Background: Rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) are chronic inflammatory diseases that often lead to work-related problems. Therefore, effective interventions targeting work-related problems and meeting the needs of people with RA or axSpA are needed.

Objectives: To evaluate the process of delivery and outcomes of a multimodal, physical therapist (PT)-led vocational intervention in working people with RA or axSpA, from the participants’ perspective.

Methods: Using a hybrid study design type 1, and in the context of possible future implementation, a qualitative evaluation of process and outcomes was performed alongside a randomized controlled trial (PT-WORKS! study) [1] comparing a PT-led vocational intervention with regular care. The RCT included 140 people with RA or axSpA who had a paid job and experienced a working problem. The qualitative study was done in a subset of 10 participants of the total of 70 participants from the experimental arm of the RCT. Participants were selected through purposive sampling. The study consisted of semi-structured interviews, based on a topic guide developed by the research team based on existing literature and insights acquired from a focus group study conducted during the development phase of the intervention [2] and conducted by two of the researchers (MV and NB). Topics included, amongst others, the perceived outcomes, the strength and weaknesses of the intervention and their possible impact on the outcomes. Interviews were recorded, transcribed using Amberscript and coded using Atlas.ti web version 7.2.0. Data analysis was conducted by two of the researchers (MV and NB) using theoretical thematic analysis. A priori, data saturation was expected after 10 interviews.

Results: The semi-structured interviews were conducted between January and April 2024. The 10 participants (6 with RA, 4 with axSpA) were 7 women and 3 men, with their age ranging between 26 and 67 years. Eight and two participants were permanently and temporarily employed, respectively. Three participants were still receiving the intervention when the interviews took place, while the other 7 had completed it (number of sessions ranging from 3-14). Three main themes and eight subthemes were identified. The first main theme concerned the perceived effects of the intervention, with subthemes a) enhanced awareness of symptoms and balance between capacity and load, b) enhanced self-management and c) improved physical functioning. The second theme included facilitators for optimal outcomes, with subthemes a) personalized approach, b) trust in expertise of physiotherapist, c) comprehensive and work-focused content and d) personalized use of optional treatment components. The third main theme concerned a mismatch between the characteristics of the intervention on the one hand and the participants’ perceived severity and nature of work-related limitations on the other hand, as a barrier for optimal outcomes.

Conclusion: Working people with RA or axSpA who were or had been receiving a multimodal, physiotherapist-led vocational intervention had overall positive experiences, whereas various facilitators and barriers for optimal outcomes were identified. Despite the personalized delivery, a suboptimal alignment between the intervention and relatively mild work problems is an important barrier. As a result, the intervention might be more useful and effective for people with more severe work problems. However, the latter remains to be examined in future research.

REFERENCES: [1] Bakker NF, van Weely SFE, Hutting N, et al. Effectiveness and cost-effectiveness of a multimodal, physiotherapist-led, vocational intervention in people with inflammatory arthritis: study protocol of the Physiotherapy WORKs trial. BMC Rheumatol. 2023 Sep 20;7(1):31.

[2] Bakker NF, van Weely SFE, Hutting N, et al. Development of a multimodal, physiotherapist-led, vocational intervention for people with inflammatory arthritis and reduced work ability: a mixed-methods design study. J Occup Rehabil. 2024;34:832–846.

Acknowledgements: Authors would like to acknowledge the Dutch Arthritis Society (ReumaNederland) and the Scientific College of Physical Therapy (Wetenschappelijk College Fysiotherapie; WCF) of the Royal Dutch Society for Physical Therapy (Koninklijk Nederlands Genootschap voor Fysiotherapie; KNGF) for funding this study. The funders had no role in the design, organization and execution of the study.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.