Sick leave before and after diagnosis of rheumatoid arthritis--a report from the Swedish TIRA project.
OBJECTIVE
Our study describes sick leave during 3 years before and 3 years after diagnosis of rheumatoid arthritis (RA) in relation to referents and identifies predictors for sick leave during the third year after diagnosis of RA.


METHODS
One hundred twenty patients (76% women) from the Swedish early RA study TIRA were included. Disease activity and disability were registered regularly during 3 years in TIRA. Referents were matched for sex, age, and home town. Sick leave data were obtained for patients 3 years before and 3 years after diagnosis and for the referents for the corresponding 6 years.


RESULTS
No differences were seen between patients and referents regarding sick leave during the first 2 years, whereas sick leave increased in patients 6 months before diagnosis, from 30% to 53%. During the 3 years after diagnosis, sick leave among patients was rather stable, varying between 50% and 60%, even though disability pension increased and sickness benefit decreased. Sick leave before diagnosis, disability 1 year after diagnosis, and type of work were identified as predictors for sick leave during the third year after diagnosis.


CONCLUSIONS
Not surprisingly, sick leave in patients increased the year before diagnosis. Although disease activity and disability diminished after diagnosis, the patients' sick leave remained essentially unchanged. Sick leave 3 years after diagnosis was foremost predicted by earlier sick leave, disability, and type of work.
Rehabilitation Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, and Pain and Rehabilitation Centre, University Hospital Linköping, Linköping, Sweden. mathilda.bjork@hhj.hj.se
Mathilda
M
Björk
Ingrid
I
Thyberg
Klas
K
Rikner
Istvan
I
Balogh
Björn
B
Gerdle
D000203:Activities of Daily Living; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data*; D013997:Time Factors; D014938:Work Capacity Evaluation