Background: People with inflammatory arthritis (IA) experience high levels of work instability, absenteeism (i.e., sick leave), and presenteeism (i.e. reduced work productivity), which can lead to premature job loss and financial strain for individuals and society. Within 10 years of diagnosis, half of all individuals with rheumatoid arthritis become work disabled [1]. While work disability appears to be decreasing, possibly due to earlier aggressive drug treatment [2] 67% still report presenteeism even with low disease activity [3]. Work difficulties include: pain (particularly hand pain); fatigue; unadapted work environments, equipment and work schedules; poor work self-efficacy (i.e. lack of confidence about working); job strain; limited use of self-management strategies; and limited support from employers and work colleagues. The WORKWELL randomised controlled trial (RCT) evaluated whether a structured job retention vocational rehabilitation programme could help individuals retain their jobs by aligning their abilities with job demands [4,5]. Objectives: To examine the effects of the WORKWELL job retention vocational rehabilitation intervention on work productivity and other work outcomes at 6-, 12- and 36-months post-intervention among people with IA. Methods: The study design was a pragmatic, multi-centre RCT comparing the effects of a job retention vocational rehabilitation programme (intervention) with written self-help advice only (control). The WORKWELL intervention is a tailored, individualised programme designed to address participants' priority work-related needs through face-to-face and online sessions, along with a 30-minute follow-up call, spread over two to four months. It includes a structured work interview to assess job roles, barriers, and condition-related limitations, followed by mutually agreed action plans incorporating strategies such as self-management, job accommodations, and employment rights, with a total intervention time of up to 6.5 hours per participant. Participants were recruited from rheumatology departments in 18 National Health Service Trusts across the United Kingdom. At baseline, 249 employed people diagnosed with rheumatoid arthritis, undifferentiated IA, or psoriatic arthritis who had concerns about being able to continue to work in the future due to arthritis were randomised 1:1 to either intervention or the control group, stratified by skill level (i.e. professional or elementary occupations). At 6 months, participants completed a short postal or online questionnaire covering presenteeism, productivity, health status, and resource data. At 12 months, they completed a more comprehensive questionnaire with most of the measures collected at baseline. At 36 months, a final questionnaire focused on presenteeism and work status was completed. The primary outcome was work productivity, measured by the Work Limitations Questionnaire (WLQ-25), at 12 months, which was also collected at 6- and 36 months. Data analysis used linear mixed-effects regression models adjusted for baseline characteristics and skill level to examine the intervention effect. Results: At the 12-month follow-up (82% response rate) there was no evidence of an effect of the intervention on work productivity, compared to the control group (adjusted mean difference, WLQ-25 1.8, 95%CI -3.8 to 7.4 points, p=0.53), and no evidence of an effect on the secondary outcomes, apart from a marginally non-significant reduction in absenteeism (number of sick days, relative reduction 46%, 95%CI -7% to 73%, p=0.08) compared to the control group. At 6 months (87% response rate) and 36 months (72% response rate), the trial also found no evidence of an effect on work productivity. The results were robust to various planned sensitivity analyses. Conclusion: The job retention vocational rehabilitation programme used in the WORKWELL trial did not improve work productivity and employment retention in employed people with IA. The trial was able to recruit to target despite the challenges of the COVID-19 pandemic, which may have affected job stability and health outcomes of participants in both arms, warranting further research into tailored and scalable support options. Future research will focus on refining work advice by developing tailored self-management resources, including digital solutions, to support flexible, scalable access to job retention strategies for individuals with arthritis. REFERENCES: [1] National Institute for Health and Care Excellence. Rheumatoid arthritis in adults: management; 2009a. https://www.nice.org.uk/guidance/cg79. Accessed 14 Nov 2024. [2] Nikiphorou et al. Work disability rates in RA. Results from an inception cohort with 24 years follow-up. Rheumatology. 2012;51:385–392. Doi 10.1093/rheumatology/ker401. [3] Kim D, Kaneko Y, Takeuchi T. Importance of obtaining remission for work productivity and activity of patients with rheumatoid arthritis. J Rheumatol. 2017;44:1112–7. [4] Hammond et al. The effect on work presenteeism of job retention vocational rehabilitation compared to a written self-help work advice pack for employed people with inflammatory arthritis: protocol for a multi-centre randomised controlled trial (the WORKWELL trial). BMC Musculoskelet Disord. 2020 Sep 10;21(1):607. DOI: 10.1186/s12891-020-03619-1. PMID: 32912199; PMCID: PMC7488441. [5] Hammond et al. The Workwell trial: protocol for the process evaluation of a randomised controlled trial of job retention vocational rehabilitation for employed people with inflammatory arthritis. Trials 23, 937 (2022). https://doi.org/10.1186/s13063-022-06871-z. Figure 1. Mean WLQ-25 Summed Score by intervention group. Acknowledgements: We would like to thank the Occupational Therapy and Rheumatology departments, as well as the participating patients and patient research partners, for their invaluable contributions to this 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.