Work disability in rheumatoid arthritis is predicted by physical and psychological health status: a 7‐year study from the Oslo RA register

Abstract

Objective: To explore the prevalence of work disability (WD) and to identify bio‐psychological factors that predicts future WD in rheumatoid arthritis (RA) over a 7‐year period.

Methods: Patients were selected from the Oslo RA register. The prevalence of WD was studied cross‐sectionally among respondents <67 years (n = 526) in a postal survey. Mean age (SD) was 51.1 (11.9) years, mean disease duration 11.3 (9.4) years, and 49% of patients were RF‐positive. The patients studied for predictive factors for WD were respondents in postal surveys both at baseline and at the 7‐year follow‐up, in work at baseline and still in working age (<67 years) at follow‐up (n = 159). Mean age at baseline (SD) was 44.5 (9.7) years, mean disease duration 8.4 (6.6) years, mean years of formal education 12.7 (3.1) years, 48% were RF‐positive. Assessments included socio‐demographic variables and health status measures (MHAQ, AIMS2, SF‐36, fatigue and pain on VAS 0–100 mm, self efficacy, and RAI as a measure for helplessness).

Results: Among the 526 respondents at baseline <67 years, the prevalence of WD was 40%. A high level of education was a predictor of reduced risk of work disability [odds ratio (OR) = 0.4, 95% confidence interval (CI) 0.1; 0.9], while female gender (OR 3.0, 95% CI 1.1; 8.0), physical disability (MHAQ‐score) (OR = 3.9, 95% CI 1.2; 12.5) and helplessness over median RAI‐score (OR = 3.0, 95% CI 1.4; 6.7) were independent predictors of increased risk for new work disability over 7 years.

Conclusion: Physical disability, increased helplessness, low formal education, and female gender were found to be independent risk factors for new work disability over the 7‐year study period.