Helping arthritis sufferers to continue at work is challenging

Press release 79/2014, Kuopio 2014-12-02

Continuing at work can possibly be made easier for sufferers of inflammatory arthritis through adapting work, vocational counselling, advice and the worker’s own actions. The latest Cochrane review looked at the results of intervention studies aiming to prevent job loss among arthritis patients of working age (16‒65-year-olds) through non-pharmacological measures.

Inflammatory arthritis is a group of diseases, for example rheumatoid arthritis, other spondylarthritis, and connective tissue diseases, which cause long-term pain and stiffening and swelling of the joints. These symptoms make it difficult to move, which in turn affects the ability to work. About 3% of the world’s population has arthritis. Around 100 000 people in Finland receive arthritis medication that is entitled to special reimbursement. The disease usually emerges at the age of 30 to 40, when the patient still has many working years left. Thus it is important to find effective ways in which to help arthritis sufferers stay at work.

The Cochrane review found three randomized controlled trials, in which a total of 414 arthritis patients who were in danger of losing their jobs due to the disease took part. The studies first assessed adaptations to the work environment to make it more suitable for the workers. The assessment included workplace visits and consultations with a physiotherapist. After this, the participants received counselling, advice or training concerning the difficulties at work. In one study, this consisted of 1.5-hour sessions over a period of five months. In another study, participants attended two consultations and underwent multidisciplinary treatments over a period of three months. The third study involved six to seven individual or group sessions over six months. The studies compared the effects of the intervention to normal treatment or to advice given in writing. Two of the studies evaluated the effect of the measures on success at work (382 people), whereas the third measured sickness absences and work ability (32 people).

”Due to flaws in the studies, the evidence regarding non-pharmacological methods helping arthritis sufferers stay on at work is unfortunately rather weak,” says Senior Researcher Jos Verbeek from the Finnish Institute of Occupational Health. “However, the results do suggest that measures to support continuation at work may have some effect.”

The results of the different studies varied: according to one study, counselling helped people continue at work. In another study, the measures had no effect on sickness absences in a six-month follow-up, but a clear improvement in work ability was observed.

In order to find the best, most effective ways to support continuation at work among arthritis sufferers, we need further research from different standpoints: the benefits gained from adapting the work environment, on both the individual and organizational level; the effects of vocational rehabilitation; and the cost benefit ratio of the interventions. The follow-up period should be sufficiently long, at least two years.

Further information:

Jos Verbeek, Senior Researcher, FIOH, +358 30 474 7289, jos.verbeek[at]ttl.fi
Cochrane Occupational Safety and Health Review Group (http://osh.cochrane.org)

Review:

Hoving JL, Lacaille D, Urquhart DM, Hannu TJ, Sluiter JK, Frings-Dresen MHW. Non-pharmacological interventions for preventing job loss in workers with inflammatory arthritis. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD010208. DOI: 10.1002/14651858.CD010208.pub2.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010208.pub2/abstract

See also:

Cochrane library
Cochrane network
Cochrane Occupational Safety and Health Review Group
 

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The Cochrane Collaboration was established in 1993 and is an international, independent, non-profit researcher network, with members in over 120 countries. The Collaboration produces syntheses of medical research, called Cochrane reviews. Each review collects and summarizes the best available high quality evidence of a given intervention that aims to address a particular health issue. Cochrane reviews are used in, for example, clinical and health-political decision making. Occupational safety and health reviews are intended to influence guidance and procedures at workplaces and occupational health services so that harmful exposures can be reduced and work-related diseases can be prevented and treated as effectively as possible.

The Finnish Institute of Occupational Health researches, develops and specializes in well-being at work. It promotes occupational health and safety and the well-being of workers. It is an independent institution under public law, working under the administrative sector of the Ministry of Social Affairs and Health. It has six regional offices, and its headquarters are in Helsinki. It employs about 730 people.