BMC Med Inform Decis Mak - Employment and arthritis: making it work a randomized controlled trial evaluating an online program to help people with inflammatory arthritis maintain employment (study protocol).


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CKGROUND: Arthritis and musculoskeletal conditions are the leading cause of long-term work disability (WD), an outcome with a major impact on quality of life and a high cost to society. The importance of decreased at-work productivity has also recently been recognized. Despite the importance of these problems, few interventions have been developed to reduce the impact of arthritis on employment. We have developed a novel intervention called "Making It Work", a program to help people with inflammatory arthritis (IA) deal with employment issues, prevent WD and improve at-work productivity. After favorable results in a proof-of-concept study, we converted the program to a web-based format for broader dissemination and improved accessibility. The objectives of this study are: 1) to evaluate in a randomized controlled trial (RCT) the effectiveness of the program at preventing work cessation and improving at-work productivity; 2) to perform a cost-utility analysis of the intervention.METHODS/DESIGN: 526 participants with IA will be recruited from British Columbia, Alberta, and Ontario in Canada. The intervention consists of a) 5 online group sessions; b) 5 web-based e-learning modules; c) consultations with an occupational therapist for an ergonomic work assessment and a vocational rehabilitation counselor. Questionnaires will be administered online at baseline and every 6?months to collect information about demographics, disease measures, costs, work-related risk factors for WD, quality of life, and work outcomes. Primary outcomes include at-work productivity and time to work cessation of>6?months for any reason. Secondary outcomes include temporary work cessation, number of days missed from work per year, reduction in hours worked per week, quality adjusted life year for the cost utility analysis, and changes from baseline in employment risk factors. Analysis of Variance will evaluate the intervention's effect on at-work productivity, and multivariable Cox regression models will estimate the risk of work cessation associated with the intervention after controlling for risk factors for WD and other important predictors imbalanced at baseline.DISCUSSION: This program fills an important gap in arthritis health services and addresses an important and costly problem. Knowledge gained from the RCT will be useful to health care professionals, policy planners and arthritis stakeholders.TRIAL REGISTRATION: NCT01852851; registered April 13, 2012; first participant randomized on July 6, 2013.

Resumo Limpo

ckground arthriti musculoskelet condit lead caus longterm work disabl wd outcom major impact qualiti life high cost societi import decreas atwork product also recent recogn despit import problem intervent develop reduc impact arthriti employ develop novel intervent call make work program help peopl inflammatori arthriti ia deal employ issu prevent wd improv atwork product favor result proofofconcept studi convert program webbas format broader dissemin improv access object studi evalu random control trial rct effect program prevent work cessat improv atwork product perform costutil analysi interventionmethodsdesign particip ia will recruit british columbia alberta ontario canada intervent consist onlin group session b webbas elearn modul c consult occup therapist ergonom work assess vocat rehabilit counselor questionnair will administ onlin baselin everi month collect inform demograph diseas measur cost workrel risk factor wd qualiti life work outcom primari outcom includ atwork product time work cessat ofmonth reason secondari outcom includ temporari work cessat number day miss work per year reduct hour work per week qualiti adjust life year cost util analysi chang baselin employ risk factor analysi varianc will evalu intervent effect atwork product multivari cox regress model will estim risk work cessat associ intervent control risk factor wd import predictor imbalanc baselinediscuss program fill import gap arthriti health servic address import cost problem knowledg gain rct will use health care profession polici planner arthriti stakeholderstri registr clinicaltrialsgov nct regist april first particip random juli

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