Impact of Rheumatoid Arthritis and disease activity on work productivity and quality of life

Introduction: Rheumatoid Arthritis (RA) physical disability can impair the Quality of Life (QoL) and professional activity. Aim of the work: to assess the impact of RA on work productivity and functional impairment in Tunisian patients. Relation to the disease activity was also considered. Patients and mehods: The study included 25 RA patients having a professional occupation at the time of disease onset. The Disease Activity Score (DAS28), Health Assessment Questionnaire (HAQ) and 'Work Productivity and Activity Impairment' (WPAI) questionnaire were assessed. Results: The mean age of the patients was 50.4 ± 8.3 years with a female: male ratio of 1.08. The mean age at onset was 40.6 ± 9.8 years and the mean disease duration was 9.8 ± 9.68 years. The patients' occupation involved a manual job in 84% of cases. The mean of DAS28 was 4.3 ± 1.6; 72% had moderate to severe disease activity. The mean HAQ was 1.4 ± 0.7 and 76% had moderate to severe disability. The evaluation of the work productivity and activity impairment objectified an absenteeism of 30.7 ± 39.4%, presenteeism of 46.7 ± 26.4%, work productivity loss of 60.4 ± 33.8% and an activity impairment of 57.2 ± 25.4%. A significant correlation was noted between WPAI parameters and HAQ (p<0.0001) and of the decline in productivity and daily activity with DAS28 (p=0.01). Conclusion: Functional impairment and disease activity affected productivity and work ability in Tunisian RA patients. Absenteeism, increase of presenteeism, decline of productivity and daily activity were associated with the HAQ and the latter 2 with the disease activity but not with the age of patients or disease duration.