A Pilot Study of Workplace Challenges and Adaptations Made by Rheumatoid Arthritis Patients

In a pilot study by Mancuso et al (Arthritis Care and Research 13:89-98, 2000), 22 employed, rheumatoid arthritis (RA) patients completed a telephone questionnaire to assess specific challenges and adaptations in the workplace. In general, the patients had diverse senior level positions, reported light to very light physical demand, and had a lot of job autonomy. 96% were women, the mean age was 50 years, and 84% were college graduates.

Results showed that fatigue and pain were the most often cited challenges that these RA patients faced in maintaining work. Additional challenges included typing, writing, maintaining a pleasant disposition, physical requirements, overtime, travel, commuting, being on time, and the inability to choose rest periods. All patients made adaptations in order to continue working, with greater that 86/ of patients making 3 or more adjustments, the most helpful of which was altering career path (36%). A frequently cited adaptation was modifying work hours (32%), which included shorter lunch breaks to allow patients to work slower, changing the number of days worked, and coordinating overtime. Other noted adaptations included increased use of disease modifying anti-rheumatic drugs (27%), use of a transportation service (23%), sleeping more (18%), and working at home (14%). Despite adaptations made, these patients lacked confidence in their ability to continue working.

Because of the small sample size, further studies are needed to address a fuller spectrum of employees and occupations. However, these results lend additional support to previous studies that indicate that RA patients face many challenges in the workplace and must employ multiple adaptations in order to continue productivity in the workplace. This information can be useful for physicians in helping RA patients maintain employment by assessing workplace challenges and establishing useful interventions.