Development of a Multimodal, Physiotherapist-Led, Vocational Intervention for People with Inflammatory Arthritis and Reduced Work Ability: A Mixed-Methods Design Study

N. F. Bakker*, S. F. E. van Weely, N. Hutting, Y. F. Heerkens, J. A. Engels, J. B. Staal, M. van der Leeden, A. Boonen, T. P. M. Vliet Vlieland, J. Knoop

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PurposeWork ability of people with rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) is reduced, but underexamined as a clinical treatment target. The evidence on vocational interventions indicates that delivery by a single healthcare professional (HCP) may be beneficial. Physiotherapist (PT)-led interventions have potential because PTs are most commonly consulted by RA/axSpA patients in the Netherlands. The aim was to develop a PT-led, vocational intervention for people with RA/axSpA and reduced work ability.MethodsMixed-methods design based on the Medical Research Council (MRC) framework for developing and evaluating complex interventions, combining a rapid literature review and six group meetings with: patient representatives (n = 6 and 10), PTs (n = 12), (occupational) HCPs (n = 9), researchers (n = 6) and a feasibility test in patients (n = 4) and PTs (n = 4).ResultsAn intervention was developed and evaluated. Patient representatives emphasized the importance of PTs' expertise in rheumatic diseases and work ability. The potential for PTs to support patients was confirmed by PTs and HCPs. The feasibility test confirmed adequate feasibility and underlined necessity of training PTs in delivery. The final intervention comprised work-focussed modalities integrated into conventional PT treatment (10-21 sessions over 12 months), including a personalized work-roadmap to guide patients to other professionals, exercise therapy, patient education and optional modalities.ConclusionA mixed-methods design with stakeholder involvement produced a PT-led, vocational intervention for people with RA/axSpA and reduced work ability, tested for feasibility and ready for effectiveness evaluation.
Original languageEnglish
Pages (from-to)832-846
Number of pages15
JournalJournal of Occupational Rehabilitation
Volume34
Issue number4
Early online date1 Feb 2024
DOIs
Publication statusPublished - Dec 2024

Keywords

  • Vocational rehabilitation
  • Physiotherapy
  • Rheumatoid arthritis
  • Axial spondyloarthritis
  • Work ability
  • RHEUMATOID-ARTHRITIS
  • OCCUPATIONAL PHYSICIANS
  • REHABILITATION PROGRAM
  • WORKPLACE
  • DISEASES
  • IMPROVE
  • BURDEN
  • CARE

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