AB1394-HPR CAN SUPPORT FROM SIGNIFICANT OTHERS RECUDE SICKNESS ABSENCE IN EARLY RHEUMATOID ARTHRITIS?
Authors: Maria Bergström, Örjan Dahlström, Ingrid Thyberg, Mathilda Bjork
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Persons with rheumatoid arthritis (RA) are at higher risk of sickness absence, and the probability of returning to work is lower compared to the general population [1]. In order for persons with RA to continue working, support from the social environment is claimed to be of importance [2]. However, this relation needs to be further investigated. <h3>Objectives</h3> To analyze how support from significant others affects the associations between disease related variables (medication, disease activity and activity limitations) at time for RA diagnosis and sickness absence one year after diagnosis. <h3>Methods</h3> Data were collected from 326 (71% women) patients in working age (18-63 years) included in the Swedish early RA cohort TIRA-2 [3] during 2006-2009. At time of inclusion, mean age was 50 years (SD=11), 89% were prescribed disease modifying anti-rheumatic drugs (DMARDs), mean disease activity score 28 joint count (DAS28) was 4.73 (SD=1.34), and mean score for activity limitation reported by Health Assessment Questionnaire (HAQ) was 0.91 (SD=0.60). The number of days with sickness absence during the first year after diagnosis and inclusion was retrieved from the Swedish Social Insurance Agency. Perceived support from significant others, family and friends separately, were self-reported by VAS scales, zero indicating no support and 100 indicating full support. The associations of disease activity, activity limitation and DMARD use with sickness absence and how these associations were moderated by support from significant others, were analyzed using zero-inflated negative binomial regression. <h3>Results</h3> Higher activity limitation (HAQ) was associated with lower risk of sickness absence (p&lt;.001) but more days with sickness absence (p=.001). Higher disease activity (DAS28) was associated with lower risk of sickness absence (p=.003). However, when including family support, this association was not significant (p=.117) and associated with higher risk of sickness absence, but the association was weaker with family support (p=.029). Disease activity was also associated with more days of sickness absence (p=.013). The use of DMARDs had no significant relation to sickness absence (p=.150) or number of days with sickness absence (p=.852). Although, when including support from friends, DMARD use was associated with higher risk of sickness absence (p=.041). However, this association decreased significantly with support from friends (p=.022). <h3>Conclusion</h3> Support from significant others has an impact on previously known relationships between disease activity, use of DMARDs and sickness absence. Hence, support from significant others has the possibility to help decrease sickness absence among persons with RA one year after diagnosis. <h3>References</h3> [1] Hansen, SM., Hetland, ML., Pedersen, J., et al. Work ability in rheumatoid arthritis patients: a register study on the prospective risk of exclusion and probability of returning to work. Rheumatology. 2017;56(7):1135-1143. [2] Feddersen, H., Kristiansen, TM., Andersen, PT., et al. Construction of meaningful identities in the context of rheumatoid arthritis, motherhood and paid work: a meta-ethnography. Journal of Clinical Nursing. 2017;26(23-24):4117-4128. [3] Thyberg, I., Dahlstrm,., Bjrk, M., et al. Hand pains in women and men in early rheumatoid arthritis, a one year follow-up after diagnosis. The Swedish TIRA project. Disability and Rehabilitation. 2017;39(3):291-300. <h3>Disclosure of Interests</h3> None declared