Occupational impacts of early inflammatory arthritis: results from the National Early Inflammatory Arthritis Audit

Katie Bechman; Emma Cook; Edward Alveyn; Abdullah Houssien; Martin Stevens; Mark D Russell; Maryam Adas; Paul Amlani-Hatcher; Sam Norton; Heidi Lempp; Joanna Ledingham; James Galloway; Karen Walker-Bone

doi:10.1093/rheumatology/kead484

Occupational impacts of early inflammatory arthritis: results from the National Early Inflammatory Arthritis Audit

Katie Bechman^* (Corresponding Author), Emma Cook, Edward Alveyn, Abdullah Houssien, Martin Stevens, Mark D Russell, Maryam Adas, Paul Amlani-Hatcher, Sam Norton, Heidi Lempp, Joanna Ledingham, James Galloway, Karen Walker-Bone

^*Corresponding author for this work

Applied Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: Inflammatory arthritis (IA) causes significant work disability. Studies frequently fail to report important contextual information such as employment type. Our objective was to explore work participation, by gender and occupation type in early IA.

METHODS: Data are from the National Early Inflammatory Arthritis Audit between 2018 and 2020. At diagnosis, clinicians collected information on demographics, IA disease activity and working status. Participants completed patient-reported outcomes at baseline, 3- and 12-months, including occupation and Work Productivity Activity Impairment (WPAI). Descriptive analyses of work participation and WPAI scores by occupational class at all timepoints were performed. Regression models examined associations between WPAI score and occupation.

FINDINGS: 12 473 people received a diagnosis of IA and reported employment status, amongst whom 5,999 (47%) were in paid-work at least 20-h/week. At diagnosis, the working cohort had statistically significant lower measures of disease activity (p< 0.001). Occupation data were available for 3,694 individuals. At diagnosis, 2,793 completed a WPAI; 200 (7.2%) had stopped work and 344 (12.3%) changed jobs because of IA symptoms. There was a high burden of absenteeism (30%) and presenteeism (40%). Compared with managerial or professional workers, the burden of work disability was greater amongst those in routine (manual) occupations. During follow-up, 9.4% of WPAI completers had stopped work and 14.6% had changed roles. Work dropout occurred almost entirely amongst people doing routine jobs.

CONCLUSION: IA associates with work disability within 12 months of diagnosis. It is easier to retain work in certain employment sectors. Participation in routine jobs is more affected, which may widen health inequalities.

Original language	English
Journal	Rheumatology
Early online date	3 Oct 2023
DOIs	https://doi.org/10.1093/rheumatology/kead484
Publication status	E-pub ahead of print - 3 Oct 2023

Bibliographical note

Funding: The National Early Inflammatory Arthritis Audit (NEIAA) is commissioned
by the Healthcare Quality Improvement Partnership (HQIP), funded by NHS England
and NHS Improvement and the Welsh government, and carried out by the British
Society for Rheumatology, King’s College London, King’s College Hospital and Net
Solving. KB is in receipt of funding from NIHR as an NIHR Clinical Lecturer. MS has
received funding from the Colt Foundation for doctoral research into work
participation amongst older people. HL has received funding from the UK Medical
Research Council in relation to Indigo Partnership and ARTEMIS awards.

Data Availability Statement

Data Sharing: Data from the National Early Inflammatory Arthritis Audit used to
produce this analysis is available on request, subject to the approval of the Healthcare Quality Improvement Partnership and the British Society for Rheumatology.

