A proof-of-concept study of the "Employment and Arthritis: Making It Work" program

Work disability is a common outcome of inflammatory arthritis (IA), yet few services address employment. We conducted a proof-of-concept study of the "Employment and Arthritis: Making It Work" self-management program aimed at preventing work disability and maintaining at-work productivity in employed people with IA.

The program was developed using the precede-proceed model and self-management concepts. Program goals included modifying risk factors for work disability and enhancing self-management of work problems due to IA, as identified in initial focus groups. The program included a self-learning manual, 5 group sessions, and individual visits with an occupational therapist for an ergonomic assessment and a vocational rehabilitation counselor. It was pilot tested in 2 groups (n = 19) and evaluated over 12 months of followup.

Participants consisted of 19 employed women with IA. Process evaluation demonstrated feasibility and excellent attendance and use of the self-learning manual. By 1 year, 80% reported increased confidence in requesting job accommodations, 74% had requested an accommodation, and 71% of requested accommodations were implemented. The occupational therapist and vocational rehabilitation counselor visits resulted in recommendations for change in 100% and 74% of participants, respectively, with implementation of some recommended changes in 89% and 63%, respectively. Improvements were observed in self-confidence in managing problems at work, fatigue interference with work, measures of limitations, and at-work productivity.

We developed a novel intervention to prevent work disability in patients with IA, combining self-management group sessions and professional assessments aimed at job retention, which resulted in people making changes to adapt their work to their arthritis, and improved fatigue, self-efficacy, and at-work productivity.