One Year Effects of a Workplace Integrated Care Intervention for Workers with Rheumatoid Arthritis: Results of a Randomized Controlled Trial.
M van Vilsteren, C R L Boot, J W R Twisk and 4 others
PMID 27056549WHAT IT FOUND
Adding integrated care and workplace interventions to usual rheumatologist-led care did not reduce at-work productivity loss, pain, fatigue, or improve quality of life in workers with rheumatoid arthritis after 12 months.
The study population may have been too stable to show benefit.
Key findings
01No significant intervention effects were observed on the primary outcome of at-work productivity loss after 12 months.
02The intervention showed no significant effects on secondary outcomes including work instability, pain, fatigue, and quality of life.
03Participants had low baseline work instability and minimal productivity loss, suggesting limited room for improvement.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study population had low baseline work instability (mean RA WIS scores of 7.9 and 9.8) and minimal at-work productivity loss, indicating limited room for improvement. A systematic error in the minimization procedure potentially affected the allocation of 37 participants, though sensitivity analyses did not change the null conclusions. Participants self-selected into the study, which may have biased the sample toward those with supportive supervisors and stable work situations. The intervention was not blinded, and outcomes were self-reported, which could introduce bias. There is no consensus on the best instrument to measure at-work productivity loss, and different tools can yield widely varying estimates.
Declared interests
The study was funded by Instituut Gak. No other specific conflicts of interest or author disclosures are detailed in the provided text.
The easy way to misread this
Do not conclude that workplace integrated care is ineffective for all workers with rheumatoid arthritis. The null results likely reflect the selection of a stable, low-risk population with minimal baseline work limitations, rather than a failure of the intervention approach for patients with greater disability risk.