Keywords

Inflammatory arthritis
Employment
Patient Reported Outcome Measures (PROM)

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10.1093/rheumatology/kead484Licence: CC BY

Cite this

Bechman, K., Cook, E., Alveyn, E., Houssien, A., Stevens, M., Russell, M. D., Adas, M., Amlani-Hatcher, P., Norton, S., Lempp, H., Ledingham, J., Galloway, J., & Walker-Bone, K. (2023). Occupational impacts of early inflammatory arthritis: results from the National Early Inflammatory Arthritis Audit. Rheumatology. Advance online publication. https://doi.org/10.1093/rheumatology/kead484

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title = "Occupational impacts of early inflammatory arthritis: results from the National Early Inflammatory Arthritis Audit",

abstract = "OBJECTIVES: Inflammatory arthritis (IA) causes significant work disability. Studies frequently fail to report important contextual information such as employment type. Our objective was to explore work participation, by gender and occupation type in early IA.METHODS: Data are from the National Early Inflammatory Arthritis Audit between 2018 and 2020. At diagnosis, clinicians collected information on demographics, IA disease activity and working status. Participants completed patient-reported outcomes at baseline, 3- and 12-months, including occupation and Work Productivity Activity Impairment (WPAI). Descriptive analyses of work participation and WPAI scores by occupational class at all timepoints were performed. Regression models examined associations between WPAI score and occupation.FINDINGS: 12 473 people received a diagnosis of IA and reported employment status, amongst whom 5,999 (47%) were in paid-work at least 20-h/week. At diagnosis, the working cohort had statistically significant lower measures of disease activity (p< 0.001). Occupation data were available for 3,694 individuals. At diagnosis, 2,793 completed a WPAI; 200 (7.2%) had stopped work and 344 (12.3%) changed jobs because of IA symptoms. There was a high burden of absenteeism (30%) and presenteeism (40%). Compared with managerial or professional workers, the burden of work disability was greater amongst those in routine (manual) occupations. During follow-up, 9.4% of WPAI completers had stopped work and 14.6% had changed roles. Work dropout occurred almost entirely amongst people doing routine jobs.CONCLUSION: IA associates with work disability within 12 months of diagnosis. It is easier to retain work in certain employment sectors. Participation in routine jobs is more affected, which may widen health inequalities.",

keywords = "Inflammatory arthritis, Employment, Patient Reported Outcome Measures (PROM)",

author = "Katie Bechman and Emma Cook and Edward Alveyn and Abdullah Houssien and Martin Stevens and Russell, {Mark D} and Maryam Adas and Paul Amlani-Hatcher and Sam Norton and Heidi Lempp and Joanna Ledingham and James Galloway and Karen Walker-Bone",

note = "Funding: The National Early Inflammatory Arthritis Audit (NEIAA) is commissioned by the Healthcare Quality Improvement Partnership (HQIP), funded by NHS England and NHS Improvement and the Welsh government, and carried out by the British Society for Rheumatology, King{\textquoteright}s College London, King{\textquoteright}s College Hospital and Net Solving. KB is in receipt of funding from NIHR as an NIHR Clinical Lecturer. MS has received funding from the Colt Foundation for doctoral research into work participation amongst older people. HL has received funding from the UK Medical Research Council in relation to Indigo Partnership and ARTEMIS awards. ",

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doi = "10.1093/rheumatology/kead484",

language = "English",

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TY - JOUR

T1 - Occupational impacts of early inflammatory arthritis

T2 - results from the National Early Inflammatory Arthritis Audit

AU - Bechman, Katie

AU - Cook, Emma

AU - Alveyn, Edward

AU - Houssien, Abdullah

AU - Stevens, Martin

AU - Russell, Mark D

AU - Adas, Maryam

AU - Amlani-Hatcher, Paul

AU - Norton, Sam

AU - Lempp, Heidi

AU - Ledingham, Joanna

AU - Galloway, James

AU - Walker-Bone, Karen

N1 - Funding: The National Early Inflammatory Arthritis Audit (NEIAA) is commissioned by the Healthcare Quality Improvement Partnership (HQIP), funded by NHS England and NHS Improvement and the Welsh government, and carried out by the British Society for Rheumatology, King’s College London, King’s College Hospital and Net Solving. KB is in receipt of funding from NIHR as an NIHR Clinical Lecturer. MS has received funding from the Colt Foundation for doctoral research into work participation amongst older people. HL has received funding from the UK Medical Research Council in relation to Indigo Partnership and ARTEMIS awards.

