‘Managing Your Career’ Is An Understatement For Patients With Arthritis

Patients with arthritis may change work hours, the type and nature of their work or may lose their jobs due to disability related to their arthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Boston, Mass.

Arthritis currently affects an estimated 46 million Americans. As the most common joint disease affecting middle age and older people, osteoarthritis is a leading cause of disability.

Inflammatory arthritis is caused by inflammatory white blood cells moving into the joint fluid. Types of inflammatory arthritis include rheumatoid arthritis, lupus, and gout.

Researchers examined work transitions (changes to work hours, type and nature of work, and occasional work loss) made by 490 people with OA and IA over a four-and-a-half year period.

All participants completed an interview-administered, structured questionnaire with demographic, illness and disability, work transition, and psychosocial (such as depression, perceived workplace support, and job stress) components. Participants were interviewed four times, 18 months apart, to determine if any changes in employment or work situations were made.

During the course of the study, sixty-three percent of the participants remained employed; however, work transitions were common. Forty-five percent of participants reduced their hours worked to accommodate their arthritis. Fifty-two percent of participants changed their type of work, eighteen percent were unable to seek and accept promotions and job transfers, and forty-one percent were unable to take on additional responsibilities.

Participants also reported using vacation time, changing positions and missing work to deal with arthritis.

“We know that arthritis can result in people having to leave their jobs. This research focuses our attention on the workplace itself and highlights how common a wide range of work transitions are in the lives of people with arthritis,” said Monique A.M. Gignac, PhD; senior scientist, Toronto Western Research Institute; associate professor, Department of Public Health Sciences, University of Toronto. “By studying these changes we hope to identify those that allow people to remain employed longer, as well as types of transitions that signal problems that need to be addressed with early intervention and treatment.”

Another goal of the study was to look in detail at a person’s workplace the types of problems that create stress in working with arthritis; the types of job demands individuals are faced with; workplace support; and the strategies people themselves have come up with to manage arthritis and work.

“We’ve sometimes focused exclusively on the negative impact of arthritis on employment. With this research, we’ve also been learning from people with arthritis about their successes. That is essential in order for us to be able to design interventions to help people remain employed,” explains Dr. Gignac.

The ACR is an organization of and for physicians, health professionals, and scientists that advances rheumatology through programs of education, research, advocacy and practice support that foster excellence in the care of people with or at risk for arthritis and rheumatic and musculoskeletal diseases. For more information on the ACR’s annual meeting, see rheumatology/annual.

Notes: Dr. Gignac will present this research during the ACR Annual Scientific Meeting at the Boston Convention and Exhibition Center from 9:00 – 11:00 am ET on Saturday, November 10, 2007, in the Exhibit Hall.

Presentation Number: 2026

Managing Arthritis and Employment: Making Arthritis-Related Work Transitions to Remain Employed

Monique Gignac1, Diane Lacaille2, Aslam Anis2, Elizabeth Badley1. 1The Arthritis Community Research & Evaluation Unit, The Toronto Western Research Institute, Toronto, ON, Canada; 2The Arthritis Research Centre of Canada, Vancouver, BC, Canada

Purpose: A focus on job loss in arthritis research has meant that relatively little is known about the number and range of work transitions that people with arthritis make to remain working. This research utilizes longitudinal data to examine work changes made by people with osteoarthritis (OA) and inflammatory arthritis (IA) to remain employed.

Methods: Participants with an MD diagnosis of OA or IA were interviewed at 4 time points, 18-months apart. At time 1 (t1), all participants were employed (n = 490; 381 women, 109 men; 57% OA, 33% IA (mostly RA, 88%), 9.2% both OA & IA). At times 2 through 4, the sample n was 413, 372, 349, respectively, resulting in 71.2% of the sample with complete 4 ВЅ year data. Respondents were recruited from rheumatology and rehabilitation clinics and using community advertising. All completed an interview-administered, structured questionnaire with demographic (e.g., age, gender), illness & disability (e.g., disease type, pain, workplace activity limitations), work transitions (e.g., changes to work hours, changes to the type or nature of work, occasional work loss) and psychosocial (e.g., depression) variables. Univariate and bivariate analyses examined work transitions and predictors across time points.

Results: Across all time points, 63% of the sample remained employed; 25.5% left the labour force at some point and did not return to work; and 5.5% left the labour force but returned to work. Among those employed, work transitions were common. Across t1 to t4, 45% of respondents reported reducing their work hours because of arthritis. 52% of participants reported a change to the type of work engaged in, 18% reported being unable to accept or seek a promotion or job transfer, and 41% were unable to take on extra projects or responsibilities. Occasional work loss attributed to arthritis was also common: 56% reported at least one arthritis-related work interruption of 20 minutes or more across t1 to t4, 54% were absent at work for one or more days because of arthritis, and 21% reported using vacation days to deal with arthritis. Changes to the type of work and occasional lost work hours were associated with being younger, IA, more pain and workplace activity limitations, and more depressive symptoms. Reducing work hours was related to sales and service occupations, IA, or having both IA and OA.

Conclusion: This study extends research on arthritis and employment by examining ways that individuals manage their condition in an effort to remain working. The results show that, in response to arthritis, a range of work transitions were frequently used, including permanent changes to work hours, changes to the type and nature of work, and occasional work loss. The findings emphasize the importance of including alternative work outcomes, in addition to work loss, when measuring the impact of arthritis or treatments on employment.

Disclosure Block: M. Gignac, None

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