Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Study protocol

An intervention program with the aim to improve and maintain work productivity for workers with rheumatoid arthritis: design of a randomized controlled trial and cost-effectiveness study

Authors: Myrthe van Vilsteren, Cécile RL Boot, Romy Steenbeek, Dirkjan van Schaardenburg, Alexandre E Voskuyl, Johannes R Anema

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Workers with rheumatoid arthritis (RA) often experience restrictions in functioning at work and participation in employment. Strategies to maintain work productivity exist, but these interventions do not involve the actual workplace. Therefore the aim of this study is to investigate the (cost)effectiveness of an intervention program at the workplace on work productivity for workers with RA.

Methods/design

This study is a randomized controlled trial (RCT) in specialized rheumatology treatment centers in or near Amsterdam, the Netherlands. Randomisation to either the control or the intervention group is performed at patient level. Both groups will receive care as usual by the rheumatologist, and patients in the intervention group will also take part in the intervention program. The intervention program consists of two components; integrated care, including a participatory workplace intervention. Integrated care involves a clinical occupational physician, who will act as care manager, to coordinate the care. The care manager has an intermediate role between clinical and occupational care. The participatory workplace intervention will be guided by an occupational therapist, and involves problem solving by the patient and the patients’ supervisor. The aim of the workplace intervention is to achieve consensus between patient and supervisor concerning feasible solutions for the obstacles for functioning at work. Data collection will take place at baseline and after 6 and 12 months by means of a questionnaire. The primary outcome measure is work productivity, measured by hours lost from work due to presenteeism. Secondary outcome measures include sick leave, quality of life, pain and fatigue. Cost-effectiveness of the intervention program will be evaluated from the societal perspective.

Discussion

Usual care of primary and outpatient health services is not aimed at improving work productivity. Therefore it is desirable to develop interventions aimed at improving functioning at work. If the intervention program will be (cost)effective, substantial improvements in work productivity might be obtained among workers with RA at lower costs. Results are expected in 2015.

