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Open Access Study protocol

“Employment and arthritis: making it work” a randomized controlled trial evaluating an online program to help people with inflammatory arthritis maintain employment (study protocol)

Erin C Carruthers1, Pamela Rogers1, Catherine L Backman12, Charles H Goldsmith13, Monique A Gignac4, Carlo Marra5, Judy Village6, Linda C Li17, John M Esdaile18 and Diane Lacaille18*

Author Affiliations

1 Arthritis Research Centre of Canada, 5591 No. 3 Rd, Richmond, BC V6X 2C7, Canada

2 Department of Occupational Science and Occupational Therapy, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada

3 Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada

4 Dalla Lana School of Public Health, University of Toronto, 10 MP-328, 399 Bathurst St, Toronto, ON M5T 2S8, Canada

5 School of Pharmacy, Memorial University, Health Sciences Centre, 300 Prince Philip Drive, St. John’s, NL A1B 3 V6, Canada

6 School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada

7 Department of Physical Therapy, University of British Columbia, 5591 No. 3 Rd, Richmond, BC V6X 2C7, Canada

8 Division of Rheumatology, University of British Columbia, 5591 No. 3 Rd, Richmond, BC V6X 2C7, Canada

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BMC Medical Informatics and Decision Making 2014, 14:59  doi:10.1186/1472-6947-14-59

Published: 21 July 2014



Arthritis and musculoskeletal conditions are the leading cause of long-term work disability (WD), an outcome with a major impact on quality of life and a high cost to society. The importance of decreased at-work productivity has also recently been recognized. Despite the importance of these problems, few interventions have been developed to reduce the impact of arthritis on employment. We have developed a novel intervention called “Making It Work”, a program to help people with inflammatory arthritis (IA) deal with employment issues, prevent WD and improve at-work productivity. After favorable results in a proof-of-concept study, we converted the program to a web-based format for broader dissemination and improved accessibility. The objectives of this study are: 1) to evaluate in a randomized controlled trial (RCT) the effectiveness of the program at preventing work cessation and improving at-work productivity; 2) to perform a cost-utility analysis of the intervention.


526 participants with IA will be recruited from British Columbia, Alberta, and Ontario in Canada. The intervention consists of a) 5 online group sessions; b) 5 web-based e-learning modules; c) consultations with an occupational therapist for an ergonomic work assessment and a vocational rehabilitation counselor. Questionnaires will be administered online at baseline and every 6 months to collect information about demographics, disease measures, costs, work-related risk factors for WD, quality of life, and work outcomes. Primary outcomes include at-work productivity and time to work cessation of > 6 months for any reason. Secondary outcomes include temporary work cessation, number of days missed from work per year, reduction in hours worked per week, quality adjusted life year for the cost utility analysis, and changes from baseline in employment risk factors. Analysis of Variance will evaluate the intervention’s effect on at-work productivity, and multivariable Cox regression models will estimate the risk of work cessation associated with the intervention after controlling for risk factors for WD and other important predictors imbalanced at baseline.


This program fills an important gap in arthritis health services and addresses an important and costly problem. Knowledge gained from the RCT will be useful to health care professionals, policy planners and arthritis stakeholders.

Trial registration NCT01852851; registered April 13, 2012; first participant randomized on July 6, 2013.

Inflammatory arthritis; Employment; Worker productivity; Work disability; eLearning program; Self-management; Ergonomics; Vocational counselling; Health education; Health promotion