A Systematic Review of Job Loss Prevention Interventions for Persons with Inflammatory Arthritis

Background:Persons with inflammatory arthritis (IA) have a higher level of absenteeism from work than those without IA and up to 20-30% become permanently work-disabled during the first years after being diagnosed with IA. Despite developments of new pharmacological and surgical treatments, people with IA still report reduced work ability. It is therefore relevant to offer effective interventions designed to prevent job loss and improve work function (i.e. job loss prevention interventions) to support people with IA to stay connected to the labour market. Initial effects of job loss prevention interventions have been established in a Cochrane review by Hoving et al. 2014 (1), but as only three randomized controlled trials (RCT) were identified, it seems relevant to investigate if new evidence has emerged.Objectives:The aim of this study was to present an overview of the evidence of the effect of job loss prevention interventions, which can improve work participation and decrease absenteeism and job loss in persons with IA.Methods:A systematic literature search was performed in the databases PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Library in two steps: 1) an update of the Cochrane review, restricted to studies published from January 2014 to February 2019 and 2) an additional search with updated keywords with no time restriction. Quality assessment and data extraction were performed independently by two authors. The results were summarized narratively.Results:The first search identified 1276 titles and the second search identified 2384 titles. Six studies (including the three RCT´s included in the Cochrane review (1)) were included. The results indicated that job loss prevention interventions may have effect on work ability, absenteeism and in particular job loss, but the results across study outcomes, were not consistent. This may be due to heterogeneity in the interventions delivered (i.e. dose, duration and setting) and outcome measures used. Most of the studies were of low quality. Therefore, the results should be interpreted with caution.Conclusion:Job loss prevention interventions may have an effect on work ability, absenteeism and in particular job loss among persons with IA. Further studies of high quality regarding job loss prevention interventions for people with IA are recommended.References:[1] Hoving, J.L. et al. 2014, “Non-pharmacological interventions for preventing job loss in workers with inflammatory arthritis”,The Cochrane database of systematic reviews,vol. 11;2014;, no. 11, pp. CD010208.Disclosure of Interests:Christina Merete Tvede Madsen: None declared, Sara Kjaer: None declared, Jette Primdahl Speakers bureau: BMS and Pfizer, Jeanette Reffstrup Christensen: None declared, Cecilie von Bülow: None declared

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OP0261-HPR PERCEIVED CHALLENGES AT WORK AND NEED FOR SUPPORT AMONG PEOPLE WITH INFLAMMATORY ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1549 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 159.1-159

Author(s):

C. M. T. Madsen ◽

J. Reffstrup Christensen ◽

A. Bremander ◽

J. Primdahl

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

At Risk ◽

Everyday Life ◽

Rheumatic Diseases ◽

Work Ability ◽

Inflammatory Arthritis ◽

Job Loss ◽

Work Related ◽

Need For Support

Background:People with inflammatory arthritis (IA), i.e. rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis, often experience low work ability and up to 38% lose their job during the first years after being diagnosed with IA (1). As a result, people with IA have a higher risk of job loss and permanent exclusion from the labor market than people without IA (1, 2). Work-related rehabilitation is complex and encompass a variety of interventions which aim to reduce barriers to maintain work and improve work ability. Unfortunately, positive results from work-related rehabilitation is scarce (3), why a better understanding of the challenges people at risk for job loss experience is needed to develop relevant interventions.Objectives:To explore perceived challenges and need for support to remain at work among people with IA who are at risk of job loss.Methods:A qualitative explorative design based on a hermeneutic approach was applied. Outpatients with IA who considered themselves at risk for long-term job loss, were recruited at the Danish Hospital for Rheumatic Diseases. An interview guide was developed based on earlier results from a systematic review and qualitative studies in close cooperation with three patient research partners. Individual semi-structured interviews were performed from December 2019 to May 2020.Results:Eleven women and four men with IA (aged 36-68 years) were interviewed. The participants were employed full time, part time or on sick leave. From the analysis, a main theme ‘Balancing work as a part of everyday life’ and four sub-themes emerged: 1) Working despite challenges, 2) Prioritizing energy for work, 3) Fatigue affects everything and 4) Need for support. To be able to work was very important to all participants. In general, they were stretching their limits, had concerns about maintaining their job and they used different strategies to deal with the challenges they met at work. Flexibility at work in every possible way and support from employers and co-workers were the main needs to be able to remain at work.Conclusion:Overall, patients with IA prioritized to keep working, but experienced challenges with balancing their work and energy in everyday life. They need support and flexibility at work to be able to remain at work.References:[1]Sokka T, Kautiainen H, Pincus T, Verstappen SMM, Aggarwal A, Alten R, et al. Work disability remains a major problem in rheumatoid arthritis in the 2000s: Data from 32 countries in the QUEST-RA Study. Arthritis Research and Therapy. 2010;12(2):R42-R.[2]Hansen SM, Hetland ML, Pedersen J, Ostergaard M, Rubak TS, Bjorner JB. Effect of rheumatoid arthritis on longterm sickness absence in 1994-2011: A danish cohort study. Journal of Rheumatology. 2016;43(4):707-15.[3]Madsen CMT, Kjaer, S., Primdahl, J., Christensen, J. R., & von Bulow, C. A SYSTEMATIC REVIEW OF JOB LOSS PREVENTION INTERVENTIONS FOR PERSONS WITH INFLAMMATORY ARTHRITIS. Annals of the rheumatic diseases, 79(Suppl 1) 916-917 [FRI0624-HPR]2020.Disclosure of Interests:None declared

