Prevention of Arthritis-Related Work Disability
Condition: Rheumatoid Arthritis; Systemic Lupus Erythematosus; Osteoarthritis, Knee; Ankylosing Spondylitis
MeSH terms: Spondylitis; Arthritis; Spondylitis, Ankylosing; Osteoarthritis, Knee; Lupus Erythematosus, Systemic
Study type: Interventional

Summary: 
      People with rheumatic disorders (arthritis) often have trouble keeping their jobs. This study
      will look at whether vocational rehabilitation (VR) will improve the ability of employed
      people with arthritis to keep their jobs. Job retention VR services target key factors that
      increase the risk of job loss. They aim to modify jobs to reduce barriers caused by
      functional limitations and disease symptoms, future career planning, and establish a
      partnership with a VR counselor for ongoing help.

      We will conduct the study among patients with rheumatic disorders recruited in eastern
      Massachusetts. We will give 120 study participants job retention services provided by VR
      counselors. We will give another 120 participants literature about employment- related
      resources. We will compare the outcomes of the two groups to evaluate the usefulness of job
      retention services in preventing job loss in people with rheumatic disorders.
    

Detailed description: 
      Job loss commonly occurs among people with rheumatic disorders. This study will determine
      whether vocational rehabilitation (VR) provided to employed people with rheumatic disorders
      will improve their ability to remain employed. VR is applied primarily to people who have
      already lost their jobs. However, using job retention VR services may prevent, or delay, the
      onset of employment work loss among people with rheumatic disorders. Job retention VR
      services target important employment-loss risk factors. They do so by modifying jobs to
      reduce barriers posed by functional limitations and symptoms, promoting future career
      planning, and establishing an alliance with a VR counselor for ongoing assistance.

      The study is a randomized, controlled trial conducted among patients with rheumatic disorders
      recruited from the practices of rheumatologists in eastern Massachusetts.

      We will randomly assign 120 study participants to receive job-retention services provided by
      VR counselors and 120 participants (controls) to receive literature about employment-related
      resources. We will assess intermediate outcome variables (self-efficacy, work limitations,
      and job accommodation-seeking behaviors) and the endpoint outcome variable, work instability
      (a measure that includes employment loss), immediately prior to the interventions and at
      6-month intervals over a 24-month period after the interventions are carried out. We will
      compare the outcomes of the two groups to evaluate the usefulness of job retention services
      in forestalling work instability in this population.
    

Intervention name(s): Rehabilitation counseling
Intervention type(s): Other
Intervention description(s): Provided in 2 in-person meetings and in follow-up phone calls
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Arthritis; Rheumatic disorders; Work-related disability; Vocational rehabilitation (VR); Job retention services; Work limitations; Work instability