Soc Sci Med 48:1743–1750

    Article  CAS  PubMed  Google Scholar 

  12. Oral presentation 42° Argentine Annual Rheumatology Meeting, 2009

  13. Allaire S, Wolfe F, Niu J, Zhang Y, Zhang B, LaValley (2008) Evaluation of the effect of anti-tumor necrosis factor agent use on rheumatoid arthritis work disability: the jury is still out. Arthritis Rheum 59(8):1082–1089

    Article  PubMed Central  PubMed  Google Scholar 

  14. Wolfe F, Allaire S, Michaud K (2007) The prevalence and incidence of work disability in rheumatoid arthritis and the effect of anti- tumor necrosis factor on work disability. J Rheumatol 34:2211–2217

    CAS  PubMed  Google Scholar 

  15. Augustsson J, Neovius M, Cullinane-Carli C, Eksborg S, van Vollenhoven RF (2010) Patients with rheumatoid arthritis treated with tumour necrosis factor antagonists increase their participation in the workforce: potential for significant long-term indirect cost gains (data from a population-based registry). Ann Rheum Dis 69(1):126–131

    Article  CAS  PubMed  Google Scholar 

  16. Yelin E, Trupin L, Katz P, Lubeck D, Rush S, Wanke L (2003) Association between etanercept use and employment outcomes among patients with rheumatoid arthritis. Arthritis Rheum 48(11):3046–3054

    Article  PubMed  Google Scholar 

  17. Verstappen SM, Watson KD, Lunt M, McGrother K, Symmons DP, Hyrich KL (2010) BSR Biologics Register. Working status in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: results from the British Society for Rheumatology Biologics Register. Rheumatology (Oxford), 49(8):1570–1577

  18. Gignac MA (2005) Arthritis and employment: an examination of behavioral doping efforts to manage workplace activity limitations. Arthritis Rheum 53:328–336

    Article  PubMed  Google Scholar 

  19. Macedo A, Oakley S, Gullick N, Kirkham B (2009) Na examination of work instability, functional impairment, and disease activity in employed patients with rheumatoid arthritis. J Rheumatol 36(2):225–230

    Article  PubMed  Google Scholar 

  20. Bansback N, Zhang W, Walsh D, Kiely P, Williams R, Guh D, Anis A, Young A (2012) Factors associated with absenteeism, presenteeism and activity impairment in patients in the first years of RA. Rheumatology (Oxford) 51(2):375–384

    Article  Google Scholar 

  21. Tang K, Beaton D, Gignac M et al (2010) The work instability scale for rheumatoid arthritis predicts arthritis related work transitions within 12 Months. Arthritis Rheum 62(11):1578–1587

    Article  Google Scholar 

  22. Gilworth G, Emery P, Gossec L (2009) Adaptation and cross-cultural validation of the RA-Wis (Work Instability Scale). Ann Rheum Dis 68(11):1686–1690

    Article  CAS  PubMed  Google Scholar 

  23. Gilworth G, Chamerlain MA et al (2003) Development of work instability scale for rheumatoid arthritis. Arhtritis and Rheum 49(3):349–354

    Article  Google Scholar 

  24. Gilworth G, Emery P, Barkham N, Smyth MG, Helliwell P, Tennant A (2009) Reducing work disability in Ankylosing Spondylitis: development of a work instability scale for AS. BMC MusculoskeletDisord. 16(10):68

    Article  Google Scholar 

  25. Beaton D, Tang K, Gignac M, Lacaille D et al (2010) Reliability, validity, and responsiveness of five at work productivity measures in patients with rheumatoid arthritis or osteoarthritis. Arthritis Care Res 62(1):28–37

    Article  Google Scholar 

  26. Tang K, Beaton DE, Lacaille D, Gignac MA, Zhang W, Anis AH, Bombardier C (2010) The work instability scale for rheumatoid arthritis (RA-WIS): does it work in osteoarthritis? Qual Life Res 19(7):1057–1068

    Article  PubMed  Google Scholar 

  27. Gignac MA, Cao X, Lacaille D, Anis H, Badley EM (2008) Arthritis related work transitions: a prospective analysis of reported productivity losses, work changes, and leaving the labor force. Arthritis Rheum 59:1805–1813

    Article  PubMed  Google Scholar 

  28. Gignac MA, Badley EM, Lacaille D, Cott CC, Adam P, Anis AH (2007) Managing arthritis and employment: making arthritis related work changes as a means of adaptation. Arthritis Rheum 57:738–747