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Effectiveness of web-based and mobile health interventions designed to enhance adherence to physical activity for people with inflammatory arthritis: a systematic review

Rheumatology Advances in Practice ◽

10.1093/rap/rkab016 ◽

2021 ◽

Author(s):

Mandeep Sekhon ◽

Claire White ◽

Emma Godfrey ◽

Aliya Amirova ◽

Åsa Revenäs ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Inflammatory Arthritis ◽

Risk Of Bias ◽

Health Interventions ◽

Behaviour Change Techniques ◽

Post Intervention ◽

Web Based ◽

Intervention Content ◽

Secondary Outcomes

Abstract Objective The aim of this systematic review was to assess the evidence from randomised controlled trials (RCT) and cohort studies for the effectiveness of digital interventions designed to enhance adherence to physical activity (PA) for people with inflammatory arthritis (IA) and describe the intervention content using established coding criteria. Methods Six electronic databases were searched for published and unpublished studies. Independent data extraction and quality assessment (Cochrane risk of bias II or ROBIN I) were conducted by two reviewers. The primary outcome was self-reported adherence to PA post-intervention. Secondary outcomes included self-reported adherence to PA at other timepoints, level of PA or engagement with intervention at any follow-up timepoint. Intervention content was assessed using the Consensus on Exercise Reporting Template and the Behaviour Change Techniques taxonomy version 1. Results From 11,136 reports, four moderate risk of bias studies (three RCTs, one cohort study) including 1,160 participants with rheumatoid arthritis or juvenile inflammatory arthritis were identified. Due to heterogeneity of outcomes, a narrative synthesis was conducted. Only one RCT reported a small between group difference in adherence to PA [mean difference (95% confidence intervals) -0.46 (-0.82. -0.09)] in favour of the intervention. There were no between group differences in any secondary outcomes. Interventions included between 3–11 behaviour change techniques but provided minimal exercise prescription information. Conclusion There is currently limited moderate quality evidence available to confidently evaluate the effect of web-based and mobile health interventions on adherence to PA or level of PA post intervention in people with IA.

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Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis

RMD Open ◽

10.1136/rmdopen-2021-001647 ◽

2021 ◽

Vol 7 (2) ◽

pp. e001647

Author(s):

Andréa Marques ◽

Eduardo Santos ◽

Elena Nikiphorou ◽

Ailsa Bosworth ◽

Loreto Carmona

Keyword(s):

Systematic Review ◽

Full Text ◽

Inflammatory Arthritis ◽

Data Extraction ◽

Management Strategies ◽

Psychosocial Interventions ◽

Behavioural Therapy ◽

Self Management ◽

Cochrane Library ◽

Management Interventions

ObjectiveTo perform a systematic review (SR) on the effectiveness of self-management interventions, in order to inform the European League Against Rheumatism Recommendations for its implementation in patients with inflammatory arthritis (IA).MethodsThe SR was conducted according to the Cochrane Handbook and included adults (≥18 years) with IA. The search strategy was run in Medline through PubMed, Embase, Cochrane Library, CINAHL Plus with Full Text, and PEDro. The assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. A narrative Summary of Findings was provided according to the Grading of Recommendations, Assessment, Development and Evaluation.ResultsFrom a total 1577 references, 57 were selected for a full-text review, and 32 studies fulfilled the inclusion criteria (19 randomised controlled trials (RCTs) and 13 SRs). The most studied self-management components were specific interactive disease education in ten RCTs, problem solving in nine RCTs, cognitive–behavioural therapy in eight RCTs, goal setting in six RCTs, patient education in five RCTs and response training in two RCTs. The most studied interventions were multicomponent or single exercise/physical activity in six SRs, psychosocial interventions in five SRs and education in two SRs. Overall, all these specific components and interventions of self-management have beneficial effects on IAs-related outcomes.ConclusionsThe findings confirm the beneficial effect of the self-management interventions in IA and the importance of their implementation. Further research should focus on the understanding that self-management is a complex intervention to allow the isolation of the effectiveness of its different components.

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