Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020;58(4):208-212.
doi: 10.5114/reum.2020.98432. Epub 2020 Aug 31.

Work instability and associated factors among patients with rheumatoid arthritis in Greater Poland

Wiktor Schmidt  1   2 , Małgorzata Tąpolska  3 , Katarzyna Pawlak-Buś  1   2 , Magdalena Owczarek  2 , Piotr Leszczyński  1   2
Affiliations

Work instability and associated factors among patients with rheumatoid arthritis in Greater Poland

Wiktor Schmidt et al. Reumatologia. 2020.

Abstract

Objectives: Rheumatoid arthritis (RA) affects patients' capacity to work. The Rheumatoid Arthritis Work Instability Scale (RA-WIS) is a reliable method to measure work instability (WI) (1-3). We lack data on the relationship between RA and work instability among Polish patients. Our study aimed to assess WI and associated factors among patients with RA.

Material and methods: The authors conducted a multi-centre cross-sectional observational study. 315 patients from three rheumatology centres were enrolled and filled in questionnaires, including demographic and self-reported clinical data, RA-WIS, and the Health Assessment Questionnaire (HAQ). Swollen and tender joint counts (SJC, TJC) were assessed by the attending physician, and current erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. We excluded 41 patients due to an incorrectly filled in form and analysed questionnaires of 274 patients. DAS28 (Disease Activity Score in 28 joints) and DAS28-CRP were calculated. We performed statistical analysis with Statistica v. 13.3 using the Mann-Whitney U test, χ2 test, and Spearman's correlation.

Results: 140 (51%) patients were currently employed and their characteristics were analysed. In univariable analysis we identified the following risk factors for high risk WI: moderate-to-high disease activity (DAS28 ≥ 3.2 - OR 2.29, 95% CI 1.06-4.96, p = 0.033; DAS28-CRP ≥ 3.2 - OR 2.34, 95% CI 1.04-5.27, p = 0.038), ESR ≥ 30 mm/h in women and ≥ 20 mm/h in men (OR 2.65, 95% CI 1.20-5.89, p = 0.010), CRP ≥ 1 mg/dl (OR 4.02, 95% CI 1.78-9.10, p < 0.001), HAQ-DI > 1.0 (OR 2.23, 95% CI 1.04-4.81, p = 0.037) and at least moderate pain on the visual analogue scale (VAS p ≥ 4.5 cm - OR 5.31, 95% CI 2.36-11.96, p < 0.001).Correlations were moderate between RA-WIS and VASp (RS = 0.59, p < 0.001) and HAQ-DI (RS = 0.52, p < 0.001) but weak with disease activity indices (DAS28 [RS = 0.31, p < 0.001]; DAS28-CRP [RS = 0.28, p < 0.001]).

Conclusions: Pain and disability are the main factors strongly associated with work instability among patients with RA.

Keywords: arthritis; rheumatoid arthritis; work disability; work instability.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. Verstappen SMM, Bijlsma JWJ, Verkleij H, et al. . Overview of work disability in rheumatoid arthritis patients as observed in cross-sectional and longitudinal surveys. Arthritis Rheum 2004; 51:488-497, DOI:10.1002/art.20419. - DOI - PubMed
    1. Shanahan EM, Smith MD. Rheumatoid arthritis, disability and the workplace. Baillieres Best Pract Res Clin Rheumatol 1999; 13: 675-688, DOI:10.1053/berh.1999.0053. - DOI - PubMed
    1. Putrik P, Ramiro S, Kvien TK, et al. . Inequities in access to biologic and synthetic DMARDs across 46 European countries. Ann Rheum Dis 2014; 73: 198-206, DOI:10.1136/annrheumdis-2012-202603. - DOI - PubMed
    1. Tamborenea MN, Pisoni C, Toloza S, et al. . Work instability in rheumatoid arthritis patients from Argentina: prevalence and associated factors. Rheumatol Int 2015; 35: 107-114, DOI:10.1007/s00296-014-3062-7. - DOI - PubMed
    1. Looper KJ, Mustafa SS, Zelkowitz P, et al. . Early Arthritis Research Group . Work instability and financial loss in early inflammatory arthritis. Int J Rheum Dis 2012; 15: 546-553, DOI:10.1111/1756-185X.12009. - DOI - PubMed