Work Disability and State benefit
McWilliams DF, Varughese S, Young A, Kiely PD, Walsh DA. Rheumatology (Oxford). 2014 Mar;53(3);473-81. Article can be accessed at; http://www.ncbi.nlm.nih.gov/pubmed/24241033
Take home message
- Work disability and benefit claims are common in people with newly diagnosed rheumatoid arthritis with pain being a major factor in predicting their future job loss.
- Paying more attention to work disability during the initial assessment of people with rheumatoid arthritis could lead to interventions that reduce its impact in later disease.
- Considering factors such as pain, vitality and reported disability has the potential to reduce subsequent work disability in people presenting with early rheumatoid arthritis.
Key findings and importance of the study
The main findings from this study were that people with worse pain and more fatigue when they are first diagnosed with rheumatoid arthritis are more likely to stop working sooner due to their condition. This study also investigated benefit claims due to the rheumatoid arthritis, and found that people who had more disability are more likely to begin benefit claims earlier due to their condition.
Rheumatoid arthritis is a painful inflammatory condition that affects the joints and can lead to severe disability. One of the major worries for people with rheumatoid arthritis is the potential loss of employment and the limitation of future work opportunities.
Aim of the study
We examined data collected from people with newly diagnosed rheumatoid arthritis who were followed for up to 10 years. The aims of this study were to identify (1) risk factors for loss of employment and (2) new benefit claims due to the rheumatoid arthritis.
How the study was carried out
We used the research database from the Early Rheumatoid Arthritis Network (ERAN) cohort study. Data on more than 1200 people (in 22 different hospitals in the UK and Ireland) were collected at the time of first diagnosis. All study participants had given permission for their data to be collected and used for research. Study participants were followed up each year and told the researchers whether they were working, unemployed, on sick leave or retired; and also whether they had lost their job due to the rheumatoid arthritis or had started to claim benefits due to the rheumatoid arthritis.
We performed two separate analyses looking at the times until loss of employment and the times until new benefit claims, and we took into account the influence of important factors that might influence our findings or bias our work. Examples of these are pain, fatigue, disability, age, gender and type of employment.
What the study found
(1) At the start of the study, 47% were working. 10% of those working at the start of the study lost employment due to the rheumatoid arthritis during the follow up time period. In the people who were working, we found that worse levels of pain and higher levels of fatigue were both associated with losing work faster, even after accounting for other factors that might also influence their employment and rheumatoid arthritis. (2) At the start of the study, 17% were claiming benefits due to rheumatoid arthritis. Of those not claiming benefits due to the rheumatoid arthritis at the start of the study, 20% commenced while being followed up. We found that people with worse levels of disability at the start of the study were more likely to being benefit claims sooner.
Significance of the study to Pain Centre's research
This study found that how people feel with their rheumatoid arthritis may be important in determining whether they lose work and claim benefits. This suggests that improving the symptoms, on top of treating the underlying inflammation, may be helpful in keeping people in work for longer.