A mismatch between self-reported physical work load and the HAQ: early identification of rheumatoid arthritis patients at risk for loss of work productivity

Clin Exp Rheumatol. May-Jun 2009;27(3):422-9.


Objective: To explore the combination of data on functioning and work load for early identification of patients at risk for diminished work productivity in rheumatoid arthritis (RA).

Patients and methods: In the FIN-RACo trial, 162 patients with recent onset RA and available for the workforce were treated with either a combination of disease-modifying antirheumatic drugs (DMARDs) or a single DMARD for 2 years. Otherwise, they received routine care and were followed up for 5 years. Data on their individual income and lost work days came from official registers. Loss of productivity was computed by the human capital approach. Self-reported data on physical work demand (Finnish Institute for Occupational Health Questionnaire) at baseline and on functioning (HAQ) at 6 months were linked according to the International Classification of Functioning, Disability and Health.

Results: Data on 112 patients were analyzable at 6 months; 35 (31%) of them had diminished capacity in functions required at paid work. Any mismatch between perceived abilities and requirements predicted future (7 through 60 months) loss of productivity - on average Euro 14,040 (95% confidence interval (CI): 9,143-20,511) per year in patients with the mismatch compared to Euro 3,043 (1,623-5,534) in those without any mismatch - and was associated with RA-related permanent work disability (hazard ratio: 11.6; 95%CI: 4.0-33.4).

Conclusion: Linking together self-reported data about functioning and work load helps in early identification of the RA patients at risk for loss of working days.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid* / drug therapy
  • Arthritis, Rheumatoid* / physiopathology
  • Arthritis, Rheumatoid* / psychology
  • Disability Evaluation
  • Drug Therapy, Combination
  • Efficiency / physiology
  • Female
  • Finland
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Occupational Health
  • Risk Factors
  • Self Disclosure*
  • Surveys and Questionnaires*
  • Work Capacity Evaluation*
  • Workload*


  • Antirheumatic Agents