A two-year follow-up of work capacity in early rheumatoid arthritis: a study of multidisciplinary team care with emphasis on vocational support.
OBJECTIVE
To explore changes in sick leave patterns and work ability in patients with early rheumatoid arthritis (RA). The patients received active team support focusing on vocational rehabilitation, in addition to treatment with disease-modifying anti-rheumatic drugs (DMARDs).


METHODS
This is an observational study of 110 patients with early RA aged 18-60 years and not permanently disabled. All patients were monitored regularly during a 2-year period by a team comprising a nurse, an occupational therapist, a physiotherapist, a rheumatologist, and a social worker. Intervention included work-site visits and rehabilitation meetings with the employer and the official from the local social insurance office in addition to DMARD treatment and different individual treatments, and support from the team members.


RESULTS
The number of patients working full-time increased from 65 to 74 (14%), those with full-time work disability decreased from 37 to 13 (65%), and patients working part-time increased from 8 to 23 (65%). This change was already evident during the first year.


CONCLUSIONS
Active vocational support in addition to DMARD treatment may prevent or delay work disability in patients with early RA.
Nordmark
B
B
Rheumatology Unit, Department of Medicine at Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. birgitta.nordmark@karolinska.se
Blomqvist
P
P
Andersson
B
B
Hägerström
M
M
Nordh-Grate
K
K
Rönnqvist
R
R
Svensson
H
H
Klareskog
L
L
D000293:Adolescent; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000534:rehabilitation*; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012050:Rehabilitation, Vocational / Q000379:methods*; D012943:Social Security / Q000706:statistics & numerical data*; D012944:Social Support; D012959:Socioeconomic Factors; D013548:Sweden