RA: Barrier to Employment

Rheumatoid arthritis may boost risk of unemployment and early death

(RxWiki News) So many diseases can get in the way of work. Some diseases make it nearly impossible to keep a job. Even though it gets less attention than other disabling diseases, rheumatoid arthritis can be a large barrier to employment.

Roughly one out of five rheumatoid arthritis patients are unable to work within 2 years of their diagnoses.

After 5 years, about one-third of patients cannot work.

"Get treated for arthritis to protect your work opportunities."

In addition to these findings, the Mayo Clinic researchers, John M. Davis III, MD, and Eric Matteson, MD, found that the life expectancy of rheumatoid arthritis patients drops within five years of diagnosis.

They found that people with rheumatoid arthritis are 50 percent more likely to have a heart attack and twice as likely to have heart failure.

According to the authors, doctors and scientists are now much more aware of the importance of early diagnosis and treatment of rheumatoid arthritis.

However, there is still much to learn about the disease.

"There are many drug therapies available now for management of rheumatoid arthritis, but the challenge for patients and their physicians is to decide on the best approach for initial management and then subsequent treatment modification based on the response," says Dr. Davis.

In other words, rheumatoid arthritis patients have many drug options. The hard part for doctors and their patients is to find which drugs are best at the beginning and which are best for continued treatment.

Rheumatoid arthritis is a disease in which the immune system mistakenly attacks healthy tissues, leading to swollen and tender joints. It even can affect other organs as well.

The main goals of rheumatoid arthritis treatment are to control the underlying causes of inflammation, reduce pain and maintain the patients' ability to continue living an active lifestyle. The long-term goal is to prevent permanent joint damage and other serious complications.

The article by Drs. Davis and Matteson gave patients and doctors several tips on controlling rheumatoid arthritis in order to give patients the opportunity to stay active and keep working.

"It is very important to have rheumatoid arthritis properly diagnosed, and treatment started early on," says Dr. Matteson.

"Getting the disease under control leads to better outcomes for the patient, the ability to continue working and take care of one's self, less need for joint replacement surgery, and reduced risk of heart disease," he says.

The authors say that patients need more than drugs to control their rheumatoid arthritis. Among their recommendations, they write that patients need more education on how to protect joints.

In addition, therapy may make patients feel less helpless.

Exercise programs also play an important role in weight loss, which can take a significant amount of strain off joints.

The authors point out that no guidelines can take every possibility into account. As such, doctors need to look in depth at the possible causes of the symptoms, like joint pain and tenderness.

Researchers are still uncertain about many aspects of rheumatoid arthritis. More research is needed to understand the heart-related risks of drug treatment and how certain drugs will work for certain patients.

"We believe it is crucial that patients and their doctors thoroughly discuss the treatment options and decide on the management plan jointly in view of individual patient preferences, goals, and values," says Dr. Davis.

For their study, the researchers reviewed the latest research offering current evidence on diagnosis and treatment approaches for rheumatoid arthritis.

Their article and treatment approach is published in the July issue of Mayo Clinic Proceedings.

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Review Date: 
July 11, 2012