The socio-economic burden of RMDs - What policies are needed to improve work capacity and avoid disability in
the European Union?Ingemar Petersson, MD, PhD, Ass.professor
Orthopedics and Rheumatology, Lund University HospitalLund, Sweden
Fit for Work Europe Coalition
The socio-economic burden of RMDs
People with disabilities have an average employment rate of around 50%.
The European Commission estimates that RMDs account for half of all absences from work and for 60% of permanent work incapacity.
TIME MagazineMarch 21, 2011
The occurence of Rheumatoid Arthritis (RA) in south SwedenOverall prevalence Dec 31 2008 0.66% (www.morse.nu )
Englund, Jöud, Geborek, Felson, Jacobsson, Petersson. Rheumatology 2010;49:1563-9
The occurence of Spondylarthridies (SpA)in south Sweden. Overall prevalence 0,45%www.morse.nu
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0.8
15-29 30-44 45-59 60-74 75-
Age
Per
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t
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Haglund, Bremander, Petersson et al. Annals of the Rheumatic Diseases 2011: in press
•Cases had an increased risk for sick leave compared with controls with a relative risk of 1.8; 95% CI 1.5, 2.1•Cases had more days with sick leave than controls (median number of more days per year 30; 95% CI 2, 72).
Rheumatic and musculoskeletal diseases (RMDs)
A focus on RMDs is Just in
TIME
The socio-economic burden of RMDsWhat policies are needed to improve work capacity and avoid disability in the European Union?
The last decade• Major changes for minor groups of patients with
RMDs within the EU This decade
• Major changes for MAJOR groups of patients with RMDs within the EU
And so EULAR and Fit for Work have drafted key recommendations for national governments
The socio-economic burden of RMDsWhat policies are needed to improve work capacity and avoid disability in the European Union?
Some national examples from Sweden
Rehabiliteringsrådet
National Guidelines for diagnosis, treatment and rehabilitation of RMDs
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.8
1
EQ-5D index, MMS
Inskrivning Utskrivning
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EQ5 index, kvinnor, MMS
Inskrivning Utskrivning
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EQ5 index, män, MMS
Inskrivning Utskrivning
National Program (Sweden) for Multimodal Rehabilitation of patients with Low Back Pain
Significant improvement in Health Related Quality of Life,
Function and Work ability after 3 months
Osteoarthritis: Treatment algoritm and sick leave (after surgery) (Petersson et al ACR 2009)
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
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TKR (N=199)
Prop
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ith o
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ng si
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ave
Day of admission for THR/TKR
THR (N= 276)
operation
pharmacotherapyassistive devices
information, education, training/physical activity, weight loss
Few
Some
ALL
Substantial and sustained decrease in sick leave among RA-patients first 12 months after start of treatment with TNF-antagonists
Days before and after treatment start
-360 -300 -240 -180 -120 -60 0 60 120 180 240 300 360
Pe
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ge
of
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cts
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0
10
20
30
40
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RA casesControls
Treatment start
n=365
n=1460
p<0.001 p<0.001
p=1.0 p=0.91
Point prevalence of sick leave
Ann Rheum Dis 2010 Dec;69(12):2131-6. Epub 2010 Aug 6
Tor Olofsson, Martin Englund, Tore Saxne, Anna Jöud, Lennart T.H. Jacobsson, Pierre Geborek, Saralynn Allaire, Ingemar F. Petersson.
Sick Leave in patients with Ankylosing Spondylitis (AS) treated with TNF blockers 2004-2007 in south Sweden as compared to controls
Kristensen LE, Petersson IF, Geborek P, Jöud A,
Saxne T, Jacobsson LTH, Englund M.
Sick leave in patients with ankylosing
spondylitis before and after anti-TNF therapy: a population-based cohort
study. Rheumatology 2011: accepted for
publication
No days of sick leave per individual and year, 2006-2009 in Sweden
The socio-economic burden of RMDsWhat policies are needed to improve work capacity and avoid disability in the European Union?
We believe that it is crucial to shift RMDs from disabling conditions to manageable conditions, and that this should be reflected in the Council Conclusions on the European Disability Strategy.
A better life for patients with RMDs …
Life. Marc Chagall, Fondation Maeght, Nice
