Work disability in rheumatoid arthritis is predicted by physical and psychological health status:: a 7-year study from the Oslo RA register

Objective: To explore the prevalence of work disability (WD) and to identify bio-psychological factors that predicts future WD in rheumatoid arthritis ( RA) over a 7-year period. Methods: Patients were selected from the Oslo RA register. The prevalence of WD was studied cross-sectionally among respondents <67 years (n=526) in a postal survey. Mean age (SD) was 51.1 (11.9) years, mean disease duration 11.3 (9.4) years, and 49% of patients were RF-positive. The patients studied for predictive factors for WD were respondents in postal surveys both at baseline and at the 7-year follow-up, in work at baseline and still in working age (<67 years) at follow- up (n=159). Mean age at baseline ( SD) was 44.5 (9.7) years, mean disease duration 8.4 (6.6) years, mean years of formal education 12.7 (3.1) years, 48% were RF-positive. Assessments included socio-demographic variables and health status measures ( MHAQ, AIMS2, SF-36, fatigue and pain on VAS 0 - 100 mm, self efficacy, and RAI as a measure for helplessness). Results: Among the 526 respondents at baseline <67 years, the prevalence of WD was 40%. A high level of education was a predictor of reduced risk of work disability [ odds ratio ( OR) 50.4, 95% confidence interval (CI) 0.1; 0.9], while female gender ( OR 3.0, 95% CI 1.1; 8.0), physical disability (MHAQ-score) (OR=3.9, 95% CI 1.2; 12.5) and helplessness over median RAI-score (OR=3.0, 95% CI 1.4; 6.7) were independent predictors of increased risk for new work disability over 7 years. Conclusion: Physical disability, increased helplessness, low formal education, and female gender were found to be independent risk factors for new work disability over the 7-year study period.