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 Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Research article

Productivity at work and quality of life in patients with rheumatoid arthritis

Authors: Myrthe van Vilsteren, Cecile RL Boot, Dirk L Knol, Dirkjan van Schaardenburg, Alexandre E Voskuyl, Romy Steenbeek, Johannes R Anema

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

Login to get access

Abstract

Background

The aim of this study was to determine which combination of personal, disease-related and environmental factors is best associated with at-work productivity loss in patients with rheumatoid arthritis (RA), and to determine whether at-work productivity loss is associated with the quality of life for these patients.

Methods

This study is based on cross-sectional data. Patients completed a questionnaire with personal, disease-related and environmental factors (related to the work environment), and clinical characteristics were obtained from patient medical records. At-work productivity loss was measured with the Work Limitations Questionnaire, and quality of life with the RAND 36. Using linear regression analyses, a multivariate model was built containing the combination of factors best associated with at-work productivity loss. This model was cross-validated internally. We furthermore determined whether at-work productivity loss was associated with quality of life using linear regression analyses.

Results

We found that at-work productivity loss was associated with workers who had poorer mental health, more physical role limitations, were ever treated with a biological therapeutic medication, were not satisfied with their work, and had more work instability (R2 = 0.50 and R2 following cross-validation was 0.32). We found that at-work productivity loss was negatively associated with health-related quality of life, especially with dimensions of mental health, physical role limitations, and pain.

