A1711 ‘Arthritis -at-Work’ : feasibility of an E-health intervention to support work functioning in patients with rheumatoid arthritis

Monday, March 19, 2012: 17:20
Xcaret 3 (Cancun Center)
Jan Lucas Hoving, Coronel Insitute for Occupational Health, Academic Medical Center, Amsterdam, Netherlands
Marrit Van Der Meer, Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, Netherlands
Simone Put, Clinical Immunology & Rheumatology, Academic Medical Center, Amsterdam, Netherlands
Carin Logtenberg, Clinical Immunology & Rheumatology, Academic Medical Center, Amsterdam, Netherlands
Niek De Vries, Clinical Immunology & Rheumatology, Academic Medical Center, Amsterdam, Netherlands
Paul-peter Tak, Clinical Immunology & Rheumatology, Academic Medical Center, Amsterdam, Netherlands
Judith Sluiter, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
Monique Frings, Coronel Insitute for Occupational Health, Academic Medical Center, Amsterdam, Netherlands
Introduction
The ability to work is very important to patients with rheumatoid arthritis (RA). Nonetheless, decreased work functioning and work disability has been an important consequence of many working RA patients over time. The evidence for interventions that aim to improve work participation is limited. The past few years have shown promising examples of self-management strategies for workers with chronic diseases using internet applications, which we build upon to develop a personalized website (reuma-at-work.nl) including personalized feedback and (tele)monitoring by rheumatology nurses, using input from several of our studies. The aim of our study was to evaluate the feasibility of this E-health intervention to support work functioning in working patients with rheumatoid arthritis.

Methods
After developing a personalized website (reuma-at-work.nl – presented during conference) we tested the feasibility of this e-health intervention in 25 patients with a diagnosis of RA who experienced difficulties with work functioning. Using a three-step problem solving approach, patients completed the reuma-at-work program on the internet, in combination with coaching by email, telephone or face-to-face. The feasibility (acceptability, demand, implementation, practicality, satisfaction and limited efficacy) of the intervention was evaluated using questionnaires and an interview.

Results
Patients were able to use the website and conduct the reuma-at-work program using a problem solving approach. In general patients appreciated the coaching by rheumatology nurses and the individualized feedback provided to them through the e-health program. The responses between patients showed variability on several feasibility items, allowing for further improvements.

Discussion
Because of the advantages that e-health interventions offer in terms of cost-effectiveness, accessibility, time planning, and options for personalized feedback we consider this a promising method to further explore for patients with rheumatoid arthritis. Building on the results of this feasibility study, we will make improvements to the e-health intervention, and plan to perform a proper (cost-)effectiveness study. 

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