Absenteeism; Activities of Daily Living; Adult; Disability Evaluation; Efficiency; Employment; Female; Health Status; Humans; Male; Middle Aged; Quality of Life; Severity of Illness Index; Spondylitis, Ankylosing/diagnosis/physiopathology; Workplace; ANKYLOSING SPONDYLITIS; WORK
Abstract :
[en] OBJECTIVE: To explore the effect of health-related and contextual factors on presenteeism, absenteeism, and overall work productivity loss in patients with active ankylosing spondylitis (AS). METHODS: Consecutive patients with AS starting their first tumor necrosis factor inhibitor and in paid employment were eligible. Patients completed the Work Productivity and Activity Impairment (WPAI) questionnaire for AS to assess presenteeism, absenteeism, and overall work productivity loss in the previous 7 days. In addition, they answered questions about work characteristics (type, characteristics of workplace, satisfaction of contacts with colleagues, and importance of work in life) and health status [Bath AS Functional Index (BASFI), AS Disease Activity Score-C-reactive protein (ASDAS-CRP)]. Physicians assessed the Bath Ankylosing Spondylitis Metrology Index, presence of articular and extraarticular manifestations, comorbidities, and laboratory indicators of inflammation. Stepwise regression models were computed to determine which work-related and health-related factors contributed to WPAI outcomes. RESULTS: The study included 80 patients. The WPAI presenteeism, absenteeism, and overall work productivity loss scores were 49.1%, 30.2%, and 53.1%, respectively. Presenteeism was associated with higher BASFI, female sex, and poor quality of contact with colleagues. Absenteeism was associated with increasing age, current smoking status, higher ASDAS-CRP, and low importance of work for life. Overall work productivity loss was associated with female sex, higher BASFI, past adaptation of job because of illness, number of working hours, and manual profession. CONCLUSION: Both health-related and contextual factors contribute to work limitations in patients with AS and suggest additional opportunities for improvement by addressing the working environment.
Disciplines :
Rheumatology
Author, co-author :
Boonen, Annelies; Maastricht University Clinical Center > Internal Medicine > Rheumatology > Pr
Boone, Caroline; Pfizer SA/NV > Medical
Albert, Adelin ; Université de Liège - ULiège > Département des sciences de la santé publique > Département des sciences de la santé publique
Braun J, Sieper J. Ankylosing spondylitis. Lancet 2007; 369:1379-90.
Kiltz U, van der Heijde D. Health-related quality of life in patients with rheumatoid arthritis and in patients with ankylosing spondylitis. Clin Exp Rheumatol 2009;27 Suppl 55:S108-11.
Bergström G, Bodin L, Hagberg J, Aronsson G, Josephson M. Sickness presenteeism today, sickness absenteeism tomorrow? A prospective study on sickness presenteeism and future sickness absenteeism. J Occup Environ Med 2009;51:629-38.
Mau W, Listing J, Huscher D, Zeidler H, Zink A. Employment across chronic inflammatory rheumatic diseases and comparison with the general population. J Rheumatol 2005;32:721-8.
Marengo MF, Schneeberger EE, Citera G, Cocco JA. Work status among patients with ankylosing spondylitis in Argentina. J Clin Rheumatol 2008;14:273-7.
Boonen A, Chorus A, Miedema H, van der Heijde D, Landewé R, Schouten H, et al. Withdrawal from labour force due to work disability in patients with ankylosing spondylitis. Ann Rheum Dis 2001;60:1033-9.
van der Heijde D, Han C, DeVlam K, Burmester G, van den Bosch F, Williamson P, et al. Infliximab improves productivity and reduces workday loss in patients with ankylosing spondylitis: results from a randomized, placebo-controlled trial. Arthritis Rheum 2006;55:569-74.
Haibel H, Song IH, Rudwaleit M, Listing J, Hildemann S, Sieper J. Multicenter open-label study with infliximab in active ankylosing spondylitis over 28 weeks in daily practice. Clin Exp Rheumatol 2008;26:247-52.
Keat AC, Gaffney K, Gilbert AK, Harris C, Leeder J. Influence of biologic therapy on return to work in people with work disability due to ankylosing spondylitis. Rheumatology 2008;47:481-3.
Kristensen LE, Petersson IF, Geborek P, Joud A, Saxne T, Jacobsson LT, et al. Sick leave in patients with ankylosing spondylitis before and after anti-TNF therapy: A population-based cohort study. Rheumatology 2012;51:243-9.
Listing J, Brandt J, Rudwaleit M, Zink A, Sieper J, Braun J. Impact of anti-tumour necrosis factor alpha treatment on admissions to hospital and days of sick leave in patients with ankylosing spondylitis. Ann Rheum Dis 2004;63:1670-2.
Maksymowych WP, Gooch KL, Wong RL, Kupper H, van der Heijde D. Impact of age, sex, physical function, health-related quality of life, and treatment with adalimumab on work status and work productivity of patients with ankylosing spondylitis. J Rheumatol 2010;37:385-92.
Boonen A, van der Heijde D, Landewé R, Spoorenberg A, Schouten H, Rutten-van Molken M, et al. Work status and productivity costs due to ankylosing spondylitis: comparison of three European countries. Ann Rheum Dis 2002;61:429-37.
Boonen A, de Vet H, van der Heijde D, van der Linden S. Work status and its determinants among patients with ankylosing spondylitis. A systematic literature review. J Rheumatol 2001;28:1056-62.
