Work instability and financial loss in early inflammatory arthritis

Authors

  • Karl J. Looper,

    Corresponding author
    • Psychiatry, McGill University, Montreal, Quebec, Canada
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  • Sally S. Mustafa,

    1. Psychiatry, McGill University, Montreal, Quebec, Canada
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  • Phyllis Zelkowitz,

    1. Psychiatry, McGill University, Montreal, Quebec, Canada
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  • Margaret Purden,

    1. Nursing, McGill University, Montreal, Quebec, Canada
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  • McGill Early Arthritis Research Group,

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    • Laeora Berkson, MD, Michael Starr, MD, Michel Gagné, MD, Michael Stein, MD, Harb Kang, MD, Morton Kapusta, MD, François Couture, MD, Mary-Ann Fitzcharles, MD, Bruce Garfield, MD, Henri A. Ménard, MD, Christian Pineau, MD, Andrzej Gutkowski, MD, Jan Schulz, MD; Division of Rheumatology, Sir Mortimer B. Davis – Jewish General Hospital. Michel Zummer, MD, Jean-Pierre Mathieu, MD, Suzanne Mercille, MD, Sophie Ligier, MD, Jiri Krasny, MD, Carole Bertrand, MD, Sai Yan Yuen, MD; Division of Rheumatology, McGill University, Montreal, Quebec, Canada; Service de rhumatologie, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada.
  • Murray Baron

    1. Rheumatology, McGill University, Montreal, Quebec, Canada
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Correspondence: Associate Professor Karl Looper, Department of Psychiatry, McGill University Jewish General Hospital, 3755 Chemin de la Côte-Ste-Catherine, Montreal, Quebec, H3T 1E2, Canada.

Email: karl.looper@mcgill.ca

Abstract

Objective

Inflammatory arthritis is associated with a high degree of work instability and financial burden. In this study, we examine the extent of work instability and financial loss as well as their association with disease characteristics during the first 18 months of inflammatory arthritis.

Method

One hundred and four patients in the early phase (more than 6 weeks, < 18 months) of inflammatory arthritis were recruited from a larger early inflammatory arthritis registry. Questionnaires recorded sociodemographic data and disease characteristics, including pain assessed using the Short Form McGill Pain Questionnaire (MPQ) and physical functioning measured with the Medical Outcomes Study Short Form 36 (SF-36) physical functioning score. The Rheumatoid Arthritis Work Instability Scale (RA-WIS) was used to measure patient-perceived functioning in the workplace and the Financial Loss Questionnaire (FLQ) measured the impact on family finances.

Results

Participants' mean age was 56 years, 70.2% were female and 49.0% were working. Average yearly household income was < 60 000 Canadian dollars (CAD) for 38.5% of the sample. Of our working patients, 43% had a medium or high risk of work loss as measured by the RA-WIS and 35% reported a financial loss. On multivariate analysis, MPQ and SF-36 contributed to the dependent variable work instability, while age and SF-36 contributed to financial loss.

Conclusion

This study identifies pain and physical dysfunction as potential modifiable risk factors for negative socioeconomic repercussions of illness in early inflammatory arthritis.

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