Conclusions

We found that at-work productivity loss was associated with personal, work-related, and clinical factors. Although our study results should be interpreted with caution, they provide insight into patients with RA who are at risk for at-work productivity loss.
Literature
1.
Ahlstrand I, Bjork M, Thyberg I, Borsbo B, Falkmer T. Pain and daily activities in rheumatoid arthritis. Disabil Rehabil. 2012;34:1245–53.CrossRefPubMed
2.
Boonen A, Severens JL. The burden of illness of rheumatoid arthritis. Clin Rheumatol. 2011;30 Suppl 1:S3–8.CrossRefPubMed
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:S49–60.CrossRefPubMed
4.
Zhang W, Anis AH. The economic burden of rheumatoid arthritis: beyond health care costs. Clin Rheumatol. 2011;30 Suppl 1:S25–32.CrossRefPubMed
5.
De Croon EM, Sluiter JK, Nijssen TF, Dijkmans BA, Lankhorst GJ, Frings-Dresen MH. Predictive factors of work disability in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis. 2004;63:1362–7.CrossRefPubMedPubMedCentral
6.
Detaille SI, Heerkens YF, Engels JA, van der Gulden JW, van Dijk FJ. Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies. Scand J Work Environ Health. 2009;35:261–81.CrossRefPubMed
7.
Tang K, Escorpizo R, Beaton DE, Bombardier C, Lacaille D, Zhang W, et al. Measuring the impact of arthritis on worker productivity: perspectives, methodologic issues, and contextual factors. J Rheumatol. 2011;38:1776–90.CrossRefPubMed
8.
Beaton DE, Tang K, Gignac MA, Lacaille D, Badley EM, Anis AH, et al. Reliability, validity, and responsiveness of five at-work productivity measures in patients with rheumatoid arthritis or osteoarthritis. Arthritis Care Res (Hoboken). 2010;62:28–37.CrossRef
9.
Tang K, Beaton DE, Boonen A, Gignac MA, Bombardier C. Measures of work disability and productivity: rheumatoid arthritis specific work productivity survey (WPS-RA), workplace activity limitations scale (WALS), work instability scale for rheumatoid arthritis (RA-WIS), work limitations questionnaire (WLQ), and work productivity and activity impairment questionnaire (WPAI). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S337–49.CrossRef
10.
Tang K, Beaton DE, Lacaille D, Gignac MA, Bombardier C. Sensibility of five at-work productivity measures was endorsed by patients with osteoarthritis or rheumatoid arthritis. J Clin Epidemiol. 2013;66:546–56.CrossRefPubMed
11.
Geuskens GA, Hazes JM, Barendregt PJ, Burdorf A. Predictors of sick leave and reduced productivity at work among persons with early inflammatory joint conditions. Scand J Work Environ Health. 2008;34:420–9.CrossRefPubMed
12.
Gignac MA, Cao X, Lacaille D, Anis AH, Badley EM. Arthritis-related work transitions: a prospective analysis of reported productivity losses, work changes, and leaving the labor force. Arthritis Rheum. 2008;59:1805–13.CrossRefPubMed
13.
Stigmar KG, Petersson IF, Joud A, Grahn BE. Promoting work ability in a structured national rehabilitation program in patients with musculoskeletal disorders: outcomes and predictors in a prospective cohort study. BMC Musculoskelet Disord. 2013;14:57.CrossRefPubMedPubMedCentral
14.
Wallenius M, Skomsvoll JF, Koldingsnes W, Rodevand E, Mikkelsen K, Kaufmann C. Work disability and health-related quality of life in males and females with psoriatic arthritis. Ann Rheum Dis. 2009;68:685–9.CrossRefPubMed
15.
Chorus AM, Miedema HS, Boonen A, van Der Linden S. Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age. Ann Rheum Dis. 2003;62:1178–84.CrossRefPubMedPubMedCentral
16.
van Vilsteren M, Boot CR, Steenbeek R, van Schaardenburg D, Voskuyl AE, Anema JR. 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. BMC Public Health. 2012;12:496.CrossRefPubMedPubMedCentral
17.
Lerner D, Amick III BC, Rogers WH, Malspeis S, Bungay K, Cynn D. The work limitations questionnaire. Med Care. 2001;39:72–85.CrossRefPubMed
18.
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.CrossRefPubMed
19.
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;32:1006–12.PubMed
20.
Allaire SH. Measures of adult work disability. Arthritis Rheum. 2003;49:85–9.CrossRef
21.
Moorer P, Suurmeije T, Foets M, Molenaar IW. Psychometric properties of the RAND-36 among three chronic diseases (multiple sclerosis, rheumatic diseases and COPD) in The Netherlands. Qual Life Res. 2001;10:637–45.CrossRefPubMed
22.
Van der Zee KI, Sanderman R. Het meten van de algemene gezondheidstoestand met de RAND-36 : een handleiding. 1993. Groningen, Noordelijk Centrum voor Gezondheidsvraagstukken, Rijksuniversiteit Groningen.
23.
Burkhard FL, Andel I, Sautner J, Fassl C, Nothnagl T, Rintelen B. The disease activity score in 28 joints in rheumatoid arthritis and psoriatic arthritis patients. Arthritis & Rheumatism. 2007;57(2):256–60.CrossRef