Trial registration number

NTR2886
Appendix
Available only for authorised users
Literature
1.
Firestein GS: Evolving concepts of rheumatoid arthritis. Nature. 2003, 423: 356-361. 10.1038/nature01661.CrossRefPubMed
2.
NVVG: Verzekeringsgeneeskundige protocollen. Artrose Heup en Knie - Reumatoïde artritis. 2008, Den Haag: NVVG
3.
Lundkvist J, Kastang F, Kobelt G: The burden of rheumatoid arthritis and access to treatment: health burden and costs. Eur J Health Econ. 2008, 8 (Suppl 2): S49-S60.CrossRefPubMed
4.
Gommer AM, Poos MJJC: Cijfers reumatoïde artritis (prevalentie, incidentie en sterfte) uit de VTV 2010. In Volksgezondheid Toekomst Verkenning, Nationaal Kompas Volksgezondheid. 2010, Bilthoven: RIVM
5.
Verstappen SM, Jacobs JW, van der Heijde DM, van Der LS, Verhoef CM, Bijlsma JW, et al: Utility and direct costs: ankylosing spondylitis compared with rheumatoid arthritis. Ann Rheum Dis. 2007, 66: 727-731. 10.1136/ard.2006.061283.CrossRefPubMed
6.
International Classification of Functioning: Disability and Health: ICF. 2001, Geneva: World Health Organization
7.
Verstappen SM, Boonen A, Bijlsma JW, Buskens E, Verkleij H, Schenk Y, et al: Working status among Dutch patients with rheumatoid arthritis: work disability and working conditions. Rheumatology (Oxford). 2005, 44: 202-206. 10.1093/rheumatology/keh400.CrossRef
8.
Zirkzee EJ, Sneep AC, de Buck PD, Allaart CF, Peeters AJ, Ronday HK, et al: Sick leave and work disability in patients with early arthritis. Clin Rheumatol. 2008, 27: 11-19. 10.1007/s10067-007-0801-0.CrossRefPubMed
9.
Burton W, Morrison A, Maclean R, Ruderman E: Systematic review of studies of productivity loss due to rheumatoid arthritis. Occup Med (Lond). 2006, 56: 18-27. 10.1093/occmed/kqi171.CrossRef
10.
Mancuso CA, Paget SA, Charlson ME: Adaptations made by rheumatoid arthritis patients to continue working: a pilot study of workplace challenges and successful adaptations. Arthritis Care Res. 2000, 13: 89-99. 10.1002/1529-0131(200004)13:2<89::AID-ANR3>3.0.CO;2-L.CrossRefPubMed
11.
Anema JR, Van Der Giezen AM: Little communication between company doctors and private physicians with respect to hindrances to return to work after prolonged absence from work because of low back pain. Ned Tijdschr Geneeskd. 1999, 143: 572-575.PubMed
12.
Lambeek LC, Anema JR, van Royen BJ, Buijs PC, Wuisman PI, van Tulder MW, et al: Multidisciplinary outpatient care program for patients with chronic low back pain: design of a randomized controlled trial and cost-effectiveness study [ISRCTN28478651]. BMC Public Health. 2007, 7: 254-10.1186/1471-2458-7-254.CrossRefPubMedPubMedCentral
13.
Gezondheidsraad: Beoordelen, behandelen, begeleiden : medisch handelen bij ziekteverzuim en arbeidsongeschiktheid. 2005, Den Haag:
14.
Lambeek LC, Van Mechelen W, Knol DL, Loisel P, Anema JR: Integrated care for chronic back pain: a randomized controlled trial evaluating a systems approach to reduce disability in working and private life. BMJ. 2010, 340:
15.
Badamgarav E, Croft JD, Hohlbauch A, Louie JS, O'Dell J, Ofman JJ, et al: Effects of disease management programs on functional status of patients with rheumatoid arthritis. Arthritis Rheum. 2003, 49: 377-387. 10.1002/art.11120.CrossRefPubMed
16.
Anema JR, Buijs PC, Amstel PJ, van Putten DJ: LHV-NVAB-Leidraad voor huisarts en bedrijfsarts bij de sociaal-medische begeleiding bij arbeidsverzuim. De Huisarts/Tijdschr Bedrijfsgeneesk Verzekeringsgeneesk. 2002, S1-19.
17.
de Zwart BC, Broersen JP, van der Beek AJ, Frings-Dresen MH, van Dijk FJ: Occupational classification according to work demands: an evaluation study. Int J Occup Med Environ Health. 1997, 10: 283-295.PubMed
18.
Scott NW, McPherson GC, Ramsay CR, Campbell MK: The method of minimization for allocation to clinical trials. a review. Control Clin Trials. 2002, 23: 662-674. 10.1016/S0197-2456(02)00242-8.CrossRefPubMed
19.
20.
Evans S, Royston P, Day S: Minim: allocation by minimisation in clinical trials. Electronic citation. 6-7-2011
21.
Anema JR, Steenstra IA, Urlings IJ, Bongers PM, de Vroome EM: van MW: Participatory ergonomics as a return-to-work intervention: a future challenge?. Am J Ind Med. 2003, 44: 273-281. 10.1002/ajim.10259.CrossRefPubMed
22.
Steenstra IA, Anema JR, Bongers PM, de Vet HC: van MW: Cost effectiveness of a multi-stage return to work program for workers on sick leave due to low back pain, design of a population based controlled trial [ISRCTN60233560]. BMC Musculoskelet Disord. 2003, 4: 26-10.1186/1471-2474-4-26.CrossRefPubMedPubMedCentral
23.
Lerner D, Amick BC, Rogers WH, Malspeis S, Bungay K, Cynn D: The Work Limitations Questionnaire. Med Care. 2001, 39: 72-85. 10.1097/00005650-200101000-00009.CrossRefPubMed
24.
Lerner D, Reed JI, Massarotti E, Wester LM, Burke TA: The Work Limitations Questionnaire's validity and reliability among patients with osteoarthritis. J Clin Epidemiol. 2002, 55: 197-208. 10.1016/S0895-4356(01)00424-3.CrossRefPubMed
25.
Walker N, Michaud K, Wolfe F: Work limitations among working persons with rheumatoid arthritis: results, reliability, and validity of the work limitations questionnaire in 836 patients. J Rheumatol. 2005, 32: 1006-1012.PubMed
26.
Allaire SH: Measures of adult work disability. Arthritis Rheum. 2003, 49: 85-89. 10.1002/art.10914.CrossRef
27.
Koopmanschap MA: PRODISQ: a modular questionnaire on productivity and disease for economic evaluation studies. Expert Rev Pharmacoecon Outcomes Res. 2005, 5: 23-28. 10.1586/14737167.5.1.23.CrossRefPubMed
28.
Brouwer WB, Koopmanschap MA, Rutten FF: Productivity losses without absence: measurement validation and empirical evidence. Health Policy. 1999, 48: 13-27. 10.1016/S0168-8510(99)00028-7.CrossRefPubMed
29.
Van der Zee KI, Sanderman R: Het meten van de algemene gezondheidstoestand met de RAND-36: een handleiding. 1993, Noordelijk Centrum voor Gezondheidsvraagstukken, Rijksuniversiteit Groningen, Groningen