Boonen A, Brinkhuizen T, Landewe R, van der Heijde D, Severens JL. Impact of ankylosing spondylitis on sick leave, presenteeism and unpaid productivity, and estimation of the societal cost. Ann Rheum Dis 2010;69:1123-8.
World Health Organization. International classification of functioning, disability and health (ICF). [Internet. Accessed September 24, 2014.] Available from: www.who.int/classifications/icf/en.
van Echteld I, Cieza A, Boonen A, Stucki G, Zochling J, Braun J, et al. Identification of the most common problems by patients with ankylosing spondylitis using the international classification of functioning, disability and health. J Rheumatol 2006;33:2475-83.
Boers M, Idzerda L, Kirwan JR, Beaton D, Escorpizo R, Boonen A, et al. Toward a generalized framework of core measurement areas in clinical trials: A position paper for OMERACT 11. J Rheumatol 2014;41:978-85.
Tang K, Escorpizo R, Beaton DE, Bombardier C, Lacaille D, Zhang W, et al. Measuring the impact of arthritis on worker productivity: perspectives, methodologic issues, and contextual factors. J Rheumatol 2011;38:1776-90.
Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: The Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 1994;21:2286-91.
Reilly MC, Gooch KL, Wong RL, Kupper H, van der Heijde D. Validity, reliability and responsiveness of the Work Productivity and Activity Impairment Questionnaire in ankylosing spondylitis. Rheumatology 2010;49:812-9.
Koopmanschap MA. PRODISQ: A modular questionnaire on productivity and disease for economic evaluation studies. Expert Rev Pharmacoecon Outcomes Res 2005;5:23-8.
Calin A, Jones SD, Garrett SL, Kennedy LG. Bath Ankylosing Spondylitis Functional Index. Br J Rheumatol 1995;34:793-4.
van der Heijde D, Lie E, Kvien TK, Sieper J, Van den Bosch F, Listing J, et al. ASDAS, a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis. Ann Rheum Dis 2009;68:1811-8.
Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 1994;21:1694-8.
van der Heijde D, Landewé R, Feldtkeller E. Proposal of a linear definition of the Bath Ankylosing Spondylitis Metrology Index (BASMI) and comparison with the 2-step and 10-step definitions. Ann Rheum Dis 2008;67:489-93.
van der Heijde D, Deodhar A, Inman RD, Braun J, Hsu B, Mack M. Comparison of three methods for calculating the Bath Ankylosing Spondylitis Metrology Index in a randomized placebo-controlled study. Arthritis Care Res 2012;64:1919-22.
Jones SD, Steiner A, Garrett SL, Calin A. The Bath Ankylosing Spondylitis Patient Global Score (BAS-G). Br J Rheumatol 1996;35:66-71.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74.
Verstappen SM, Watson KD, Lunt M, McGrother K, Symmons DP, Hyrich KL. Working status in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: results from the British Society for Rheumatology Biologics Register. Rheumatology 2010;49:1570-7.
Healey EL, Haywood KL, Jordan KP, Garratt A, Packham JC. Impact of ankylosing spondylitis on work in patients across the UK. Scand J Rheumatol 2011;40:34-40.
Ariza-Ariza R, Hernandez-Cruz B, Collantes E, Batlle E, Fernandez-Sueiro JL, Gratacos J, et al. Work disability in patients with ankylosing spondylitis. J Rheumatol 2009;36:2512-6.
Bakland G, Gran JT, Becker-Merok A, Nordvag BY, Nossent JC. Work disability in patients with ankylosing spondylitis in Norway. J Rheumatol 2011;38:479-84.
Barlow JH, Wright CC, Williams B, Keat A. Work disability among people with ankylosing spondylitis. Arthritis Rheum 2001; 45:424-9.
Cakar E, Taskaynatan MA, Dincer U, Kiralp MZ, Durmus O, Ozgul A. Work disability in ankylosing spondylitis: differences among working and work-disabled patients. Clin Rheumatol 2009;28:1309-14.
Chorus AM, Boonen A, Miedema HS, van der Linden S. Employment perspectives of patients with ankylosing spondylitis. Ann Rheum Dis 2002;61:693-9.
Gran JT, Skomsvoll JF. The outcome of ankylosing spondylitis: A study of 100 patients. Br J Rheumatol 1997;36:766-71.
Ramos-Remus C, Hernandez-Rios G, Duran-Barragan S, Sanchez-Ortiz A, Aceves-Avila FJ, Castillo-Ortiz JD, et al. Fifteen-year trends of long-term disability and sick leaves in ankylosing spondylitis. Clin Rheumatol 2011;30:361-7.
Rkain H, Allali F, Bentalha A, Lazrak N, Abouqal R, Hajjaj-Hassouni N. Socioeconomic impact of ankylosing spondylitis in Morocco. Clin Rheumatol 2007;26:2081-8.
Ward MM, Kuzis S. Risk factors for work disability in patients with ankylosing spondylitis. J Rheumatol 2001;28:315-21.
Grazio S, Jajić Z, Nemcić T, Jajić I. [Work capacity evaluation in patients with ankylosing spondylitis]. [Article in Croatian] Reumatizam 1997;45:1-5.
Guillemin F, Briancon S, Pourel J, Gaucher A. Long-term disability and prolonged sick leaves as outcome measurements in ankylosing spondylitis. Possible predictive factors. Arthritis Rheum 1990;33:1001-6.
