Background/Purpose: More than two-thirds of U.S. adults with arthritis are working-age (< 65), and arthritis is a leading cause of work disability. The Chronic Disease Self-Management Program (CDSMP) has evidence for improving physical and mental health outcomes, but few studies specifically address employment. We examined work-related outcomes following participation in CDSMP.

Methods: From 6/2016-9/2017, we recruited participants through flyer, e-mail, and digital advertisements in communities, worksites, and other channels. No reference was made to CDSMP; participation was described in either a “health self-management program” or a “financial self-management program” (FSMP). Potential participants consented and enrolled through a website which screened for age (40-64 years), being employed, income, ≥1 chronic condition, English fluency, and living/working in the study area (5 North Carolina counties). Study design was a randomized controlled trial: intervention group=CDSMP, attenuated attention-control group=FSMP. Our primary study outcome was percent work productivity loss due to health-related presenteeism using the Work Limitations Questionnaire (WLQ) 4 Question Time Loss Module and the WLQ 25 Item Online Version. Baseline sample characteristics were summarized using descriptive statistics. Analyses of primary outcomes were conducted using simple t-tests, paired t-tests, and multivariate generalized linear models using an intent-to-treat (ITT) approach. We also did a post hoc analysis comparing CDSMP completers (attended ≥4 of the 6 sessions) to the FSMP group using α=0.10 due to the small sample size of CDSMP completers (n=41).

Results: A total of 327 enrolled and were randomized to CDSMP (n=160) or FSMP (n=167). The sample was predominantly white (54%), female (89%), and college educated (73%), with an average 2.89 chronic conditions, and average household income of $62,009. There were no significant group differences at baseline. Participation rates (attending any portion of program) were 35% (n=56) CDSMP and 25% (n=41) FSMP.

ITT analysis: There were no significant between-group differences in work-related outcomes (e.g., percent work productivity loss, time management, work output, or work self-efficacy) from baseline to 6 or 12-month follow up. In the CDSMP group (vs FSMP) depressive symptoms improved at 6 months (p=0.04) but not at 12 months; general health significantly improved at 12 months (p=0.02) but was clinically negligible.

CDSMP Completer Analysis: Compared to the FSMP group, CDSMP completers reported a greater reduction in percent work productivity loss (p=0.06) and subscales mental/interpersonal tasks (p=0.05) and work output (p=0.07) using α=0.10.

Conclusion: Low participation rates decreased power to find significant differences in the ITT analysis. However, the CDSMP completer analysis suggested a positive effect of CDSMP on work productivity among those who completed ≥4 sessions. A larger sample size of CDSMP completers is necessary to confirm these promising findings.

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/too-soon-to-say-promising-results-from-a-community-delivered-rct-examining-work-related-outcomes-of-the-chronic-disease-self-management-program/