Op0010 effectiveness of the Making It Work™ Program at Improving Presenteeism and Work Cessation in Workers With Inflammatory Arthritis – Results of a Randomized Controlled Trial

Abstract

Background:Arthritis often leads to presenteeism (decreased at-work productivity), missed days from work and permanent work disability, leading to reduced quality of life and high costs to individuals and society. Yet, health services addressing the employment needs of people with arthritis are lacking.Objectives:We evaluated the effectiveness of the Making-it-WorkTM(MiW) program, an online self-management program developed to help people with inflammatory arthritis (IA) deal with employment issues.Methods:A multi-center RCT evaluated the effectiveness of MiW at improving presenteeism and preventing work cessation (WC) over two years. Participants were recruited from rheumatologist practices, consumer organizations and arthritis programs, in three Canadian provinces. Eligibility criteria: diagnosis of IA, employed, age 18-59, and concerned about ability to work. Participants were randomized 1:1 to MiW or usual care plus printed material on workplace tips. MiW consists of five online self-learning modules and group meetings, and individual vocational counselling and ergonomic consultations. Questionnaires were administered every 6 months. Outcomes were presenteeism [Rheumatoid Arthritis Work Instability Scale (RA-WIS)], time to WC ≥ 6 months, and time to WC ≥ 2 months (secondary outcome). Baseline characteristics (age, gender, ethnicity, occupation, education, disease duration and self-employment) were collected. Intention-to-treat (ITT) longitudinal analysis of RA-WIS using linear mixed effect regression models with 2-year comparison as primary endpoint and survival analysis for time to WC using Kaplan-Meier and Cox Proportional Hazard models were performed. Robustness analyses were conducted by using various missing values imputation methods like last observation carried forward, imputation using worse possible outcomes and model-based multiple imputations; using square root transformation of RA-WIS outcome; and adjusting for baseline covariates. SAS version 9.4 was used.Results:A total of 564 participants were recruited, with 478 (84.75%) completing 2-year follow-up. Baseline characteristics were similar between groups. Mean RA-WIS scores were significantly lower in the intervention group from 6 months onwards, with the greatest difference observed at 2 years (-1.78, 95%CI: -2.7, -0.9, p < .0001), yielding a standardized effect size of 32%. Satisfactory robustness was observed. Work cessation occurred less often in intervention than control groups, but only reached statistical significance for WC ≥ 2 months (WC ≥ 6 months: 31 versus 44 events, aHR 0.70, 95%CI: 0.44, 1.11, p = 0.13; WC ≥ 2 months: 39 versus 61 events, aHR: 0.65, 95%CI: 0.43, 0.98, p = 0.04).Conclusion:Results of the RCT reveal the program was effective at improving presenteeism and preventing short-term WC. Effectiveness at preventing long-term work disability will be assessed at 5 years. This program fills one of the most important and costly unmet needs for people with inflammatory arthritis.References:[1]Carruthers EC, Rogers P, Backman CL, et al. “Employment and arthritis: making it work” a randomized controlled trial evaluating an online program to help people with inflammatory arthritis maintain employment (study protocol).BMC Med Inform Decis Mak. 2014;14:59. Published 2014 Jul 21. doi:10.1186/1472-6947-14-59Disclosure of Interests:Andre Luquini: None declared, Yufei Zheng: None declared, Hui Xie: None declared, Catherine Backman: None declared, Pamela Rogers: None declared, Alex Kwok: None declared, Astrid Knight: None declared, Monique Gignac: None declared, Dianne Mosher: None declared, Linda Li: None declared, John Esdaile: None declared, Carter Thorne Consultant of: Abbvie, Centocor, Janssen, Lilly, Medexus/Medac, Pfizer, Speakers bureau: Medexus/Medac, Diane Lacaille: None declared

Occupational Therapy Is a Vital Member of the Interprofessional Team‐Based Approach for the Management of Rheumatoid Arthritis: Applying the 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis

“…OT has been associated with improved work outcomes (49). It is important to note that while the 2022 ACR Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis reports that there were no studies that supported interventions at work for people with RA, workrelated OT interventions exist but were not included in the guideline because they did not examine only people with RA (50)(51)(52)(53). Although ergonomics assessment and work self-management are effective strategies to reduce work disability, few workers with RA are referred for work interventions.…”

Testing the feasibility and acceptability of an online ‘Fatigue and Activity Management Education for Work (FAME‐W) programme’ for individuals with inflammatory arthritis

“…Although present interventions for reducing work disability have been mainly in person, as a result of the widespread use of online learning and communication platforms, self-management programs have been adapted to e-learning and telehealth delivery methods (Luquini, et al, 2020, Carandang et al, 2022MacIver et al, 2021).…”

Testing the effectiveness of a Fatigue and Activity Management Education for Work (FAME‐W) intervention for individuals with inflammatory arthritis: Study protocol for a randomized control trial

“…However, a more recent study in United Kingdom testing an individual-based vocational rehabilitation programme, achieved significant workrelated improvements, including reduced presenteeism and absenteeism (Hammond et al, 2017). Similarly, a self-management webbased programme in Canada, Making It Work, proved effective in improving presenteeism and preventing short-term work cessation (Luquini et al, 2020). Although both of these interventions resulted in significant improvements in work performance, individuals participating in an Irish study indicated a preference for a group-based intervention which would provide them with an opportunity to meet others with similar conditions (Connolly et al, 2015(Connolly et al, , 2016.…”