Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries

Polina Putrik; Sofia Ramiro; Francis Guillemin; Marta Pentek; Francisca Sivera; Tuulikki Sokka; Maarten de Wit; Anthony D. Woolf; Angela Zink; Daina Andersone; Florian Berghea; Irena Butrimiene; Sandra Brouwer; Karen Cassar; Paraskevi Charalambous; Roberto Caporali; Elena Deseatnicova; Nemanja S. Damjanov; Axel Finckh; Oliver FitzGerald; Gerdur Grondal; Nino Gobejishjvili; Piotr Gluszko; Marco Hirsch; Igor Jovanovic; Jiri Vencovsky; Xavier Janssens; Andras P. Keszei; Maria Kovarova; Mart Kull; Luis Cunha Miranda; Miroslav Mayer; Snezana Misevska-Percinkova; Nevsun Inanc; Oleg Nadashkevich; Ingemar F. Petersson; Kari Puolakka; Bernadette Rojkovich; Helga Radner; Fruzsina Szabados; Gleb Slobodin; Ivan Shirinsky; Nikolay Soroka; Prodromos Sidiropoulos; Russka Shumnalieva; Sekib Sokolovic; Surayo Shukurova; Argjend Tafaj; Matija Tomsic; Till Uhlig; Suzanne M. M. Verstappen; Annelies Boonen

doi:10.1136/annrheumdis-2019-215294

Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries

Polina Putrik^*, Sofia Ramiro, Francis Guillemin, Marta Pentek, Francisca Sivera, Tuulikki Sokka, Maarten de Wit, Anthony D. Woolf, Angela Zink, Daina Andersone, Florian Berghea, Irena Butrimiene, Sandra Brouwer, Karen Cassar, Paraskevi Charalambous, Roberto Caporali, Elena Deseatnicova, Nemanja S. Damjanov, Axel Finckh, Oliver FitzGeraldGerdur Grondal, Nino Gobejishjvili, Piotr Gluszko, Marco Hirsch, Igor Jovanovic, Jiri Vencovsky, Xavier Janssens, Andras P. Keszei, Maria Kovarova, Mart Kull, Luis Cunha Miranda, Miroslav Mayer, Snezana Misevska-Percinkova, Nevsun Inanc, Oleg Nadashkevich, Ingemar F. Petersson, Kari Puolakka, Bernadette Rojkovich, Helga Radner, Fruzsina Szabados, Gleb Slobodin, Ivan Shirinsky, Nikolay Soroka, Prodromos Sidiropoulos, Russka Shumnalieva, Sekib Sokolovic, Surayo Shukurova, Argjend Tafaj, Matija Tomsic, Till Uhlig, Suzanne M. M. Verstappen, Annelies Boonen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objectives To describe and explore differences in formal regulations around sick leave and work disability (WD) for patients with rheumatoid arthritis (RA), as well as perceptions by rheumatologists and patients on the system's performance, across European countries.

Methods We conducted three cross-sectional surveys in 50 European countries: one on work (re-)integration and social security (SS) system arrangements in case of sick leave and long-term WD due to RA (one rheumatologist per country), and two among approximately 15 rheumatologists and 15 patients per country on perceptions regarding SS arrangements on work participation. Differences in regulations and perceptions were compared across categories defined by gross domestic product (GDP), type of social welfare regime, European Union (EU) membership and country RA WD rates.

Results Forty-four (88%) countries provided data on regulations, 33 (75%) on perceptions of rheumatologists (n=539) and 34 (77%) on perceptions of patients (n=719). While large variation was observed across all regulations across countries, no relationship was found between most of regulations or income compensation and GDP, type of SS system or rates of WD. Regarding perceptions, rheumatologists in high GDP and EU-member countries felt less confident in their role in the decision process towards WD (beta=-0.5 (95% CI -0.9 to -0.2) and beta=-0.5 (95% CI -1.0 to -0.1), respectively). The Scandinavian and Bismarckian system scored best on patients' and rheumatologists' perceptions of regulations and system performance.

