One Year Effects of a Workplace Integrated Care Intervention for Workers with Rheumatoid Arthritis: Results of a Randomized Controlled Trial

Abstract

Purpose To evaluate the effectiveness of a workplace integrated care intervention on at-work productivity loss in workers with rheumatoid arthritis (RA) compared to usual care. Methods In this randomized controlled trial, 150 workers with RA were randomized into either the intervention or control group. The intervention group received an integrated care and participatory workplace intervention. Outcome measures were the Work Limitations Questionnaire, Work Instability Scale for RA, pain, fatigue and quality of life (RAND 36). Participants filled out a questionnaire at baseline, and after 6 and 12 months. We performed linear mixed models to analyse the outcomes. Results Participants were on average 50 years of age, and mostly female. After 12 months, no significant intervention effect was found on at-work productivity loss. We also found no significant intervention effects on any of the secondary outcomes. Conclusions We did not find evidence for the effectiveness of our workplace integrated care intervention after 12 months of follow up. Future studies should focus on investigating the intervention in groups of workers with severe limitations in work functioning, and an unstable work situation.

Impact of a fatigue management in work programme on meeting work demands of individuals with rheumatic diseases: A pilot study

“…Health behaviour changes can take a long time to establish (Rollnick, Mason, & Butler, ), so one could argue that 4 weeks was not long enough to detect change. A lack of observed improvement immediately post‐programme has previously been reported in other studies of similar interventions (van Vilsteren et al, ). Therefore, perhaps these findings correlate with the fact that it takes time for people to make changes, especially at work, leading to a delay in the effect of the intervention.…”

“…However, the intervention in that study was delivered individually, which is more resource intensive than the group‐based approach of FAME‐W. Following poor outcomes for their integrated care intervention, van Vilsteren et al () recommended that future work‐related studies should investigate interventions in groups of workers. In the present study, FAME‐W resulted in significant changes; however, given the pilot nature of the study, further testing is required to identify cause and effect.…”

“…The first half of each session consists of education and information‐sharing on topics related to fatigue management, including energy management, pain and stress management, joint protection, ergonomics, effective communication in work, and employment legislation. The inclusion of these topics were based on findings from previous fatigue‐related studies in an Irish context, and work‐related intervention studies (Connolly et al, , ; Hammond et al, ; Macedo et al, ; van Vilsteren et al, ). In order to facilitate health behaviour change related to fatigue management, the second half of each session consisted of individual goal setting, where participants set goals to apply fatigue management strategies into their work practices over the coming week (Lorig & Holman, ).…”

“…Presenteeism is defined as a reduced quantity or quality in productivity by workers with illness or injury who are present in work (Roy, Desmeules, & MacDermid, ). van Vilsteren et al () evaluated the effectiveness of an integrated care work‐based intervention for workers with rheumatoid arthritis and reported no significant intervention effect at the 6‐ or 12‐month follow‐ups for work outcomes or quality of life. They recommended that future studies investigate interventions in groups of workers.…”

Efficacy of a Work Disability Prevention Program for People with Rheumatic and Musculoskeletal Conditions: A Single‐Blind Parallel‐Arm Randomized Controlled Trial

“…The WLQ was selected to ascertain work limitations based on previous studies , and the study was adequately powered to determine an effect. Another trial of an integrated care and coordinated workplace job accommodation program for people with rheumatic conditions also reported no effect of the intervention on WLQ scores . The WLQ may not be responsive to change for work limitation prevention.…”