{"id":1060,"date":"2022-10-25T09:40:50","date_gmt":"2022-10-25T09:40:50","guid":{"rendered":"https:\/\/blogs.bmj.com\/rheumsummaries\/?p=1060"},"modified":"2022-11-30T11:38:10","modified_gmt":"2022-11-30T11:38:10","slug":"new-eular-points-to-consider-for-supporting-people-with-rmds-to-work","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/rheumsummaries\/2022\/10\/25\/new-eular-points-to-consider-for-supporting-people-with-rmds-to-work\/","title":{"rendered":"New: EULAR points to consider for supporting people with RMDs to work"},"content":{"rendered":"<p><span style=\"font-weight: 400\">This is the lay version of the EULAR points to consider for supporting people with RMDs to work. The original\u00a0 publication can be downloaded from the EULAR website: <\/span><a href=\"http:\/\/www.eular.org\"><span style=\"font-weight: 400\">w<\/span><span style=\"font-weight: 400\">ww.eular.org<\/span><\/a><span style=\"font-weight: 400\">.\u00a0\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/ard.bmj.com\/content\/early\/2022\/10\/13\/ard-2022-222678\">Boonen A, Webers C, Butink M, et al2021 EULAR points to consider to support people with rheumatic and \u00a0musculoskeletal diseases to participate in healthy and sustainable paid workAnnals of the Rheumatic \u00a0Diseases Published Online First: 15 September 2022. doi: 10.1136\/ard-2022-222678<\/a><\/p>\n<p><b>Introduction\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400\">EULAR gives advice not only to doctors, nurses and patients about the best way to treat and manage\u00a0 diseases but also to public administrators and political organizations at the European (and beyond Europe\u00a0 international) level to ensure that policies and practices are developed that meet the needs of people with\u00a0 rheumatic and musculoskeletal diseases (shortened RMDs).<\/span><\/p>\n<p><span style=\"font-weight: 400\">Health professionals, patients and expects in work and health worked together to develop these <\/span><i><span style=\"font-weight: 400\">points to\u00a0 consider to support people with RMDs to participate in healthy and sustainable paid work<\/span><\/i><span style=\"font-weight: 400\">. The patients in the\u00a0 team ensured that the patient point of view was included.\u00a0\u00a0<\/span><\/p>\n<p><b>What do we already know?\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400\">RMDs are a diverse group of diseases that commonly affect the joints, but can also affect your muscles,\u00a0 other tissues and internal organs. In nearly all European countries, people with RMDs experience more\u00a0 restrictions to participate in paid jobs compared to people in the general population. One of the most\u00a0 common reasons for this is that people with RMDs experience symptoms of pain and functional limitations caused by their disease. RMDs account for up to 60% of prolonged sickness absence and work disability in\u00a0 the European Union and are one of the leading causes of work disability in each country. One of EULAR\u2019s\u00a0 strategic objectives is to help increase healthy and sustainable participation in work for people with RMDs.\u00a0\u00a0<\/span><\/p>\n<p><b>Definitions in these PtC\u00a0<\/b><\/p>\n<ul>\n<li><i><span style=\"font-weight: 400\">Work status <\/span><\/i><span style=\"font-weight: 400\">means whether or not a person has paid work (either as an employee or self-employed).<\/span><\/li>\n<li><i><span style=\"font-weight: 400\">Work disability <\/span><\/i><span style=\"font-weight: 400\">means not being employed (anymore) because of health reasons (usually an official\u00a0 status associated with income substitution).\u00a0<\/span><\/li>\n<li><i><span style=\"font-weight: 400\">Sickness absence <\/span><\/i><span style=\"font-weight: 400\">or sick leave means needing to take time off work (due to health issues) while\u00a0 having an employment contract.\u00a0<\/span><\/li>\n<li><i><span style=\"font-weight: 400\">Presenteeism <\/span><\/i><span style=\"font-weight: 400\">is when a person goes to work when ill, which may make them less productive, or less\u00a0 able to do their job because of their health problems.\u00a0\u00a0<\/span><\/li>\n<li><i><span style=\"font-weight: 400\">Work outcomes <\/span><\/i><span style=\"font-weight: 400\">includes a person\u2019s work status, sickness absence, and presenteeism. <\/span><i><span style=\"font-weight: 400\">Poor\u00a0 outcomes <\/span><\/i><span style=\"font-weight: 400\">would be classed as someone who cannot work because of their RMD, or who is often\u00a0 sick or attending work when they are unwell.\u00a0\u00a0<\/span><\/li>\n<\/ul>\n<p><b>What do the points say?\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400\">In total, there are three overarching principles and eleven points to consider. The principles say first that participation in good work increases a person\u2019s self-worth and self-esteem, as well as giving them financial\u00a0 independence and social interactions, which generally translate into better health and well-being. Second, it\u00a0 is emphasized the aim of work-related support for people with RMDs is to optimise their working life and to\u00a0 support their best physical and mental health. Third, EULAR believes it is a shared responsibility of all\u00a0 members of the society to support people with RMDs to take part in healthy and sustainable work.