The longitudinal association of hand osteoarthritis with paid and unpaid work restrictions and related societal costs: the Hand Osteoarthritis in Secondary Care cohort

Objectives To investigate the course of restrictions in paid and unpaid work and corresponding societal costs in patients with hand osteoarthritis (OA). Methods Patients with data of at least baseline and one follow-up moment (year one up to year eight) of the Dutch Hand OSTeoArthritis in Secondary care cohort (HOSTAS) were included. The Health and Labour Questionnaire was used to assess over the last two weeks hand OA-related restrictions for paid and unpaid work. Societal costs of productivity loss were estimated with Dutch government data on 2021. Results 351 patients were included (mean age 60 years, 84% women). At baseline, 166/351 (47%) had paid work, decreasing to 54/164 (33%) at year eight. Loss of productive time over the two-week period was reported by 32/166 (19%) patients with paid work at baseline, 17/104 (16%) at year four, among whom 12/104 (11%) patients at both moments. Any restrictions over this two-week period were experienced by 89/166 patients (54%) at baseline and 41/104 (39%) at year four for those with paid work. Regarding unpaid work, 157/351 (45%) reported replacement of tasks by others at baseline and 72/164 (44%) at year eight. 205/351 (59%) reported restrictions at baseline, and 99/164 (60%) at year eight. Mean total societal costs for loss of paid and unpaid work were, per patient, €89/two weeks (95% confidence interval 52;127) at baseline and €47/two weeks (26;69) at year eight. Conclusions The proportion of patients with paid work decreases during follow-up, but restrictions at paid and unpaid work seem mostly stable.