Work disability and state benefit claims in early rheumatoid arthritis: the ERAN cohort.
OBJECTIVE
RA is an important cause of work disability. This study aimed to identify predictive factors for work disability and state benefit claims in a cohort with early RA.


METHODS
The Early RA Network (ERAN) inception cohort recruited from 22 centres. At baseline, and during each annual visit, participants (n = 1235) reported employment status and benefits claims and how both were influenced by RA. Survival analysis derived adjusted hazard ratios (aHRs) and 95% CIs to predict associations between baseline factors and time until loss of employment due to RA or a state benefits claim due to RA.


RESULTS
At baseline, 47% of participants were employed and 17% reported claiming benefits due to RA. During follow-up, loss of employment due to RA was reported by 10% (49/475) of the participants and 20% (179/905) began to claim benefits. Independent predictors of earlier work disability were bodily pain (aHR 2.45, 95% CI 1.47, 4.08, P = 0.001) and low vitality (aHR 1.84, 95% CI 1.18, 2.85, P = 0.007). Disability (aHR 1.28, 95% CI 1.02, 1.61, P = 0.033), DAS28 (aHR 1.48, 95% CI 1.05, 2.09, P = 0.026) and extra-articular disease (aHR 1.77, 95% CI 1.17, 2.70, P = 0.007) predicted earlier benefits claims.


CONCLUSIONS
Work disability and benefits claims due to RA were predicted by different baseline factors. Pain and low vitality predicted work disability. Baseline disability, extra-articular disease manifestations and disease activity predicted new benefits claims due to RA. Future research on interventions targeting these factors could investigate job retention and financial independence.
Academic Rheumatology, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK. dan.mcwilliams@nottingham.ac.uk.
Daniel F
DF
McWilliams
Sneha
S
Varughese
Adam
A
Young
Patrick D
PD
Kiely
David A
DA
Walsh
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000453:epidemiology; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007342:Insurance Benefits / Q000706:statistics & numerical data*; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D007494:Ireland / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data*; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
employment; rheumatoid arthritis; social security; work disability