Impact of rheumatoid arthritis on work capacity impairment and its predictors.

Introduction: A decline in work capacity is an important outcome of rheumatoid arthritis (RA). In a first such study from India, we evaluated the impact of RA on work capacity and its predictors.

Methodology: We included 52 RA patients meeting 2010 Rheumatoid Arthritis Classification Criteria. Clinical history, physical examination and HAQ-DI, to assess the functional capability, were done. Information on socio-demographic, working and financial conditions of the patients was collected. Disease-specific characteristics: DAS28, ESR and CRP were included. Statistical analysis was carried out using Pearson's exact chi-square analysis.

Results: Among 52 RA patients, 10 patients had retired from their jobs before diagnosis, and 42 were of working age. Mean disease duration was 6.85 years (range 0.3-26 years). A total of 73% of patients suffered impaired work capacity: reduced working hours (48%), changed their job (8%) and left the labour force early (17%), while 27% had no work capacity impairment. Reduced working hours was significantly associated with lower educational level (p = 0.03), lower monthly income (p = 0.02), manual job (p = 0.01) and concerning disease-related factors: DAS-28 (p = 0.008), CRP level (p = 0.007) and HAQ-DI (p = 0.01). However, leaving the labour force early was related to no medical insurance (p = 0.04) and manual job (p = 0.02). No significant effect was seen in the group with job change.

Conclusion: RA impacts work capacity in Indian population. Socio-demographics (educational level, monthly income, job type) and disease-related factors (disease activity, CRP, physical function) are potential predictors for work capacity impairment in RA. Manual job and absence of medical insurance predicted leaving the labour force before official retirement age due to RA.Key Points• A decline in work capacity is an important outcome of the disease.• Attention has not been paid to this issue in India.• Potential predictors for work capacity impairment in RA include: educational level, monthly income, job type, disease activity, CRP, physical function.• Targeting the predictors may result in reducing work capacity impairment in RA.