Work disability and state benefit claims in early rheumatoid arthritis: the ERAN cohort

Abstract

Objective. RA is an important cause of work disability. This study aimed to identify predictive factors for work disability and state benefit claims in a cohort with early RA.Methods. The Early RA Network (ERAN) inception cohort recruited from 22 centres. At baseline, and during each annual visit, participants (n = 1235) reported employment status and benefits claims and how both were influenced by RA. Survival analysis derived adjusted hazard ratios (aHRs) and 95% CIs to predict associations between baseline factors and time until loss of employment due to RA or a state benefits claim due to RA.Results. At baseline, 47% of participants were employed and 17% reported claiming benefits due to RA. During follow-up, loss of employment due to RA was reported by 10% (49/475) of the participants and 20% (179/905) began to claim benefits. Independent predictors of earlier work disability were bodily pain (aHR 2.45, 95% CI 1.47, 4.08, P = 0.001) and low vitality (aHR 1.84, 95% CI 1.18, 2.85, P = 0.007). Disability (aHR 1.28, 95% CI 1.02, 1.61, P = 0.033), DAS28 (aHR 1.48, 95% CI 1.05, 2.09, P = 0.026) and extra-articular disease (aHR 1.77, 95% CI 1.17, 2.70, P = 0.007) predicted earlier benefits claims.Conclusion. Work disability and benefits claims due to RA were predicted by different baseline factors. Pain and low vitality predicted work disability. Baseline disability, extra-articular disease manifestations and disease activity predicted new benefits claims due to RA. Future research on interventions targeting these factors could investigate job retention and financial independence.

Fibromyalgia onset has a high impact on work ability in Australians

“…It is notable that the rate of loss of employment due to FM reported here appears worse than that reported for the loss of employment due to rheumatoid arthritis in both Australia 33 and the United Kingdom. 34 The number of people accessing financial support payments is similar to previous Australian data. In a cohort of patients attending an Australian tertiary hospital outpatient clinic with a diagnosis of FM, 41.3% were receiving disability or other pension payments.…”

“…It is notable that the rate of loss of employment due to FM reported here appears worse than that reported for the loss of employment due to rheumatoid arthritis in both Australia and the United Kingdom …”

The Scottish Early Rheumatoid Arthritis (SERA) Study: an inception cohort and biobank

“…The proportion of patients who remained in any employment fell after diagnosis, even though there were significant improvements in disease activity, functional ability and health related quality of life observed over the same time period. The employment rate changes observed in the SERA cohort are similar to a recently published analysis of another UK-based early RA cohort that demonstrated that the greatest risk of work instability was within the first 2 years after diagnosis [32]. Furthermore, the results demonstrate that a significant proportion of patients (23 % at baseline) report symptoms that are consistent with anxiety and/or depression, which remained static during follow-up.…”

Predictors of sick leave and improved worker productivity after 52 weeks of intensive treatment in patients with early rheumatoid arthritis

“…It seems that the overall models are a result of different variables working together. This finding may explain why the HAQ score was not identified as important in the prediction of sick leave and efficiency at work within our population, in contrast to other studies in patients with (early) RA (26)(27)(28)(29)(30). Other variables may have been too strong.…”