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Evaluation of work disability in Japanese patients with rheumatoid arthritis: from the TOMORROW study

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Abstract

To evaluate work disability and associated factors in patients with rheumatoid arthritis (RA) who participated in the TOMORROW study, a 10-year cohort study in Japan. Subjects in this cross-sectional analysis comprised 191 RA patients and 191 age- and sex-matched non-RA individuals. Work-related outcomes were measured using the Work Productivity and Activity Impairment questionnaire by employment status (full-time worker (FTW), employed ≥ 35 h/week; part-time worker (PTW), < 35 h/week; home worker (HW), non-employed). In addition, we assessed the EuroQol-5 Dimensions (EQ-5D) and Health Assessment Questionnaire (HAQ) to evaluate quality of life and activities of daily living. No significant differences were evident between groups in percentages of participants in each employment status (p = 0.11), percentages of absenteeism (FTW, p = 1.00; PTW, p = 0.29), presenteeism (FTW, p = 0.23; PTW, p = 0.54), overall work impairment (FTW, p = 0.23; PTW, p = 0.73), or percentage of activity impairment (AI) (FTW, p = 0.62; PTW, p = 0.60). In the HW group, percentage of AI was higher in RA patients than that in non-RA patients (p < 0.01). Among RA patients, HW showed lower EQ-5D and higher HAQ than FTW or PTW (p < 0.001 each). Higher disease activity was observed in HW than FTW (p < 0.01). In terms of the effect of biological disease-modifying anti-rheumatic drugs, no significant differences in work-related outcomes, health status, or daily activity were evident between users and non-users. No significant differences in employment status or work impairment were seen between RA and non-RA groups among paid workers. HW with RA showed more impaired daily activity and higher disease activity compared to working RA patients. Trial registration: University Hospital Medical Information Network Clinical Trials Registry: UMIN000003876. Registered 1 Jun 2010.

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Acknowledgements

We wish to thank Atsuko Kamiyama, Tomoko Nakatsuka, the Center for Drug and Food Clinical Evaluation, Department of Radiology, and Department of Central Clinical Laboratory in Osaka City University Hospital for serving as research coordinators in terms of recruiting participants, collecting data, and managing the quality of the data. We greatly appreciate the cooperation of the patients with RA and the healthy volunteers who participated in this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Shirahama Hamayu Hospital, 1447 Shirahamacho, Nishimurogun, Wakayama, 649-2211, Japan

    Shohei Anno & Tatsuya Koike

  2. Search Institute for Bone and Arthritis Disease (SINBAD), Shirahama Foundation for Health and Welfare, 1447 Shirahamacho, Nishimurogun, Wakayama, 649-2211, Japan

    Shohei Anno & Tatsuya Koike

  3. Center for Senile Degenerative Disorders (CSDD), Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Yuko Sugioka & Tatsuya Koike

  4. Department of Orthopaedic Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Kentaro Inui, Masahiro Tada, Tadashi Okano & Kenji Mamoto

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  1. Shohei Anno
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  2. Yuko Sugioka
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Correspondence to Tatsuya Koike.

Ethics declarations

The Ethics Committee at the Osaka City University Medical School approved the study protocol (no. 1660, 2009). The study was carried out in compliance with the Declaration of Helsinki, and informed consent was obtained from all participants prior to enrolment.

Conflict of interest disclosures

Tatsuya Koike has received research fees, consulting fees, or other remuneration from AbbVie, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Janssen Pharmaceutical K.K., Eli Lilly, Mitsubishi Tanabe Pharma Co., MSD K.K., Ono Pharmaceutical, Pfizer, Roche, Takeda Pharmaceutical Co. Ltd., Teijin Pharma, and UCB. Kentaro Inui has received research grants and/or speaking fees from Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Astellas Pharma Inc., AbbVie, Eisai Co., Ltd., MSD K.K., Bristol-Myers K.K., Takeda Pharmaceutical Co., Ltd. and Janssen Pharmaceutical K.K. Tadashi Okano received speaking fees from AbbVie. The other authors have no conflicts of interest to disclose. No specific funding was received from any companies in the public, commercial or not-for-profit sectors to carry out the work described in this article.

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Anno, S., Sugioka, Y., Inui, K. et al. Evaluation of work disability in Japanese patients with rheumatoid arthritis: from the TOMORROW study. Clin Rheumatol 37, 1763–1771 (2018). https://doi.org/10.1007/s10067-018-4060-z

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  • DOI: https://doi.org/10.1007/s10067-018-4060-z

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