    Article  PubMed  Google Scholar 

  29. Looper KJ, Mustafa SS, Zelkowitz P, Purden M, Baron M (2012) McGill early arthritis research group. Work instability and financial loss in early inflammatory arthritis. Int J Rheum Dis 5(6):546–553

    Article  Google Scholar 

  30. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  CAS  PubMed  Google Scholar 

  31. Detaille SI, Heerkens YF, Engels JA, van der Gulden JW, van Dijk FJ (2009) Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies. Scand J Work Environ Health 35(4):261–281

    Article  PubMed  Google Scholar 

  32. Citera G, Arriola MS, Maldonado-Cocco JA, Rosemffet MG, Sánchez MM, GoñiMA Spindler A, Lucero E, Berman A (2004) Validation and crosscultural adaptation of an argentine spanish version of the health assessment questionnaire disability index. J Clin Rheumatol 10(3):110–115

    Article  PubMed  Google Scholar 

  33. Hogrefe JF, Marengo MF, Schneerberger EE, Rosemffet M, Maldonado Cocco JC, Citera G (2009) Valor de corte de HAQ para predecir discapacidad laboral en pacientes con artritis reumatoidea. Revista Argentina de Reumatología. 2: 23–27

  34. Kvein TK (2002) Epidemiology of disability in rheumatoid arthritis. Rheumatol 41:121–123

    Article  Google Scholar 

  35. Geuskens G, Hazes J, Barendregt P, Burdorf A (2008) Work and sick leave among patients with early inflammatory joint conditions. Arthritis Rheum 59(10):1458–1466

    Article  PubMed  Google Scholar 

  36. Barrett EM, Scott DG, Wiles NJ, Symmons PM (2000) The impact of rheumatoid arthritis on employment status in the early years of disease: a UK community base study. Rheumatol 39:1403–1409

    Article  CAS  Google Scholar 

  37. Young A, Dixey J, Kulinkaya E, Cox N et al (2002) Which patients stop working because of rheumatoid arthritis? Results of five years follow up in 732 patients from the Early RA Study (ERAS). Ann Rheum Dis 61:335–340

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Eberhardt K (2009) Very early intervention is crucial to improve work outcome in patients with rheumatoid arthritis. J Rheumatol 36(6):1104–1106

    Article  PubMed  Google Scholar 

  39. Sokka T, Pincus T (2001) Markers for work disability in rheumatoid arthritis. J Rheumatol 28:1718–1722

    CAS  PubMed  Google Scholar 

  40. Macedo AM, Oakley SP, Panayi GS, Kirkham BW (2009) Functional and work outcomes improve in patients with rheumatoid arthritis who receive targeted, comprehensive occupational therapy. Arthritis Rheum 61(11):1522–1530

    Article  PubMed  Google Scholar 

  41. Han C, Smolen J, Kavanaugh A, StClair EW, Baker D, Bala M (2008) Comparison of employability outcomes among patients with early or long-standing rheumatoid arthritis. Arthritis Rheum. 59(4):510–514

    Article  PubMed  Google Scholar 

  42. Ikeda K, Cox S, Emery P (2007) Aspects of early arthritis. Biological therapy in early arthritis–overtreatment or the way to go? Arthritis Res Ther. 9: 211

  43. Olofsson T, Englund M, Saxne T, Jöud A, Jacobsson LT, Geborek P, Allaire S, Petersson IF (2010) Decrease in sick leave among patients with rheumatoid arthritis in the first 12 months after start of treatment with tumour necrosis factor antagonists: a population-based controlled cohort study. Ann Rheum Dis 69(12):2131–2136

    Article  CAS  PubMed  Google Scholar 

  44. Verstappen SM, Watson KD, Lunt M, McGrother K, Symmons DP, Hyrich KL (2010) Working status in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: results from the British Society for Rheumatology Biologics Register. Rheumatol(Oxford) 49(8):1570–1577

  45. Puolakka K, Kautiainen H, Möttönen T, Hannonen P, Korpela M, Hakala M, Järvinen P, Ahonen J, Forsberg S, Leirisalo-Repo M (2005) Early suppression of disease activity is essential for maintenance of work capacity in patients with recent-onset rheumatoid arthritis: five-year experience from the FIN-RACo trial. Arthritis Rheum 52(1):36–41

