The WORKWELL programme: a randomised controlled trial of job retention vocational rehabilitation for people with inflammatory arthritis

Tools

HAMMOND, Alison, PARKER, Jennifer, COTTERILL, Sarah, SUTTON, Chris, MIRZA, Selman, CHING, Angela, O'NEILL, Terence W, HOLLAND, Fiona, MARSDEN, Antonia, HOLLAND, Paula, RADFORD, Kathryn, VERSTAPPEN, Suzanne M M, EDEN, Martin, DALAL, Garima, BATTISTA, Simone, CULLEY, June, WALKER-BONE, Karen, WOODBRIDGE, Sarah, O'BRIEN, Rachel, HOUGH, Yvonne and PRIOR, Yeliz (2026). The WORKWELL programme: a randomised controlled trial of job retention vocational rehabilitation for people with inflammatory arthritis. Rheumatology: keag373. [Article]

Documents
37758:1340301
[thumbnail of Replace with VoR once available]
Preview
PDF (Replace with VoR once available)
O'Brien-TheWORKWELLProgramme(AM).pdf - Accepted Version
Available under License Creative Commons Attribution.

Download (341kB) | Preview
Abstract

Objective

People with inflammatory arthritis (IA) frequently experience work instability, absenteeism, and reduced productivity, culminating in early job loss. This study evaluated the effectiveness and cost-effectiveness of WORKWELL job retention vocational rehabilitation (JRVR) delivered by occupational therapists, compared to a control group receiving written self-help advice.

Methods

A pragmatic, multi-centre randomised controlled trial was conducted across 18 UK NHS Trusts. Employed adults (n = 249) with IA experiencing moderate to severe work instability, were randomised (1:1) to intervention or control groups. WORKWELL included structured work assessment, individually tailored action plans, and interventions over 2-4 months. Follow-up was at 6, 12, and 36 months. The primary outcome was the Work Limitations Questionnaire-25 (WLQ-25). Analyses used linear mixed-effects regression adjusted for baseline characteristics and occupational skill level. An NHS perspective was used for the within-trial cost-effectiveness analysis. Much of the trial was affected by the COVID-19 pandemic.

Results

At 12 months, there was no significant difference in WLQ-25 between groups (adjusted mean difference: -1.8; 95% CI -7.4 to 3.8; p = 0.53), or in most secondary outcomes at 12- or 36-months. However, absenteeism showed a relative reduction of 46% at 12 months (p = 0.08), and employment retention at 36 months was higher in the intervention (93%) vs. control group (85%). The intervention was not cost-effective from an NHS perspective.

Conclusion

WORKWELL did not lead to improved work productivity compared to self-help advice. Future research should explore more flexible delivery methods, including digital tools, to support sustainable employment for people with IA. A plain-language abstract is available in the supplementary material.

Trial registration

ClinicalTrials.gov; NCT03942783. ISRCTN Registry; ISRCTN61762297.
More Information
Official URL:
https://doi.org/10.1093/rheumatology%2Fkeag373

Identifiers

Identification Number:
10.1093/rheumatology/keag373
ORCID for Alison Hammond: ORCID iD orcid.org/0000-0002-5266-9991
ORCID for Jennifer Parker: ORCID iD orcid.org/0000-0002-2235-5748
ORCID for Sarah Cotterill: ORCID iD orcid.org/0000-0001-5136-390X
ORCID for Chris Sutton: ORCID iD orcid.org/0000-0002-6406-1318
ORCID for Selman Mirza: ORCID iD orcid.org/0009-0000-4314-3640
ORCID for Angela Ching: ORCID iD orcid.org/0000-0002-3765-2534
ORCID for Terence W O'Neill: ORCID iD orcid.org/0000-0002-8896-4677
ORCID for Fiona Holland: ORCID iD orcid.org/0000-0003-2702-307X
ORCID for Paula Holland: ORCID iD orcid.org/0000-0002-8324-9957
ORCID for Kathryn Radford: ORCID iD orcid.org/0000-0001-6246-3180
ORCID for Suzanne M M Verstappen: ORCID iD orcid.org/0000-0001-6181-0646
ORCID for Martin Eden: ORCID iD orcid.org/0000-0002-1542-2527
ORCID for Garima Dalal: ORCID iD orcid.org/0000-0002-4073-4215
ORCID for Simone Battista: ORCID iD orcid.org/0000-0002-7471-1951
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459
ORCID for Sarah Woodbridge: ORCID iD orcid.org/0000-0002-6843-0395
ORCID for Rachel O'Brien: ORCID iD orcid.org/0000-0002-4720-1956
ORCID for Yeliz Prior: ORCID iD orcid.org/0000-0001-9831-6254

Library

Publisher:
Oxford University Press
Item Type:
Article
Depositing User:
Justine Gavin
Date record made live:
20 Jul 2026 13:39
Last Modified:
20 Jul 2026 14:00
Date of first compliant deposit:
20 July 2026
Date of first compliant Open Access:
20 July 2026
Version of first compliant deposit:
Author Accepted Manuscript
ISSN:
1462-0324
URI:
https://shura.shu.ac.uk/id/eprint/37758
Statistics

Downloads

Downloads per month over past year

View more statistics

Metrics

Altmetric Badge

Dimensions Badge

Share
Add to AnyAdd to TwitterAdd to FacebookAdd to LinkedinAdd to PinterestAdd to Email

Actions (login required)

View Item View Item

SHURA supports OAI 2.0 with a base URL of https://shura.shu.ac.uk/cgi/oai2