PY - 2023/10/3

Y1 - 2023/10/3

N2 - OBJECTIVES: Inflammatory arthritis (IA) causes significant work disability. Studies frequently fail to report important contextual information such as employment type. Our objective was to explore work participation, by gender and occupation type in early IA.METHODS: Data are from the National Early Inflammatory Arthritis Audit between 2018 and 2020. At diagnosis, clinicians collected information on demographics, IA disease activity and working status. Participants completed patient-reported outcomes at baseline, 3- and 12-months, including occupation and Work Productivity Activity Impairment (WPAI). Descriptive analyses of work participation and WPAI scores by occupational class at all timepoints were performed. Regression models examined associations between WPAI score and occupation.FINDINGS: 12 473 people received a diagnosis of IA and reported employment status, amongst whom 5,999 (47%) were in paid-work at least 20-h/week. At diagnosis, the working cohort had statistically significant lower measures of disease activity (p< 0.001). Occupation data were available for 3,694 individuals. At diagnosis, 2,793 completed a WPAI; 200 (7.2%) had stopped work and 344 (12.3%) changed jobs because of IA symptoms. There was a high burden of absenteeism (30%) and presenteeism (40%). Compared with managerial or professional workers, the burden of work disability was greater amongst those in routine (manual) occupations. During follow-up, 9.4% of WPAI completers had stopped work and 14.6% had changed roles. Work dropout occurred almost entirely amongst people doing routine jobs.CONCLUSION: IA associates with work disability within 12 months of diagnosis. It is easier to retain work in certain employment sectors. Participation in routine jobs is more affected, which may widen health inequalities.

AB - OBJECTIVES: Inflammatory arthritis (IA) causes significant work disability. Studies frequently fail to report important contextual information such as employment type. Our objective was to explore work participation, by gender and occupation type in early IA.METHODS: Data are from the National Early Inflammatory Arthritis Audit between 2018 and 2020. At diagnosis, clinicians collected information on demographics, IA disease activity and working status. Participants completed patient-reported outcomes at baseline, 3- and 12-months, including occupation and Work Productivity Activity Impairment (WPAI). Descriptive analyses of work participation and WPAI scores by occupational class at all timepoints were performed. Regression models examined associations between WPAI score and occupation.FINDINGS: 12 473 people received a diagnosis of IA and reported employment status, amongst whom 5,999 (47%) were in paid-work at least 20-h/week. At diagnosis, the working cohort had statistically significant lower measures of disease activity (p< 0.001). Occupation data were available for 3,694 individuals. At diagnosis, 2,793 completed a WPAI; 200 (7.2%) had stopped work and 344 (12.3%) changed jobs because of IA symptoms. There was a high burden of absenteeism (30%) and presenteeism (40%). Compared with managerial or professional workers, the burden of work disability was greater amongst those in routine (manual) occupations. During follow-up, 9.4% of WPAI completers had stopped work and 14.6% had changed roles. Work dropout occurred almost entirely amongst people doing routine jobs.CONCLUSION: IA associates with work disability within 12 months of diagnosis. It is easier to retain work in certain employment sectors. Participation in routine jobs is more affected, which may widen health inequalities.

KW - Inflammatory arthritis

KW - Employment

KW - Patient Reported Outcome Measures (PROM)

U2 - 10.1093/rheumatology/kead484

DO - 10.1093/rheumatology/kead484

M3 - Article

C2 - 37725361

SN - 1462-0324

JO - Rheumatology

JF - Rheumatology

ER -

Occupational impacts of early inflammatory arthritis: results from the National Early Inflammatory Arthritis Audit

Abstract

Bibliographical note

Data Availability Statement

Keywords

Access to Document

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