24.
Bruce B, Fries JF. The Stanford health assessment questionnaire: a review of its history, issues, progress, and documentation. J Rheumatol. 2003;30:167–78.PubMed
25.
26.
Wolfe F. Fatigue assessments in rheumatoid arthritis: comparative performance of visual analog scales and longer fatigue questionnaires in 7760 patients. J Rheumatol. 2004;31:1896–902.PubMed
27.
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;3:322–55.CrossRefPubMed
28.
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;49:349–54.CrossRefPubMed
29.
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;68:1686–90.CrossRefPubMed
30.
Koopmanschap MA. PRODISQ: a modular questionnaire on productivity and disease for economic evaluation studies. Expert Rev Pharmacoecon Outcomes Res. 2005;5:23–8.CrossRefPubMed
31.
Van den Bossche SNJ, Koppes LLJ, Granzier JJM, De Vroome EEM, Smulders PGW. Netherlands working conditions survey 2007. Methods and general results. 2008. Hoofddorp, TNO Quality of Life.
32.
Twisk J. Inleiding in de toegepaste biostatistiek. Maarssen: Elsevier gezondheidszorg; 2007.
33.
Ter Wee MM, Lems WF, Usan H, Gulpen A, Boonen A. The effect of biological agents on work participation in rheumatoid arthritis patients: a systematic review. Ann Rheum Dis. 2012;71:161–71.CrossRefPubMed
34.
Emery P, Breedveld FC, Hall S, Durez P, Chang DJ, Robertson D, et al. Comparison of methotrexate monotherapy with a combination of methotrexate and etanercept in active, early, moderate to severe rheumatoid arthritis (COMET): a randomised, double-blind, parallel treatment trial. Lancet. 2008;372:375–82.CrossRefPubMed
35.
Smolen J, Landewe RB, Mease P, Brzezicki J, Mason D, Luijtens K, et al. Efficacy and safety of certolizumab pegol plus methotrexate in active rheumatoid arthritis: the RAPID 2 study. A randomised controlled trial. Ann Rheum Dis. 2009;68:797–804.CrossRefPubMed
36.
Moreland LW. Drugs that block tumour necrosis factor: experience in patients with rheumatoid arthritis. Pharmacoeconomics. 2004;22:39–53.CrossRefPubMed
37.
Tang K, Beaton DE, Gignac MA, Lacaille D, Zhang W, Bombardier C. The Work Instability Scale for rheumatoid arthritis predicts arthritis-related work transitions within 12 months. Arthritis Care Res (Hoboken). 2010;62:1578–87.CrossRef
38.
Heymans MW, Anema JR, van Buuren S, Knol DL, Van Mechelen W, de Vet HC. Return to work in a cohort of low back pain patients: development and validation of a clinical prediction rule. J Occup Rehabil. 2009;19:155–65.CrossRefPubMed
39.
Steyerberg EW, Vickers AJ, Cook NR, Gerds T, Gonen M, Obuchowski N, et al. Assessing the performance of prediction models: a framework for traditional and novel measures. Epidemiology. 2010;21:128–38.CrossRefPubMedPubMedCentral
40.
van de Stadt LA, Witte BI, Bos WH, van Schaardenburg D. A prediction rule for the development of arthritis in seropositive arthralgia patients. Ann Rheum Dis. 2013;72:1920–6.CrossRefPubMed
41.
Bansback N, Young A, Brennan A, Dixey J. A prognostic model for functional outcome in early rheumatoid arthritis. J Rheumatol. 2006;33:1503–10.PubMed
42.
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;37:1805–14.CrossRefPubMed
43.
Linton SJ. Correspondence of back pain patients' self-reports of sick leave and Swedish National Insurance Authority register. Percept Mot Skills. 2011;112:133–7.CrossRefPubMed
Metadata
Title
Productivity at work and quality of life in patients with rheumatoid arthritis
Authors
Myrthe van Vilsteren
Cecile RL Boot
Dirk L Knol
Dirkjan van Schaardenburg
Alexandre E Voskuyl
Romy Steenbeek
Johannes R Anema
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0562-x

Other articles of this Issue 1/2015

BMC Musculoskeletal Disorders 1/2015 Go to the issue

Research article

Self-reported quality of life, anxiety and depression in individuals with Ehlers-Danlos syndrome (EDS): a questionnaire study

Research article

Bone mineral density after implantation of a femoral neck hip prosthesis – a prospective 5 year follow-up

Research article

Work related etiology of de Quervain’s tenosynovitis: a case-control study with prospectively collected data

Study protocol

Cervical spine kinematics after anterior cervical discectomy with or without implantation of a mobile cervical disc prosthesis; an RCT

Research article

The Amsterdam wrist rules: the multicenter prospective derivation and external validation of a clinical decision rule for the use of radiography in acute wrist trauma

Research article

Pain intensity, neck pain and longer duration of complaints predict poorer outcome in patients with shoulder pain – a systematic review