Upper extremity joint tenderness as a practical indicator for assessing presenteeism in rheumatoid arthritis patients

ObjectiveRheumatoid arthritis (RA) causes chronic polyarthritis and joint dysfunction, reducing work productivity. This reduction is mainly due to presenteeism, characterized by impaired work performance despite being present at work. This study aims to investigate the impact of specific joint involvement, particularly in the upper extremities, on work disability in RA patients. MethodsAnnual surveys assessing work disability were conducted among RA outpatients enrolled in the Nagahama Riumachi Cohort at Nagahama City Hospital, using the Work Productivity and Activity Impairment Questionnaire (WPAI). A multivariate regression analysis was performed to examine the cross-sectional and longitudinal associations between presenteeism and the tender joint count (TJC) in the extremities across two WPAI surveys. ResultsThe analysis included 201 patients, 52% of whom reported presenteeism. Cross-sectional analysis revealed a significant positive correlation between three or more TJCs of the upper extremity and presenteeism, with a regression coefficient ({beta}) = 17.9 (95% confidence interval [CI]: 9.85-25.9). Among the joints evaluated, the sum of TJCs in the shoulder area ({beta} = 9.55, CI: 5.39-13.7) and the fingers ({beta} = 1.60, CI: 0.35-2.85) were significantly correlated with presenteeism. Additionally, change in presenteeism were significantly correlated with change in upper extremity TJCs ({beta} = 1.41, CI: 0.05-2.77). ConclusionsThe upper extremity TJC is strongly associated with presenteeism in RA patients. The TJC of the upper extremities serves as a valuable indicator for clinicians, helping them effectively assess a patients underlying work disability.