Functional capacity and treatment data from a community based study of patients with rheumatoid arthritis.

Owen, Susan G.; Friesen, W. T.; Roberts, Michael S.; Francis, Hilton; Flux, W

doi:10.1136/ard.45.4.293

Cited by 15 publications

(6 citation statements)

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“…These findings were made with patients who, in general, were well educated, had diverse senior level positions, had light physical demands, and had a lot of job autonomy. We did not initially intend to predominantly enroll patients with these job characteristics; however, it is well known that work disability is lowest among individuals with more education, more autonomy, and less physically demanding jobs (1,10,18,19). It was surprising, however, to find that job maintenance was still considered threatened even by patients in this study.…”

Section: Discussionmentioning

confidence: 94%

“…The impact of work disability in RA is extensive, affecting all occupations, and potentially leading to lower self-esteem, lower life satisfaction, decreased life adaptation, lower perceived health status, altered family relationships, and fewer social supports (7)(8)(9)(10)(11)(12)(13). Among valued activities in patients with RA, the highest losses over 5 years are in work-related activities (14).…”

Section: Introductionmentioning

confidence: 99%

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Adaptations made by rheumatoid arthritis patients to continue working: A pilot study of workplace challenges and successful adaptations

Mancuso

Paget

Charlson

2000

Arthritis & Rheumatism

111

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Objectives. The goals of this pilot study were to use qualitative research techniques in a group of currently employed patients with rheumatoid arthritis (RA) to develop categories of challenges encountered in maintaining employment and categories of successful adaptations made to continue working; and to identify obstacles considered to be persistent threats to continued employment. Methods. Patients were interviewed by telephone with a questionnaire composed of structured-response format and open-ended response format questions focusing on specific challenges and adaptations in the workplace. Results. Of the 22 patients interviewed, 96% were women, mean age was 50 years, 84% were college graduates, and the majority had light physical job demands and high autonomy over their work and hours worked. Patients encountered diverse challenges, such as fatigue, pain, typing, writing , physical requirements, maintaining a pleasant disposition, working overtime, traveling for business , commuting, being on time, not being able to choose rest periods, and environmental issues. Patients also made multiple adaptations to continue working, the most helpful being changing job or altering career path (36%), altering work hours (32%), using more disease-modifying antirheumatic drugs (27%), using car service (23%), sleeping more (18%), and working at home (14%). Patients were not at all confident in their ability to continue working because of RA, and perceived the following persistent threats to continued employment: fatigue (45%), not being able to use hands (45%), not being able to choose rest periods (27%), and commuting problems (18%). In addition, patients confronted psychological stresses, such as dealing with cowork-ers and supervisors and balancing job and personal roles. These challenges and adaptations included unfavorable work-related occurrences, or "negative work-role events." Conclusions. Seemingly successfully employed patients with RA faced multiple challenges and made major adaptations to maintain employment and still perceived their employment to be in jeopardy because of RA. The findings of this study have important implications for screening patients at risk for negative work-role events and for possible work-related and social support interventions aimed at preserving employment.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Adaptations made by rheumatoid arthritis patients to continue working: A pilot study of workplace challenges and successful adaptations

Mancuso

Paget

Charlson

2000

Arthritis & Rheumatism

111

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“…Nach einer Kohortenstudie von Owen et al (1986) [4] in Tasmanien sind nur 26 % der Patienten mit r. A. funktionell unbeeinträchtigt; neben den Gelenkdestruktionen vor allem der Hände [5] vermindern auch Schmerzen und psychische Erkrankungsfolgen wie Angst und Depressionen deren Produktivität [6]. In rund einem Drittel der Fälle betrifft die rheumatoide Arthritis initial die Hand, bei mindestens zwei Dritteln wird diese irgendwann im Krankheitsverlauf involviert.…”

Section: Einleitung Und Problemstellungunclassified

Die Entfernung entzündeter Schleimhaut an den Strecksehnen des Handgelenks bei rheumatoider Arthritis - vergleichende funktionelle Untersuchungen

