Job retention vocational rehabilitation for employed people with inflammatory arthritis (WORK-IA): a feasibility randomized controlled trial

BMC Musculoskeletal Disorders

Kate Radford¹  Alison Hammond²  Yeliz Prior²  Rachel O’Brien³  June Culley⁴  Diane Whitham⁵  Lucy Bradshaw⁵  Sarah Woodbridge⁶  Ruth Pulikottil-Jacob⁷ 

[1] Ageing and Disability Research Unit, Queen’s Medical Centre, University of Nottingham;Centre for Health Sciences Research (OT), L701 Allerton, University of Salford;Centre for Health and Social Care Research, Sheffield Hallam University;Derby National Rheumatoid Arthritis Society branch;Nottingham Clinical Trials Unit, Queens Medical Centre, University of Nottingham;Occupational Therapy, Royal Derby Hospital;Warwick Clinical Trials Unit, University of Warwick;

关键词: Feasibility trial;    Randomized controlled trial;    Arthritis;    Inflammatory arthritis;    Rheumatoid arthritis;    Vocational rehabilitation;   

DOI  :  10.1186/s12891-017-1671-5

来源: DOAJ

【 摘 要 】

Abstract Background Inflammatory arthritis leads to work disability, absenteeism and presenteeism (i.e. at-work productivity loss) at high cost to individuals, employers and society. A trial of job retention vocational rehabilitation (VR) in the United States identified this helped people keep working. The effectiveness of this VR in countries with different socioeconomic policies and conditions, and its impact on absenteeism, presenteeism and health, are unknown. This feasibility study tested the acceptability of this VR, modified for the United Kingdom, compared to written advice about managing work problems. To help plan a randomized controlled trial, we tested screening, recruitment, intervention delivery, response rates, applicability of the control intervention and identified the relevant primary outcome. Methods A feasibility randomized controlled trial with rheumatoid, psoriatic or inflammatory arthritis patients randomized to receive either job retention VR or written information only (the WORK-IA trial). Following three days VR training, rheumatology occupational therapists provided individualised VR on a one to one basis. VR included work assessment, activity diaries and action planning, and (as applicable) arthritis self-management in the workplace, ergonomics, fatigue and stress management, orthoses, employment rights and support services, assistive technology, work modifications, psychological and disclosure support, workplace visits and employer liaison. Results Fifty five (10%) people were recruited from 539 screened. Follow-up response rates were acceptable at 80%. VR was delivered with fidelity. VR was more acceptable than written advice only (7.8 versus 6.7). VR took on average 4 h at a cost of £135 per person. Outcome assessment indicated VR was better than written advice in reducing presenteeism (Work Limitations Questionnaire (WLQ) change score mean: VR = −12.4 (SD 13.2); control = −2.5 (SD 15.9), absenteeism, perceived risk of job loss and improving pain and health status, indicating proof of concept. The preferred primary outcome measure was the WLQ, a presenteeism measure. Conclusions This brief job retention VR is a credible and acceptable intervention for people with inflammatory arthritis with concerns about continuing to work due to arthritis. Trial registration ISRCTN 76777720 . Registered 21.9.12.

【 授权许可】

Unknown