30.
Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, et al: Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011
31.
Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed
32.
Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A: Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Br J Rheumatol. 1997, 36: 551-559. 10.1093/rheumatology/36.5.551.CrossRefPubMed
33.
Ho K, Spence J, Murphy MF: Review of pain-measurement tools. Ann Emerg Med. 1996, 27: 427-432. 10.1016/S0196-0644(96)70223-8.CrossRefPubMed
34.
Wolfe F: Fatigue assessments in rheumatoid arthritis: comparative performance of visual analog scales and longer fatigue questionnaires in 7760 patients. J Rheumatol. 2004, 31: 1896-1902.PubMed
35.
Jensen MP, Karoly P, Braver S: The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986, 27: 117-126. 10.1016/0304-3959(86)90228-9.CrossRefPubMed
36.
Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B: The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998, 3: 322-355.CrossRefPubMed
37.
Gilworth G, Chamberlain MA, Harvey A, Woodhouse A, Smith J, Smyth MG, et al: Development of a work instability scale for rheumatoid arthritis. Arthritis Rheum. 2003, 49: 349-354. 10.1002/art.11114.CrossRefPubMed
38.
Gilworth G, Emery P, Gossec L, Vliet Vlieland TP, Breedveld FC, Hueber AJ, et al: Adaptation and cross-cultural validation of the rheumatoid arthritis work instability scale (RA-WIS). Ann Rheum Dis. 2009, 68: 1686-1690. 10.1136/ard.2008.098921.CrossRefPubMed
39.
Bruce B, Fries JF: The Stanford Health Assessment Questionnaire: a review of its history, issues, progress, and documentation. J Rheumatol. 2003, 30: 167-178.PubMed
40.
Linnan L, Steckler A: Process evaluation for public health interventions and research. 2002, San Francisco:
41.
Hakkaart L, Tan SS, Bouwmans CAM: Handleiding voor kostenonderzoek. Methoden en standaard kostprijzen voor economische evaluaties in de gezondheidszorg. 2010, Erasmus MC Rotterdam: Instituut voor Medische Technology Assessment
42.
Noben CY, Nijhuis FJ, de Rijk AE, Evers SM: Design of a trial-based economic evaluation on the cost-effectiveness of employability interventions among work disabled employees or employees at risk of work disability: the CASE-study. BMC Public Health. 2012, 12: 43-10.1186/1471-2458-12-43.CrossRefPubMedPubMedCentral
43.
Zhang W, Gignac MA, Beaton D, Tang K, Anis AH: Productivity loss due to presenteeism among patients with arthritis: estimates from 4 instruments. J Rheumatol. 2010, 37: 1805-1814. 10.3899/jrheum.100123.CrossRefPubMed
44.
de Buck PD, Schoones JW, Allaire SH, Vliet Vlieland TP: Vocational rehabilitation in patients with chronic rheumatic diseases: a systematic literature review. Semin Arthritis Rheum. 2002, 32: 196-203. 10.1053/sarh.2002.34609.CrossRefPubMed
45.
de Buck PD, le Cessie S, Van den Hout WB, Peeters AJ, Ronday HK, Westedt ML, et al: Randomized comparison of a multidisciplinary job-retention vocational rehabilitation program with usual outpatient care in patients with chronic arthritis at risk for job loss. Arthritis Rheum. 2005, 53: 682-690. 10.1002/art.21452.CrossRefPubMed
46.
de Buck PD, Breedveld J, van der Giesen FJ, Vlieland TP: A multidisciplinary job retention vocational rehabilitation programme for patients with chronic rheumatic diseases: patients' and occupational physicians' satisfaction. Ann Rheum Dis. 2004, 63: 562-568. 10.1136/ard.2003.007260.CrossRefPubMedPubMedCentral
47.
Allaire SH, Li W, LaValley MP: Reduction of job loss in persons with rheumatic diseases receiving vocational rehabilitation: a randomized controlled trial. Arthritis Rheum. 2003, 48: 3212-3218. 10.1002/art.11256.CrossRefPubMed
48.
van Oostrom SH, van MW, Terluin B, de Vet HC, Knol DL, Anema JR: A workplace intervention for sick-listed employees with distress: results of a randomised controlled trial. Occup Environ Med. 2010, 67: 596-602. 10.1136/oem.2009.050849.CrossRefPubMed
49.
Linton SJ: Correspondence of back pain patients' self-reports of sick leave and Swedish National Insurance Authority register. Percept Mot Skills. 2011, 112: 133-137. 10.2466/13.15.17.26.PMS.112.1.133-137.CrossRefPubMed
50.
Ferrie JE, Kivimaki M, Head J, Shipley MJ, Vahtera J, Marmot MG: A comparison of self-reported sickness absence with absences recorded in employers' registers: evidence from the Whitehall II study. Occup Environ Med. 2005, 62: 74-79. 10.1136/oem.2004.013896.CrossRefPubMedPubMedCentral
51.
Adair JG: The hawthorne effect: a reconsideration of the methodological Artifact. J Appl Psychol. 1984, 69: 334-345.CrossRef
Metadata
Title
An intervention program with the aim to improve and maintain work productivity for workers with rheumatoid arthritis: design of a randomized controlled trial and cost-effectiveness study
Authors
Myrthe van Vilsteren
Cécile RL Boot
Romy Steenbeek
Dirkjan van Schaardenburg
Alexandre E Voskuyl
Johannes R Anema
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-496

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue

Research article

Small proportions of actively-smoking patrons and high PM2.5 levels in southern California tribal casinos: support for smoking bans or designated smoking areas

Research article

Symptom load and functional status: results from the Ullensaker population study

Research article

Correlates of delayed sexual intercourse and condom use among adolescents in Uganda: a cross-sectional study

Research article

Predicting the outcome of a cognitive-behavioral group training for patients with unexplained physical symptoms: a one-year follow-up study

Research article

Understanding the drive to escort: a cross-sectional analysis examining parental attitudes towards children’s school travel and independent mobility

Research article

Community health workers improve contact tracing among immigrants with tuberculosis in Barcelona