Ab0211 the Impact of Inflammatory Arthritis on Employment Patterns in the West of Ireland

Background: Inflammatory arthritis is a complex progressive disease, with 2,250 cases diagnosed in Ireland annually. Arthritis and musculoskeletal conditions are the leading cause of long-term work disability, an outcome with a major impact on quality of life and a high cost to society. Patients with Inflammatory Arthritis in remission can improve their psychological and physical health through employment. In November 2022, we established a multidisciplinary Inflammatory Arthritis clinic in our Centre. All patients diagnosed with Inflammatory Arthritis were seen by a Rheumatology Nurse, either in person or virtually, within 2 days of diagnosis, for further disease and drug education. In addition, all newly diagnosed patients were seen by an Occupational Therapist and Physiotherapist for further assessment and treatment within 6 weeks of diagnosis. They continued to be seen by the multidisciplinary team throughout the first year of diagnosis according to their clinical needs. We conducted a longitudinal study looking at retrospective data on patients attending the Early Inflammatory Arthritis Clinic over 12 months, from November 2022 to November 2023 in our University Hospital in the West of Ireland, with a catchment area of 486,000 people. Objectives: The objective of our study was to evaluate the effect of Inflammatory Arthritis on employment patterns, and to assess the return to employment after receiving a diagnosis and commencing treatment. Methods: Inclusion criteria were patients with a diagnosis of Inflammatory Arthritis, either Rheumatoid Arthritis, Psoriatic Arthritis or Undifferentiated Inflammatory Arthritis, between the ages of 15-64 years. During the initial clinic visit, to study employment trends, patients were asked how many hours they worked per week and in what type of employment. Employment type was categorized based on the "International Standard of Occupations Classification (ISCO-08)", and patients were asked whether they worked greater than or less than 20 hours per week. Working age was between 15-64 years, corresponding to the Labour Force Survey carried out by the Central Statistics Office. Patients were then asked either by a telephone call or in follow-up visits to the clinic whether they returned to employment. Results: 277 patients attended the clinic. 80 of those patients met the inclusion criteria. Our patient cohort had a mean age of 46 Years (20-64 years). From the 80 patients included, 3 were missing data on employment. 41 were in paid employment, 12 working less than 20 hours per week and 29 patients working greater than 20 hours a week. 36 patients were not in paid employment, 4 of whom were retired. Between baseline and 3 months, 2 patients increased their employment hours from 0 to greater than 20 hours per week, and 1 patient increased from 0 to less than 20 hours. Between baseline and 6 months, 2 patients increased their working hours from less than 20 to greater than 20 hours. Between baseline and 12 months, 1 patient increased their employment hours from 0 to greater than 20 hours per week. Overall, 6 patients increased their employment hours from attending the Early Inflammatory Arthritis Clinic. Conclusion: The Central Statistics Office reports a national average employment rate of 74.1% in the third quarter of 2023. Using the same working age population of 15-64 years, our cohort reveals a notably lower employment rate of 53.2%. This Figure emphasizes the importance of further research and interventions in this area to promote employment amongst those with Inflammatory Arthritis. The Early Inflammatory Arthritis Clinic promotes this aspect, by giving frequent clinic education, using an MDT approach, being responsive to patient's needs and rehabilitating our patients back into the workplace. With extended time on this project, we anticipate our study will show trends of increased uptake of employment hours coinciding with disease remission and thus leading to a lower incremental cost effectiveness ratio. REFERENCES: NIL. Acknowledgements: Many thanks to Consultant Supervisor Dr.Bernadette Lynch for her guidance through my intern rotation, and to Medical Student Grace Jones for her great work starting this research. Disclosure of Interests: None declared.