title: Work disability in early rheumatoid arthritis: higher rates but better clinical status in Finland compared with the US.
abstract: OBJECTIVE
  To analyse and compare work disability attributed to rheumatoid arthritis in two cohorts of patients with early disease: one in the US and the other in Finland.
  
  
  METHODS
  Two cohorts of patients who were working and aged <65 years at the time of their first symptom of rheumatoid arthritis were studied: 269 patients in Nashville, TN, USA (median age 46 years, 72.5% females), and 364 patients from Jyväskylä, Finland, (median age 47.1 years, 70.9% females). The cohorts were analysed and compared for measures of clinical status and work disability status over a median (interquartile range) of 38.9 months in Nashville and 48.4 months in Jyväskylä.
  
  
  RESULTS
  The probability of working at 36 months was 0.89 (0.84-0.92) for patients from Nashville and 0.84 (0.80-0.88) for patients from Jyväskylä (p = 0.02). These rates were lower than in earlier decades. Patients from Jyväskylä had significantly higher rates of work disability (p = 0.02) than those from Nashville, but better scores for self-report physical function (p<0.001), pain (p<0.001) and global status (p<0.001) at last observation. The likelihood of being disabled from work was 2.6-fold higher in Jyväskylä compared to Nashville (95% confidence interval 1.44 to 4.59, p = 0.001), after adjustment for demographic and disease-specific variables.
  
  
  CONCLUSIONS
  Rates of work disability in both early rheumatoid arthritis cohorts were improved from earlier decades, but differed significantly in two different social systems. Higher work disability rates with better clinical status was seen in the Finnish early rheumatoid arthritis cohort than in the US cohort.
authors.affiliation: Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-4500, USA.
authors.forename: C P
authors.initials: CP
authors.lastname: Chung
authors.forename: T
authors.initials: T
authors.lastname: Sokka
authors.forename: P G
authors.initials: PG
authors.lastname: Arbogast
authors.forename: T
authors.initials: T
authors.lastname: Pincus
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000008:administration & dosage; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000534:rehabilitation*; D015331:Cohort Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012720:Severity of Illness Index; D013714:Tennessee
chemical_list: D018501:Antirheumatic Agents