Conclusions There is large heterogeneity in rules and regulations of SS systems across Europe in relation to WD of patients with RA, and it cannot be explained by existing welfare regimes, EU membership or country's wealth.

Original language	English
Pages (from-to)	1472-1479
Number of pages	8
Journal	Annals of the Rheumatic Diseases
Volume	78
Issue number	11
DOIs	https://doi.org/10.1136/annrheumdis-2019-215294
Publication status	Published - Nov 2019

Keywords

ACCESS
CONSEQUENCES
DETERMINANTS
HEALTH
INCOME
INFLAMMATORY ARTHRITIS
RA

Access to Document

10.1136/annrheumdis-2019-215294

Cite this

Putrik, P., Ramiro, S., Guillemin, F., Pentek, M., Sivera, F., Sokka, T., de Wit, M., Woolf, A. D., Zink, A., Andersone, D., Berghea, F., Butrimiene, I., Brouwer, S., Cassar, K., Charalambous, P., Caporali, R., Deseatnicova, E., Damjanov, N. S., Finckh, A., ... Boonen, A. (2019). Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries. Annals of the Rheumatic Diseases, 78(11), 1472-1479. https://doi.org/10.1136/annrheumdis-2019-215294

@article{bb1849edf4134715a745ffd8c3c38cbf,

title = "Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries",

abstract = "Objectives To describe and explore differences in formal regulations around sick leave and work disability (WD) for patients with rheumatoid arthritis (RA), as well as perceptions by rheumatologists and patients on the system's performance, across European countries.Methods We conducted three cross-sectional surveys in 50 European countries: one on work (re-)integration and social security (SS) system arrangements in case of sick leave and long-term WD due to RA (one rheumatologist per country), and two among approximately 15 rheumatologists and 15 patients per country on perceptions regarding SS arrangements on work participation. Differences in regulations and perceptions were compared across categories defined by gross domestic product (GDP), type of social welfare regime, European Union (EU) membership and country RA WD rates.Results Forty-four (88%) countries provided data on regulations, 33 (75%) on perceptions of rheumatologists (n=539) and 34 (77%) on perceptions of patients (n=719). While large variation was observed across all regulations across countries, no relationship was found between most of regulations or income compensation and GDP, type of SS system or rates of WD. Regarding perceptions, rheumatologists in high GDP and EU-member countries felt less confident in their role in the decision process towards WD (beta=-0.5 (95% CI -0.9 to -0.2) and beta=-0.5 (95% CI -1.0 to -0.1), respectively). The Scandinavian and Bismarckian system scored best on patients' and rheumatologists' perceptions of regulations and system performance.Conclusions There is large heterogeneity in rules and regulations of SS systems across Europe in relation to WD of patients with RA, and it cannot be explained by existing welfare regimes, EU membership or country's wealth.",

keywords = "ACCESS, CONSEQUENCES, DETERMINANTS, HEALTH, INCOME, INFLAMMATORY ARTHRITIS, RA",

author = "Polina Putrik and Sofia Ramiro and Francis Guillemin and Marta Pentek and Francisca Sivera and Tuulikki Sokka and {de Wit}, Maarten and Woolf, {Anthony D.} and Angela Zink and Daina Andersone and Florian Berghea and Irena Butrimiene and Sandra Brouwer and Karen Cassar and Paraskevi Charalambous and Roberto Caporali and Elena Deseatnicova and Damjanov, {Nemanja S.} and Axel Finckh and Oliver FitzGerald and Gerdur Grondal and Nino Gobejishjvili and Piotr Gluszko and Marco Hirsch and Igor Jovanovic and Jiri Vencovsky and Xavier Janssens and Keszei, {Andras P.} and Maria Kovarova and Mart Kull and Miranda, {Luis Cunha} and Miroslav Mayer and Snezana Misevska-Percinkova and Nevsun Inanc and Oleg Nadashkevich and Petersson, {Ingemar F.} and Kari Puolakka and Bernadette Rojkovich and Helga Radner and Fruzsina Szabados and Gleb Slobodin and Ivan Shirinsky and Nikolay Soroka and Prodromos Sidiropoulos and Russka Shumnalieva and Sekib Sokolovic and Surayo Shukurova and Argjend Tafaj and Matija Tomsic and Till Uhlig and Verstappen, {Suzanne M. M.} and Annelies Boonen",

