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Abstract Number: 2363

Examining Workplace Supports in the Context of RA Disease Activity

W. Benjamin Nowell1, Kelly Gavigan1, Guillermo Ernest Gonzales2, Shilpa Venkatachalam1, Jeffrey R. Curtis3, Sheiva Ghazanfari4, Danielle Cavazzini4 and Leticia Ferri4, 1Global Healthy Living Foundation, Upper Nyack, NY, 2Silver School of Social Work, New York University, New York, NY, 3University of Alabama at Birmingham, Birmingham, AL, 4Bristol-Myers Squibb, Princeton, NJ

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Employment, PRO and rheumatoid arthritis (RA)

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Session Information

Date: Tuesday, October 23, 2018

Title: Patient Outcomes, Preferences, and Attitudes Poster II: Patient Perspectives

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

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.

Table 1. Workplace environment and flexibility by employment status (N=296)

Employment characteristics, n (%)

Currently employed
(n=170)

No longer employed
(n=126)

Physically demanding tasks

High physical effort*

14 (8)

40 (32)

Lifting heavy loads*

5 (3)

19 (15)

Stooping, kneeling, crouching*

9 (5)

40 (32)

Standing for majority of time*

15 (9)

28 (22)

Traveling within the community or long distance*

12 (7)

19 (15)

Sedentary tasks

Good eyesight

108 (64)

85 (67)

Intense concentration or attention*

91 (54)

90 (71)

Use of computers*

124 (73)

72 (57)

Sitting for majority of time*

57 (34)

26 (21)

Altering work hours

Frequently changing starting and quitting times (e.g. daily basis)*

76 (45)

29 (23)

Vary work schedule from typical work schedule*

71 (42)

27 (21)

Compress work week (i.e. longer hours on fewer days)*

48 (28)

20 (16)

Occasionally changing starting and quitting times*

92 (54)

46 (37)

nput into amount of overtime hours*

66 (39)

33 (26)

Controlling work

Control breaks*

120 (71)

58 (46)

Work from off-site location for part or all of work week*

59 (35)

18 (14)

Take extra “unpaid” vacation days

44 (26)

25 (20)

All values are n (%)

*p<0.05, differences bolded


Disclosure: W. B. Nowell, GSK, Merck & Co., AbbVie Inc., Janssen, Pfizer, Bristol-Myers Squibb, Eli Lilly, 1,GSK, Pfizer, Bristol-Myers Squibb, Eli Lilly, Novartis, 2,Global Health Living Foundation, 3; K. Gavigan, Global Healthy Living Foundation (GHLF), 3; G. E. Gonzales, None; S. Venkatachalam, None; J. R. Curtis, AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Radius, Roche/Genentech, UCB, 2,AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Radius, Roche/Genentech, UCB, 5; S. Ghazanfari, Bristol-Myers Squibb, 3; D. Cavazzini, Bristol-Myers Squibb, 3; L. Ferri, Bristol-Myers Squibb, 1,Bristol-Myers Squibb, 3.

To cite this abstract in AMA style:

Nowell WB, Gavigan K, Gonzales GE, Venkatachalam S, Curtis JR, Ghazanfari S, Cavazzini D, Ferri L. Examining Workplace Supports in the Context of RA Disease Activity [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/examining-workplace-supports-in-the-context-of-ra-disease-activity/. Accessed .
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