FRI0637 Barriers to remain in work: results from the national rheumatoid arthritis society survey (NRAS)

Background: Problems at work and work loss are still major socio-economic consequences for patients with Rheumatoid Arthritis (RA), employers and the society. Currently, there is a lack of understanding what the main barriers and facilitators are to remain in paid work. For patients and employers identifying these barriers and facilitators will enable them to make the right adjustments at a personal level. For policy makers these factors can determine future policies, aiming to reduce the overall socio-economic burden of RA. Objectives: i) To understand reasons for work loss in people with RA; and ii) to compare problems at work in employed RA patients and those who had to stop working due to RA. Methods: An online survey about employment was sent to UK NRAS members and distributed to non-members via social media including questions about problems at work in those employed or problems related to work in those who had to stop working or retire early due to RA. Rates of problems related to work were compared using Chi2 tests. Results: 891 patients who completed the survey were in paid employment and 189 had stopped working due to RA or retired early due to their RA. Median [IQR] symptom duration was 12.5 [7.5–23.2] years and the majority were women (91%). Main reasons for leaving work included (patients could tick all that applied): unable to carry out duties (73%); time off sick (46%); fatigue (74%); problems with colleagues (12%); need for specific adaptations (11%); unable to travel to work (13%); lack of family support (3%); lack of support from employer (33%); and side effects of medication (24%). The majority of patients left their job >5 years earlier than they had expected (72%) and 62/172 (36%) mentioned that their employer had not been helpful in assisting them to stay in work. For those in employment, the main challenges to remain in work were: demanding role; RA symptoms; no reasonable adjustments; commuting to work; and lack of understanding. Compared to patients in employment at time of survey, those who had to stop work due to their arthritis, reported having significantly serious problems regarding commuting to work, lack of understanding employers/colleagues, time off due to flare or medical appointments, health and safety and reluctance to make adjustments in their last job (table 1). Lack of family support was not significantly significant. Conclusions: Barriers to remain in work with RA are multi-factorial and related to the disease, nature of the work and understanding from employers and colleagues. Increasing understanding about RA amongst employers and colleagues in addition to often simple work adjustments, such as adaptations in the workplace and the opportunity to work more flexible, can prevent problems at work and work loss in the long-term and reduce the socio-economic burden. Disclosure of Interest: None declared