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GOEDELE A. GEUSKENS, ALEX BURDORF, and JOHANNA M.W. HAZES
ABSTRACT. Methods. Participation categories were selected from the International Classification of Functioning, Disability and Health (ICF) (preliminary) Comprehensive Core Set for RA. A literature search was performed utilizing PubMed and PsychInfo. Articles were included if: (1) performance in at least one of the participation categories was described; (2) patients with RA were compared to a healthy reference population or their performance over time was described; (3) published between 1995 and 2005; and (4) written in English. Results. Seven participation categories were selected from the Comprehensive Core Set for RA, resulting in 50 articles included in the review. Almost all studies focused on remunerative employment (n = 30), recreation and leisure (n = 17), or both (n = 3). RA patients had an increased risk of being without a paid job compared to well adjusted reference groups (absolute difference 4% to 28%, odds ratios 1.2 to 3.4). Restrictions in employment occurred already within the early phase of RA and varied greatly among studies. Two years after diagnosis, disability benefits increased up to roughly 30% in some European cohorts. In the category of recreation and leisure most studies focused on socializing (n = 16). Patients with longstanding RA experienced a decrease in socializing (range, Cohen's d, –0.46 to –1.0), but changes over time were minor. Conclusion. RA patients experience restrictions in the performance of remunerative employment and in recreation and leisure (socializing). Due to the lack of studies, no conclusions on other ICF categories describing social roles could be made. (First Release April 1 2007; J Rheumatol 2007;34:1248-60) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Department of Rheumatology and Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. Supported by a grant from the Dutch Arthritis Association. G.A. Geuskens, MSc, Department of Rheumatology and Department of Public Health, University Medical Center Rotterdam; A. Burdorf, PhD, Department of Public Health, University Medical Center Rotterdam; J.M.W. Hazes, MD, PhD, Department of Rheumatology, University Medical Center Rotterdam. Address reprint requests to G.A. Geuskens, Erasmus MC, Department of Rheumatology, University Medical Center, Z-712, PO Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail: g.geuskens@erasmusmc.nl Accepted for publication January 17, 2007. |