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Each point is based on the best current knowledge from studies of scientific evidence or expert opinion. The\u00a0 more stars a point has the stronger the evidence is. However, points to consider with limited scientific\u00a0 evidence may be important, because the experts can have a strong opinion even when the published\u00a0 evidence may be lacking.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">One star (*) means it is a point with limited scientific evidence.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Two stars (**) means it is a point with some scientific evidence.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Three stars (***) means it is a point with quite a lot of scientific evidence.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Four stars (****) means it is a point supported with a lot of scientific evidence.<\/span><span style=\"font-weight: 400\">\u00a0<\/span><\/p>\n<p><b>Points to consider\u00a0<\/b><\/p>\n<ul>\n<li style=\"text-align: left\"><b>Throughout their life, people with RMDs should be supported and encouraged to enter, sustain,\u00a0 or return to work.*\u00a0\u00a0<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">RMDs can occur across the life course and influence career opportunities. At each stage of their RMD,\u00a0 people should be supported by persons with the knowledge to help them stay in work. There should\u00a0 also be individual tailored support for people experiencing poor work outcomes, or who are at risk of\u00a0 poor outcomes.\u00a0\u00a0<\/span><\/p>\n<ul>\n<li><b>People with RMDs should have timely access to health and job support to promote sustained work ability and productivity, and to prevent long-term absence.*\u00a0\u00a0<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">People with RMDs on long-term sickness absence or on work disability benefits have low chances of\u00a0 successful return to work. Therefore, people at risk of sickness absence due to their RMD should\u00a0 receive support while they are still in paid work.\u00a0\u00a0<\/span><\/p>\n<ul>\n<li><b>All groups should work together to minimise the employment gap and optimise employment\u00a0 opportunities among people with RMDs.*\u00a0\u00a0<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Health professional organisations, policymakers, patient organisations and employers need to work\u00a0 together to increase healthy and sustainable work opportunities for people with RMDs.\u00a0\u00a0<\/span><\/p>\n<ul>\n<li><b>If you have an RMD, you should be supported by your care team when deciding whether, when\u00a0 and how to discuss any work-related challenges with your employer.*\u00a0\u00a0<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Your healthcare team can play an important role in helping you decide what information to share with\u00a0 your employer, and how to talk to them about what specific needs you might have in the workplace.\u00a0\u00a0<\/span><\/p>\n<ul>\n<li><b>Presenteeism and sick leave can be signals for future poor work outcomes.***<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">If you had recent sick leave because of ill health, or often go to work when you feel unwell, you are\u00a0 more likely than other people to have long-term sick leave or work disability in the future. Your employer\u00a0 and your healthcare team should support you to maintain healthy and sustainable work participation,\u00a0 and put processes in place to help you avoid needing long-term sick leave.\u00a0 <\/span><\/p>\n<ul>\n<li><b>In addition to your health, also your personal, social and physical environmental situation should be considered when addressing work participation needs.***\u00a0<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Something called the \u201cbiopsychosocial model of human health outlines how a person\u2019s work outcomes are affected by their specific personal background and living environment, as well as physical and\u00a0 mental health. In people with an RMD, limited physical function or disease activity is the strongest\u00a0 disease-related predictor of poor work outcomes. You are also more likely to have poor work outcomes\u00a0 if you did not obtain a higher educational or university degree, are older, or female. You are also more\u00a0 likely to have poorer work outcomes if you work in a physically demanding job.<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400\">\u00a0<\/span><b style=\"font-size: 1rem\">Disease-modifying treatments for inflammatory RMDs improve work participation and should be\u00a0 started as early as possible.****\u00a0<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">The evidence for the beneficial effect of disease-modifying drugs on work comes mostly from studies among people with rheumatoid arthritis or spondyloarthritis. However, it is thought that treating persons\u00a0 with any RMD early in the disease course will help avoid poor work outcomes.\u00a0\u00a0<\/span><\/p>\n<ul>\n<li><b>Non-pharmacological interventions should be considered to reduce or prevent sickness\u00a0 absence and possibly improve work ability.