Background/Purpose: RA can diminish patients’ (pts) work productivity and increase the risk of long-term disability, economic insecurity and worsening health, but limited research informs these issues. The objective was to identify associations between RA and treatment status on pts’ productivity and workplace support, using real-world data from the ArthritisPower registry.

Methods: US-resident adult pts with physician-diagnosed RA and a history of or current DMARD use were surveyed from the ArthritisPower registry via smartphone or web app. Pt-reported outcomes included Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference, fatigue, sleep disturbance, physical function, social participation and Routine Assessment of Pt Index Data 3 (RAPID3) score. The Work Productivity and Activity Impairment (WPAI) questionnaire was used to rate how RA affected pt work productivity for past 3 months (scale: 0 [no effect] to 10 [completely prevented from working]).

Results: Of 296 pts, 88% were currently treated with DMARDs (non-biologic and biologic) and 74% had high disease activity (HDA) assessed by RAPID3 (>12). HDA was associated with lower education, lower employment and lower full-time employment, with a higher proportion of pts with HDA reporting being disabled (p<0.05 for each). Average self-reported days missed from work due to problems associated with RA in the past 3 months differed between pts with and without HDA (6.1 vs 3.8 days, respectively; p<0.05). Pts without HDA missed more work days for medical appointments than pts with HDA (2.6 vs 1.2 days, respectively). Pts with HDA missed more days due to side effects from RA treatment than pts without HDA (mean: 0.5 vs 0.1 days, respectively). RA affected work productivity to a greater extent in pts with HDA than without (WPAI scores 5.3 and 3.3, respectively; p<0.05). Unemployed pts had more physically demanding tasks (e.g. heavy load lifting) in their most recent paid position than currently employed pts (Table 1). Pts who were employed had access to greater workplace flexibility (e.g. changes in start and finish times, working from home) than unemployed pts.

Conclusion: Despite treatment with DMARDs, the majority of HDA pts with RA were more likely to be unemployed or disabled. Physically demanding tasks and less flexible work arrangements were associated with a higher unemployment rate. Attaining lower disease activity and facilitating workplace flexibility (i.e. assign fewer physical tasks, permit flexible hours) may help pts with RA remain employed. Work flexibility policies have been proposed or passed federally in 33 states, yet there is a need for greater visibility, compliance and accessibility to these options for pts with RA. Indirect costs of RA in the workplace should be considered when determining the total cost of RA care.

Medical writing assistance: Carol Keys, PhD (Caudex); funding: Bristol-Myers Squibb.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/examining-workplace-supports-in-the-context-of-ra-disease-activity/