note = "Funding Information: Funding This study was partially funded by abbvie in the context of Fit for Work initiative. smmV was supported by Versus arthritis (grant no. 20385) and niHR manchester Biomedical Research centre. Funding Information: This study was partially funded by Abbvie in the context of Fit for Work initiative. SMMV was supported by Versus Arthritis (grant no. 20385) and NIHR Manchester Biomedical Research Centre. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2019",

month = nov,

doi = "10.1136/annrheumdis-2019-215294",

language = "English",

volume = "78",

pages = "1472--1479",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

publisher = "BMJ Publishing Group",

number = "11",

}

Putrik, P, Ramiro, S, Guillemin, F, Pentek, M, Sivera, F, Sokka, T, de Wit, M, Woolf, AD, Zink, A, Andersone, D, Berghea, F, Butrimiene, I, Brouwer, S, Cassar, K, Charalambous, P, Caporali, R, Deseatnicova, E, Damjanov, NS, Finckh, A, FitzGerald, O, Grondal, G, Gobejishjvili, N, Gluszko, P, Hirsch, M, Jovanovic, I, Vencovsky, J, Janssens, X, Keszei, AP, Kovarova, M, Kull, M, Miranda, LC, Mayer, M, Misevska-Percinkova, S, Inanc, N, Nadashkevich, O, Petersson, IF, Puolakka, K, Rojkovich, B, Radner, H, Szabados, F, Slobodin, G, Shirinsky, I, Soroka, N, Sidiropoulos, P, Shumnalieva, R, Sokolovic, S, Shukurova, S, Tafaj, A, Tomsic, M, Uhlig, T, Verstappen, SMM & Boonen, A 2019, 'Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries', Annals of the Rheumatic Diseases, vol. 78, no. 11, pp. 1472-1479. https://doi.org/10.1136/annrheumdis-2019-215294

Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries. / Putrik, Polina; Ramiro, Sofia; Guillemin, Francis et al.
In: Annals of the Rheumatic Diseases, Vol. 78, No. 11, 11.2019, p. 1472-1479.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations

T2 - a study among rheumatologists and patients from 44 European countries

AU - Putrik, Polina

AU - Ramiro, Sofia

AU - Guillemin, Francis

AU - Pentek, Marta

AU - Sivera, Francisca

AU - Sokka, Tuulikki

AU - de Wit, Maarten

AU - Woolf, Anthony D.

AU - Zink, Angela

AU - Andersone, Daina

AU - Berghea, Florian

AU - Butrimiene, Irena

AU - Brouwer, Sandra

AU - Cassar, Karen

AU - Charalambous, Paraskevi

AU - Caporali, Roberto

AU - Deseatnicova, Elena

AU - Damjanov, Nemanja S.

AU - Finckh, Axel

AU - FitzGerald, Oliver

AU - Grondal, Gerdur

AU - Gobejishjvili, Nino

AU - Gluszko, Piotr

AU - Hirsch, Marco

AU - Jovanovic, Igor

AU - Vencovsky, Jiri

AU - Janssens, Xavier

AU - Keszei, Andras P.

AU - Kovarova, Maria

AU - Kull, Mart

AU - Miranda, Luis Cunha

AU - Mayer, Miroslav

AU - Misevska-Percinkova, Snezana

AU - Inanc, Nevsun

AU - Nadashkevich, Oleg

AU - Petersson, Ingemar F.

AU - Puolakka, Kari

AU - Rojkovich, Bernadette

AU - Radner, Helga

AU - Szabados, Fruzsina

AU - Slobodin, Gleb

AU - Shirinsky, Ivan

AU - Soroka, Nikolay

AU - Sidiropoulos, Prodromos

AU - Shumnalieva, Russka

AU - Sokolovic, Sekib

AU - Shukurova, Surayo

AU - Tafaj, Argjend

AU - Tomsic, Matija

AU - Uhlig, Till

AU - Verstappen, Suzanne M. M.

