Department of Orthopaedic Surgery, Shirahama Hamayu Hospital, 1447 Shirahamacho, Nishimurogun, Wakayama, 649-2211, Japan.
Search Institute for Bone and Arthritis Disease (SINBAD), Shirahama Foundation for Health and Welfare, 1447 Shirahamacho, Nishimurogun, Wakayama, 649-2211, Japan.
Clin Rheumatol. 2018 Jul;37(7):1763-1771. doi: 10.1007/s10067-018-4060-z. Epub 2018 Mar 10.
To evaluate work disability and associated factors in patients with rheumatoid arthritis (RA) who participated in the TOMORROW study, a 10-year cohort study in Japan. Subjects in this cross-sectional analysis comprised 191 RA patients and 191 age- and sex-matched non-RA individuals. Work-related outcomes were measured using the Work Productivity and Activity Impairment questionnaire by employment status (full-time worker (FTW), employed ≥ 35 h/week; part-time worker (PTW), < 35 h/week; home worker (HW), non-employed). In addition, we assessed the EuroQol-5 Dimensions (EQ-5D) and Health Assessment Questionnaire (HAQ) to evaluate quality of life and activities of daily living. No significant differences were evident between groups in percentages of participants in each employment status (p = 0.11), percentages of absenteeism (FTW, p = 1.00; PTW, p = 0.29), presenteeism (FTW, p = 0.23; PTW, p = 0.54), overall work impairment (FTW, p = 0.23; PTW, p = 0.73), or percentage of activity impairment (AI) (FTW, p = 0.62; PTW, p = 0.60). In the HW group, percentage of AI was higher in RA patients than that in non-RA patients (p < 0.01). Among RA patients, HW showed lower EQ-5D and higher HAQ than FTW or PTW (p < 0.001 each). Higher disease activity was observed in HW than FTW (p < 0.01). In terms of the effect of biological disease-modifying anti-rheumatic drugs, no significant differences in work-related outcomes, health status, or daily activity were evident between users and non-users. No significant differences in employment status or work impairment were seen between RA and non-RA groups among paid workers. HW with RA showed more impaired daily activity and higher disease activity compared to working RA patients.
University Hospital Medical Information Network Clinical Trials Registry: UMIN000003876 . Registered 1 Jun 2010.
评估参加日本为期 10 年的队列研究 TOMORROW 研究的类风湿关节炎（RA）患者的工作残疾及其相关因素。本横断面分析的研究对象包括 191 名 RA 患者和 191 名年龄和性别匹配的非 RA 个体。通过就业状况（全职工作者（FTW），每周工作≥35 小时；兼职工作者（PTW），每周工作＜35 小时；居家工作者（HW），非就业者）使用工作生产力和活动障碍问卷来测量工作相关结局。此外，我们评估了欧洲五维健康量表（EQ-5D）和健康评估问卷（HAQ），以评估生活质量和日常生活活动。各组参与者在每种就业状况中的比例（p=0.11）、缺勤率（FTW，p=1.00；PTW，p=0.29）、在职病假率（FTW，p=0.23；PTW，p=0.54）、总体工作障碍率（FTW，p=0.23；PTW，p=0.73）或活动障碍率（AI）（FTW，p=0.62；PTW，p=0.60）均无显著差异。HW 组中，RA 患者的 AI 比例高于非 RA 患者（p＜0.01）。在 RA 患者中，HW 患者的 EQ-5D 评分低于 FTW 或 PTW 患者，HAQ 评分高于 FTW 或 PTW 患者（p＜0.001）。HW 患者的疾病活动度高于 FTW 患者（p＜0.01）。在生物改善病情抗风湿药物的作用方面，使用者和非使用者在工作相关结局、健康状况或日常活动方面无显著差异。在有报酬的劳动者中，RA 组和非 RA 组之间的就业状况或工作障碍无显著差异。与工作中的 RA 患者相比，HW 中的 RA 患者日常活动受损程度更高，疾病活动度更高。
大学医院医疗信息网络临床试验注册：UMIN000003876。注册于 2010 年 6 月 1 日。