    Article  PubMed  Google Scholar 

  46. National Institute of Statistics and Censuses (INDEC). Argentinean Census 2010

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Authors and Affiliations

  1. Reumatologia, Organizacion Medica de Investigacion. Servicio Nacional de Rehabilitacion, Buenos Aires, Argentina

    Maria N. Tamborenea

  2. Reumatologia, Organizacion Medica de Investigacion, Buenos Aires, Argentina

    Cecilia Pisoni, Eduardo Mysler & Guillermo Tate

  3. Reumatologia, Hospital San Juan Bautista, Catamarca, Argentina

    Sergio Toloza

  4. Reumatologia, HIGA, Buenos Aires, Argentina

    Dora Pereira

  5. Reumatologia, Hospital de Clinicas, Buenos Aires, Argentina

    M. García Carrasco, J. Quintero & A. Granel

  6. Reumatologia, Hospital Cesar Milstein, Buenos Aires, Argentina

    A. Cappuccio

  7. Reumatologia, Hospital de San Isidro, Buenos Aires, Argentina

    M. Lazaro & A. Cusa

  8. Reumatologia, IREP, Buenos Aires, Argentina

    Pablo Arturi & Gustavo Citera

  9. Reumatologia, CER, Buenos Aires, Argentina

    J. Velazco Zamora

  10. Reumatologia, Hospital Privado, Cordoba, Argentina

    Veronica Saurit & A. Alvarellos

  11. Reumatologia, Sanatorio Parque, Santa Fe, Argentina

    S. B. Pons Estel

  12. Reumatologia, CPR, Santiago del Estero, Argentina

    C. Danielsen

  13. Reumatologia, Centro Medico Mitre, Entre rios, Argentina

    C. Graf

  14. Reumatologia, Hospital Cullen, Santa Fe, Argentina

    Sergio Paira & F. Ceccatto

  15. Reumatologia, Hospital Iturraspe, Santa Fe, Argentina

    Javier Cavallasca

  16. Reumatologia, Hospital El Carmen, Mendoza, Argentina

    E. Civit

  17. Reumatologia, CER, San Juan, Argentina

    J. Moreno & A. Estevez

  18. Reumatologia, Centro Traumatologico Bariloche, Neuquen, Argentina

    M. Diaz

  19. Reumatologia, Hospital Rivadavia, Buenos Aires, Argentina

    Marcela Verando & Antonio Catalan Pellet

  20. Reumatologia, Instituto Lanari, Buenos Aires, Argentina

    G. Gomez

  21. Reumatologia, ECIER, Buenos Aires, Argentina

    Pablo Maid

  22. Reumatologia, Hospital Carrillo San Vicente, Buenos Aires, Argentina

    Ana Beron

  23. Reumatologia, IPRI, Santiago del Estero, Argentina

    Gabriela Salvatierra

  24. Reumatologia, Consultorios Madryn, Chubut, Argentina

    Marcos Mendez

  25. Reumatologia, Hospital Tornu, Buenos Aires, Argentina

    Oscar Rillo

  26. Reumatologia, OSEP, Mendozam, Argentina

    M. Paez, M. Gallo & A. Conforti

  27. Reumatologia, TEMPO, Buenos Aires, Argentina

    M. Larraude

  28. Reumatologia, Instituto Roche, Buenos Aires, Argentina

    D. Sohn

  29. Reumatologia, CPR, Buenos Aires, Argentina

    Veronica Malah

  30. Reumatologia, Hospital Carrillo, Buenos Aires, Argentina

    Patricio Tate

  31. Reumatologia, IMAI, Buenos Aires, Argentina

    A. Baños

Authors
  1. Maria N. Tamborenea
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  2. Cecilia Pisoni
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  3. Sergio Toloza
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  4. Eduardo Mysler
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  5. Guillermo Tate
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  6. Dora Pereira
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  7. M. García Carrasco
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  9. A. Cappuccio
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  11. M. Lazaro
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  23. E. Civit
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  24. J. Moreno
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  27. Marcela Verando
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  28. Antonio Catalan Pellet
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  30. Pablo Maid
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  31. Ana Beron
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  33. Marcos Mendez
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  34. A. Cusa
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  35. Oscar Rillo
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  36. M. Paez
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  37. M. Larraude
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  38. D. Sohn
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  39. M. Gallo
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  40. A. Conforti
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  41. Veronica Malah
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  42. Patricio Tate
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  43. A. Baños
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Correspondence to Maria N. Tamborenea.

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Tamborenea, M.N., Pisoni, C., Toloza, S. et al. Work instability in rheumatoid arthritis patients from Argentina: prevalence and associated factors. Rheumatol Int 35, 107–114 (2015). https://doi.org/10.1007/s00296-014-3062-7

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