Prevention of Arthritis-Related Work Disability

Study Overview
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Brief Summary
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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
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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.

Official Title
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Prevention of Arthritis-Related Work Disability: A Trial of Job Retention Services Provided to Employed Persons With Arthritis

Conditions
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Rheumatoid Arthritis, Systemic Lupus Erythematosus, Osteoarthritis, Knee, Ankylosing Spondylitis

Intervention / Treatment
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* Other: Rehabilitation counseling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must currently be employed full or part time Must live in selected communities in eastern Massachusetts Exclusion Criteria: Plans to move from area Plans to have joint replacement surgery in next 6 months Plans to retire or go on disability within next 2 years

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Rehabilitation counseling<br>Rehabilitation counseling Experimental Rehabilitation counseling was provided by rehabilitation counselors. They administered the Work Experience Survey; provided and discussed disability rights and responsibilities and provided career counseling they as needed. | Other: Rehabilitation counseling<br>* Provided in 2 in-person meetings and in follow-up phone calls<br>|
| Active Comparator: printed information<br>Active comparator Control group participants received relevant printed information in the mail only; no rehabilitation counseling | Other: Rehabilitation counseling<br>* Provided in 2 in-person meetings and in follow-up phone calls<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| job losses | Periods of work cessation of at least 6 months. | every 6 months for up to 42 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| limitation in ability to work | Extent of on the job limitation due to health condition as measured by the Work Limitations Questionnaire. | every 6 months for up to 42 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Arthritis, Rheumatic disorders, Work-related disability, Vocational rehabilitation (VR), Job retention services, Work limitations, Work instability