Association of vocational interventions and work-related factors with disease and work outcomes in people with RMDs: A systematic review

Maud Wieczorek, Suzanne MM Verstappen, Polina Putrik, James M. Gwinnutt, Andra Balanescu, Heike A. Bischoff-Ferrari, Annelies Boonen, Giulio Cavalli, Savia de Souza, Annette de Thurah, Thomas E. Dorner, Rikke Helene Moe, Javier Rodríguez-Carrio, Lucía Silva-Fernández, Tanja Stamm, Karen Walker-Bone, Joep Welling, Mirjana Zlatković-Švenda, Francis Guillemin

Research output: Contribution to journalReview ArticleResearchpeer-review

1 Citation (Scopus)


Objective: A EULAR taskforce was convened to develop recommendations for lifestyle behaviours amongst people with rheumatic and musculoskeletal diseases (RMDs). This paper reviews the literature on work-related factors and disease-specific outcomes for people with osteoarthritis, rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis, systemic sclerosis (SSc) and gout. Methods: Two separate systematic literature reviews (SLRs) were conducted. The first identified SLRs, published between 01/2013 and 09/2018. The second identified original observational and intervention studies published before 05/2019. Manuscripts were included if they assessed the effects of vocational interventions on disease-specific outcomes (i.e. clinical outcomes, patient-reported outcomes, and work outcomes) or if they assessed the association between work-related factors and these outcomes. Medline, Embase, Cochrane Library of systematic reviews and CENTRAL databases were searched. Results: Two SLRs were identified including individuals with SSc and inflammatory arthritis. Subsequently, 23 original manuscripts were identified, with most of them (43.5%) including people with RA and no manuscripts on gout. Most observational studies evaluated the association between work-related factors and work outcomes while limited information was available on the impact of work on clinical outcomes. A few studies suggested that physically demanding jobs have a small detrimental effect on radiographic progression in axSpA and PsA. Intervention studies showed beneficial effects of vocational interventions for disease-specific outcomes, but with small effect sizes. Conclusion: Many studies indicated that work participation is not likely to be detrimental and, in some cases, may be beneficial for RMD-specific outcomes and should therefore receive attention within healthcare consultations.

Original languageEnglish
Article number152135
Number of pages14
JournalSeminars in Arthritis and Rheumatism
Publication statusPublished - Feb 2023
Externally publishedYes


  • Absenteeism
  • Epidemiology
  • Presenteeism
  • Randomised controlled trials
  • Systematic review
  • Work

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