AU - Boonen, Annelies

N1 - Funding Information: Funding This study was partially funded by abbvie in the context of Fit for Work initiative. smmV was supported by Versus arthritis (grant no. 20385) and niHR manchester Biomedical Research centre. Funding Information: This study was partially funded by Abbvie in the context of Fit for Work initiative. SMMV was supported by Versus Arthritis (grant no. 20385) and NIHR Manchester Biomedical Research Centre. Publisher Copyright: © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/11

Y1 - 2019/11

N2 - Objectives To describe and explore differences in formal regulations around sick leave and work disability (WD) for patients with rheumatoid arthritis (RA), as well as perceptions by rheumatologists and patients on the system's performance, across European countries.Methods We conducted three cross-sectional surveys in 50 European countries: one on work (re-)integration and social security (SS) system arrangements in case of sick leave and long-term WD due to RA (one rheumatologist per country), and two among approximately 15 rheumatologists and 15 patients per country on perceptions regarding SS arrangements on work participation. Differences in regulations and perceptions were compared across categories defined by gross domestic product (GDP), type of social welfare regime, European Union (EU) membership and country RA WD rates.Results Forty-four (88%) countries provided data on regulations, 33 (75%) on perceptions of rheumatologists (n=539) and 34 (77%) on perceptions of patients (n=719). While large variation was observed across all regulations across countries, no relationship was found between most of regulations or income compensation and GDP, type of SS system or rates of WD. Regarding perceptions, rheumatologists in high GDP and EU-member countries felt less confident in their role in the decision process towards WD (beta=-0.5 (95% CI -0.9 to -0.2) and beta=-0.5 (95% CI -1.0 to -0.1), respectively). The Scandinavian and Bismarckian system scored best on patients' and rheumatologists' perceptions of regulations and system performance.Conclusions There is large heterogeneity in rules and regulations of SS systems across Europe in relation to WD of patients with RA, and it cannot be explained by existing welfare regimes, EU membership or country's wealth.

AB - Objectives To describe and explore differences in formal regulations around sick leave and work disability (WD) for patients with rheumatoid arthritis (RA), as well as perceptions by rheumatologists and patients on the system's performance, across European countries.Methods We conducted three cross-sectional surveys in 50 European countries: one on work (re-)integration and social security (SS) system arrangements in case of sick leave and long-term WD due to RA (one rheumatologist per country), and two among approximately 15 rheumatologists and 15 patients per country on perceptions regarding SS arrangements on work participation. Differences in regulations and perceptions were compared across categories defined by gross domestic product (GDP), type of social welfare regime, European Union (EU) membership and country RA WD rates.Results Forty-four (88%) countries provided data on regulations, 33 (75%) on perceptions of rheumatologists (n=539) and 34 (77%) on perceptions of patients (n=719). While large variation was observed across all regulations across countries, no relationship was found between most of regulations or income compensation and GDP, type of SS system or rates of WD. Regarding perceptions, rheumatologists in high GDP and EU-member countries felt less confident in their role in the decision process towards WD (beta=-0.5 (95% CI -0.9 to -0.2) and beta=-0.5 (95% CI -1.0 to -0.1), respectively). The Scandinavian and Bismarckian system scored best on patients' and rheumatologists' perceptions of regulations and system performance.Conclusions There is large heterogeneity in rules and regulations of SS systems across Europe in relation to WD of patients with RA, and it cannot be explained by existing welfare regimes, EU membership or country's wealth.

KW - ACCESS

KW - CONSEQUENCES

KW - DETERMINANTS

KW - HEALTH

KW - INCOME

KW - INFLAMMATORY ARTHRITIS

KW - RA

U2 - 10.1136/annrheumdis-2019-215294

DO - 10.1136/annrheumdis-2019-215294

M3 - Article

C2 - 31427438

SN - 0003-4967

VL - 78

SP - 1472

EP - 1479

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

IS - 11

ER -