title: Vocational rehabilitation programs for individuals with chronic arthritis.
abstract: OBJECTIVE
  To summarize recent literature on vocational rehabilitation interventions in patients with chronic arthritis.
  
  
  RESULTS
  The current literature shows that the prevalence of work disability, including work cessation, sick leave, and any other restriction in the work status among patients with chronic arthritis, is substantial. In some studies, a trend towards a decline in work disability in chronic arthritis is seen, possibly reflecting improvements in medical treatment. The proof of effectiveness of comprehensive vocational rehabilitation interventions aimed at individuals in various stages of work disability is scanty. With prolonged sick leave being a major determinant of job loss, interventions are nowadays developed that specifically address patients with chronic arthritis at a stage in which sick leave occurs, with promising results. Economic evidence is limited, but savings on productivity are likely to outweigh the costs of an effective intervention.
  
  
  CONCLUSIONS
  Despite advances in medical treatment, work disability among individuals with chronic arthritis is substantial. Although the (cost-)effectiveness of interventions in patients with established work disability is unclear, the results of studies on interventions employed in the early stages of threatened work ability point to a favorable effect.
authors.affiliation: Leiden University Medical Center, Department of Orthopaedics and Department of Rheumatology, The Netherlands.
authors.forename: Theodora P M Vliet
authors.initials: TP
authors.lastname: Vlieland
authors.forename: Petronella D M
authors.initials: PD
authors.lastname: de Buck
authors.forename: Wilbert B
authors.initials: WB
authors.lastname: van den Hout