Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the joints and, in severe cases, vital organs.
Marked by pain, fatigue, and loss of dexterity and mobility, RA has been strongly associated with work disability in the US. In previous studies of patients with advanced RA, 10 years in duration, the prevalence of work disability has been estimated at as high as 50 percent. However, most studies examining this costly effect of RA are well over a decade old. Since then, much has changed about the disease and the nature of work.
Prompted by these changes, researchers at Boston University speculated that the high prevalence of work disability among RA patients may have changed, and they set out to provide a comprehensive, up-to-date estimate. Featured in the April 2008 issue of Arthritis Care & Research ( www.interscience.wiley.com/journal/arthritis), their data suggests that the employability outlook for men and women with advanced RA has improved since the mid-1980s.
Using the National Data Bank (NDB) longitudinal study of RA, researchers identified 5,384 subjects for analyses. All participants completed extensive surveys every 6 months between January 2002 and December 2005. Questions covered employment status at disease onset, discontinuation of work prior to traditional retirement age—65 years, cessation of work attributed to arthritis, and, for those currently employed, work characteristics. Participants were also asked to supply demographic data and the date of RA diagnosis. Functional limitation was determined by score on the Health Assessment Questionnaire (HAQ). Subgroups of patients were formed to assess prevalence of work disability by 5-year intervals of disease duration. In addition, the annual incidence of work disability was calculated over 3 separate time periods: 2003, 2004, and 2005.
The mean age of the RA study population was 52 years. 82 percent of the subjects were women and 63 percent had more than a high school education. The mean disease duration was 14 years and the mean HAQ score was 1.0, indicating moderate functional limitation. 85 percent of subjects had been employed at disease onset and 56 percent were currently employed. Nearly three-quarters of these employed subjects worked full-time, 41 percent held professional or managerial jobs, and 16 percent were self-employed. Among subjects who were not employed, 43.5 percent were disabled; the remainder described themselves as either retired, full-time homemakers, or unemployed.