Sofie M Hansen1,2,3, Merete Lund Hetland2,3,4, Jacob Pedersen1, Mikkel Østergaard3,4, Tine Steen Rubak5, Jakob Bue Bjorner1,6,7. 1. National Research Centre for the Working Environment, Copenhagen. 2. The DANBIO registry, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup. 3. Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup. 4. Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen. 5. Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen. 6. Optum Outcomes, Lincoln, RI, USA. 7. Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Abstract
Objectives: The aim was to study work ability in patients with RA compared with the general population by investigating the rates and risks of long-term sickness absence, unemployment and disability pension, and the chance of returning to work and the changes in these risks over time (1994-2011). Methods: This was a cohort study with up to 17 years of follow-up (mean 6.95 years/person) including 6677 RA patients of working age (identified in the nationwide DANBIO registry) and 56 955 matched controls from the general population. A multi-state model was used to analyse all shifts between the work-related states (long-term sickness absence, unemployment and disability pension, as well as the chance of returning to work) and calculate hazard rates (HRs). Analyses were stratified by disease duration and controlled for socio-demographic factors, physical job exposure and somatic and psychiatric co-morbidities. Results: RA patients had increased risk of long-term sickness absence (e.g. early RA: HR = 4.00, 95% CI: 3.64, 4.30) and disability pension (e.g. established RA: HR = 2.75, 95% CI: 2.54, 2.98) relative to controls. From 1994-99 to 2006-11, a decrease in the effect of established RA was observed [long-term sickness absence: from HR = 2.25 (95% CI: 1.99, 2.54) to 1.63 (95% CI: 1.51, 1.75); and disability pension: from HR = 3.49 (95% CI: 2.83, 4.32) to 2.40 (95% CI: 2.15, 2.69)]. RA patients had a lower chance of returning to work from long-term sickness absence or unemployment (HR = 0.60, HR=0.80), and this did not change over time. Conclusion: RA patients remain at high risk for long-term sickness absence and disability pension, despite a positive development between 1996-99 and 2006-11. Returning to work after sick leave or unemployment remains a challenge for RA patients.
Objectives: The aim was to study work ability in patients with RA compared with the general population by investigating the rates and risks of long-term sickness absence, unemployment and disability pension, and the chance of returning to work and the changes in these risks over time (1994-2011). Methods: This was a cohort study with up to 17 years of follow-up (mean 6.95 years/person) including 6677 RApatients of working age (identified in the nationwide DANBIO registry) and 56 955 matched controls from the general population. A multi-state model was used to analyse all shifts between the work-related states (long-term sickness absence, unemployment and disability pension, as well as the chance of returning to work) and calculate hazard rates (HRs). Analyses were stratified by disease duration and controlled for socio-demographic factors, physical job exposure and somatic and psychiatric co-morbidities. Results:RApatients had increased risk of long-term sickness absence (e.g. early RA: HR = 4.00, 95% CI: 3.64, 4.30) and disability pension (e.g. established RA: HR = 2.75, 95% CI: 2.54, 2.98) relative to controls. From 1994-99 to 2006-11, a decrease in the effect of established RA was observed [long-term sickness absence: from HR = 2.25 (95% CI: 1.99, 2.54) to 1.63 (95% CI: 1.51, 1.75); and disability pension: from HR = 3.49 (95% CI: 2.83, 4.32) to 2.40 (95% CI: 2.15, 2.69)]. RApatients had a lower chance of returning to work from long-term sickness absence or unemployment (HR = 0.60, HR=0.80), and this did not change over time. Conclusion:RApatients remain at high risk for long-term sickness absence and disability pension, despite a positive development between 1996-99 and 2006-11. Returning to work after sick leave or unemployment remains a challenge for RApatients.
Authors: Else Helene Ibfelt; Jan Sørensen; Dorte V Jensen; Lene Dreyer; Berit Schiøttz-Christensen; Pia H Thygesen; Ada Colic; Johnny L Raun; Natalia Manilo; Anne Rødgaard; Uta E Poulsen; Claus Rasmussen; Torben Hansen; Babara Unger; Randi Pelck; Anita Kincses; Henrik Nordin; Tove Lorenzen; Ali Theibich; Inger Marie Jensen Hansen; Jakob Espesen; Jolanta Grydehøj; Mette Holland-Fischer; Anne Gitte Loft; Merete Lund Hetland Journal: Clin Epidemiol Date: 2017-11-29 Impact factor: 4.790
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