Rehart¹,

Kerschbaumer²

2006

Akt Rheumatol

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ZusammenfassungSchmerzhafte Funktionsbeeinträchtigungen oder gar Invalidisierungen an den Händen, wie sie bei der rheumatoiden Arthritis typischerweise auftreten, sind wegen ihres ausgesprochen nachhaltigen Eingreifens in praktisch alle Abläufe des täglichen Lebens sehr viel stärker behindernd als Symptome an anderen Gelenken. Der vorbeugende Effekt der Tenosynovektomie im Hinblick auf das Auftreten von frühzeitigen Sehnenrupturen ist allgemein anerkannt; in der vorliegenden Arbeit wird der Versuch unternommen, Auswirkungen dieses Eingriffs auf die subjektiven und objektiven Befunde an der Hand zu überprüfen. Besonderes Augenmerk wurde dabei auf folgende Fragen gelegt: 1. Die mittelfristige Entwicklung der Handfunktion, 2. eine Differenzierung der Ergebnisse nach Operationen an der dominanten bzw. nicht dominanten Hand und 3. die subjektive Zufriedenheit des Patienten mit dem Ergebnis des Eingriffs. In die Untersuchung wurden insgesamt 94 Patienten (68 Frauen, 26 Männer, Durchschnittsalter 59,9 € 10,4 Jahre) einbezogen; bei 65 dieser Patienten -diese werden in dieser Arbeit vorgestellt -war eine isolierte Tenosynovektomie am dorsalen Handgelenk ohne weitere Eingriffe an derselben Hand vorgenommen worden, 29 nicht operierte Patienten dienten als Vergleichsgruppe. Patienten und Kontrollen unterschieden sich bezüglich der Alters-und Geschlechtsverteilung nicht signifikant. Neben der allgemein anerkannten und wichtigen Prophylaxe der Sehnenruptur zeigte die isolierte Frühtenosynovektomie in der chirurgisch versorgten Gruppe folgende Effekte: 1. Kein schnelles Fortschreiten von Gelenkdeformationen, 2. Erhalt der Funktion, insbesondere bei feinmotorisch diffizilen Tätigkeiten. Subjektiv trat nur bei 3 Patienten (4,6 %) eine Verschlechterung des Befundes ein; es kam nur zu einem Tenosynovialitisrezidiv. Im Vergleich mit einer Gruppe von Patienten ohne Tenosynovialitis ergaben sich AbstractPainful functional impairment of the hands is a key symptom of rheumatoid arthritis and especially disabling because of the paramount importance of the hands for activities of daily living. Early, isolated tenosynovectomy has been shown to avoid or delay tendon ruptures; in the present study, we investigate its effect on clinical signs of the disease, namely 1. the continuous development of joint function, 2. the subjective patient satisfaction and 3. a possible influence of operations on the dominant or nondominant hand. 94 patients were enrolled in the study (68 females, 26 males, average age 59.9 € 10.4 years); 65 of the patients had undergone an isolated dorsal tenosynovectomy at the wrist, 29 patients without surgical intervention served as a control group. Patients and controls did not differ significantly in terms of gender, or age. Besides the known and proven tendon rupture prevention, the operation did not lead to rapid further joint destruction and improved the function of the hand especially in terms of fine-motoric tasks. Subjectively, there were only 3 cases (4.6 %) of deterioration, and only one tenosynovialitis relapse....

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“…DMARDs inhibit joint damage, suppress the acute phase response, decrease autoantibody levels and exert effects on long-term functional outcome beyond those on signs and symptoms alone, as conveyed merely by symptomatic drugs. ‘Slow acting antirheumatic drugs’ (SAARDs)4 was an alternative term because—in contrast to the symptomatic drugs—it frequently took several weeks to months until the efficacy of these agents became recognisable,3 and even longer to reach maximal effects. However, when using biologicals that do affect structural changes, acute phase reactant and rheumatoid factor levels, rapid clinical and serological improvement is seen in a considerable number of patients, and therefore, the term SAARDs is not appropriate any more as an alternative for DMARDs.…”

mentioning

confidence: 99%

Proposal for a new nomenclature of disease-modifying antirheumatic drugs

Smolen

Heijde

Machold

et al. 2014

Annals of the Rheumatic Diseases

226

121

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In light of the recent emergence of new therapeutics for rheumatoid arthritis, such as kinase inhibitors and biosimilars, a new nomenclature for disease-modifying antirheumatic drugs (DMARDs), which are currently often classified as synthetic (or chemical) DMARDs (sDMARDS) and biological DMARDs (bDMARDs), may be needed. We propose to divide the latter into biological original and biosimilar DMARDs (boDMARDs and bsDMARDs, respectively, such as abatacept, adalimumab, anakinra, certolizumab pegol, etanercept, golimumab, infliximab, rituximab or tocilizumab, but also emerging ones like clazakizumab, ixekizumab, sarilumab, secukinumab or sirukumab) and the former into conventional synthetic and targeted synthetic DMARDs (csDMARDs and tsDMARDs, respectively). tsDMARDs would then constitute only those that were specifically developed to target a particular molecular structure (such as tofacitinib, fostamatinib, baricitinib or apremilast, or agents not focused primarily on rheumatic diseases, such as imatinib or ibrutinib), while csDMARDs would comprise the traditional drugs (such as methotrexate, sulfasalazine, leflunomide, hydroxychloroquine, gold salts and others). The proposed nomenclature may provide means to group and distinguish the different types of DMARDs in clinical studies and review articles.

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Functional capacity and treatment data from a community based study of patients with rheumatoid arthritis.

Cited by 15 publications

References 14 publications

Adaptations made by rheumatoid arthritis patients to continue working: A pilot study of workplace challenges and successful adaptations

Adaptations made by rheumatoid arthritis patients to continue working: A pilot study of workplace challenges and successful adaptations

Die Entfernung entzündeter Schleimhaut an den Strecksehnen des Handgelenks bei rheumatoider Arthritis - vergleichende funktionelle Untersuchungen

Proposal for a new nomenclature of disease-modifying antirheumatic drugs

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