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 Hospital Lund, 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 Magazine March 21, 2011

The occurence of Rheumatoid Arthritis (RA) in south Sweden Overall prevalence Dec % ( ) Englund, Jöud, Geborek, Felson, Jacobsson, Petersson. Rheumatology 2010;49:1563-9

The occurence of Spondylarthridies (SpA) in south Sweden. Overall prevalence 0,45% 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 RMDs What 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 RMDs What 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

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) operation pharmacotherapy assistive 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 Ann Rheum Dis 2010 Dec;69(12): 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 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, in Sweden

The socio-economic burden of RMDs What 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