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

BMC Musculoskeletal Disorders

Research Article

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

[1] Ageing and Disability Research Unit, Queen’s Medical Centre, University of Nottingham, NG7 2UH, Nottingham, UK;Centre for Health Sciences Research (OT), L701 Allerton, University of Salford, Frederick Road, M6 6PU, Salford, UK;Centre for Health and Social Care Research, Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, S10 2BP, Sheffield, UK;Derby National Rheumatoid Arthritis Society branch, Derby, UK;Nottingham Clinical Trials Unit, Queens Medical Centre, University of Nottingham, NG7 2UHL, Nottingham, UK;Occupational Therapy, Royal Derby Hospital, DE22 3NE, Derby, UK;

关键词: Feasibility trial;    Randomized controlled trial;    Arthritis;    Inflammatory arthritis;    Rheumatoid arthritis;    Vocational rehabilitation;    Occupational therapy;    Employment;    Work and presenteeism;   

DOI  :  10.1186/s12891-017-1671-5

 received in 2017-03-09, accepted in 2017-07-12,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundInflammatory 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.MethodsA 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.ResultsFifty 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.ConclusionsThis 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 registrationISRCTN 76777720. Registered 21.9.12.

【 授权许可】

CC BY   
© The Author(s). 2017