****\u00a0\u00a0<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Non-drug interventions may include education about your work in relation your disease , physical\u00a0 exercise training, or workplace adaptations to help you perform your role. These should to be tailored to\u00a0 your individual needs.\u00a0<\/span><\/p>\n<ul>\n<li><b>Social security systems should develop policies and practices to promote work sustainability\u00a0 and return-to-work efforts.**\u00a0<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Characteristics of social security systems vary across countries. However, there is a need to develop\u00a0 policies that protect the working rights of people with RMDs, and help to promote sustainable work, and\u00a0 to support people in getting back to work after sick leave or unemployment.\u00a0\u00a0<\/span><\/p>\n<ul>\n<li><b>Healthy workplaces and supportive attitudes are essential for people with RMDs.** <\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">People working with colleagues who have an RMD should adopt an understanding attitude and offer\u00a0 active support when it is needed. This includes employers, managers, and colleagues, and is essential\u00a0 for a culture of inclusiveness.\u00a0<\/span><\/p>\n<ul>\n<li><b>Employers should develop policies and practices to promote a workplace culture of inclusivity,\u00a0 flexibility, and support.*\u00a0<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Employers have a legal duty to ensure safety and equality at work. To improve career perspectives and\u00a0 sustainable work participation for people with RMDs, workplaces need to be flexible in accommodating\u00a0 the needs of people with RMDs. These needs will differ between individuals and across jobs, and may\u00a0 vary over time.<\/span><\/p>\n<p><b>Summary\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400\">Overall, this project should help improve healthy and sustainable work participation of people with RMDs. The points will be useful for people with RMDs and healthcare professionals, as well as employers, trade unions, occupational health and safety organisations, policymakers, researchers and others involved in durable work participation for people with chronic diseases such as RMDs.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Points with just one or two stars are based mainly on expert opinion and not backed up by studies, but these\u00a0 may be as important as those with three or four stars.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">If you have any questions or concerns about these recommendations you should speak to a health\u00a0 professional involved in your care.\u00a0<\/span><\/p>\n<p><strong>Disclaimer:<\/strong>\u00a0This is a summary of a scientific article written by a medical professional (\u201cthe Original Article\u201d). The Summary is written to assist non medically trained readers to understand general points of the Original Article. It is supplied \u201cas is\u201d without any warranty. You should note that the Original Article (and Summary) may not be fully relevant nor accurate as medical science is constantly changing and errors can occur. It is therefore very important that readers not rely on the content in the Summary and consult their medical professionals for all aspects of their health care and only rely on the Summary if directed to do so by their medical professional. Please view our full\u00a0<a href=\"https:\/\/www.bmj.com\/company\/legal-information\/\">Website Terms and Conditions<\/a>.<\/p>\n<p><strong>Copyright<\/strong>\u00a0\u00a9 2022 BMJ Publishing Group Ltd &amp; European League Against Rheumatism. Medical professionals may print copies for their and their patients and students non commercial use. Other individuals may print a single copy for their personal, non commercial use. For other uses please contact our\u00a0<a href=\"https:\/\/www.bmj.com\/company\/products-services\/rights-and-licensing\/\">Rights and Licensing Team<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This is the lay version of the EULAR points to consider for supporting people with RMDs to work. The original\u00a0 publication can be downloaded from the EULAR website: www.eular.org.\u00a0\u00a0 Boonen A, Webers C, Butink M, et al2021 EULAR points to consider to support people with rheumatic and \u00a0musculoskeletal diseases to participate in healthy and sustainable [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/rheumsummaries\/2022\/10\/25\/new-eular-points-to-consider-for-supporting-people-with-rmds-to-work\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":470,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,1],"tags":[],"class_list":["post-1060","post","type-post","status-publish","format-standard","hentry","category-eular-recommendations","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts\/1060","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/users\/470"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/comments?post=1060"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts\/1060\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/media?parent=1060"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/categories?post=1060"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/tags?post=1060"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}