Abstract
Objective: To assess the rate of employment and factors associated with work productivity loss in Ankylosing spondylitis (AS).
Material and Method: This study was designed as a cross-sectional study that included 70 patients with AS. Fatigue, morning stiffness, and pain were assessed on a visual analogue scale (VAS). Disease activity, physical function, quality of life, anxiety and depression were assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL), and Hospital Anxiety and Depression Scale (HAD), respectively. We used the Work Productivity and Activity Impairment Questionnaire (WPAI) to determine the impact of AS on work productivity. The clinical and demographic characteristics of working and not working patients were compared. Factors associated with absenteeism and presenteeism were assessed using univariable logistic and linear regression analysis, respectively.
Results: Mean age of 70 patients (24 women, 46 men) with AS was 42.96 ± 7.83 years. The percentages of working patients was 65.7%. The percentages of presenteeism and absenteeism were 60.21% and 37%, respectively. The clinical and demographic characteristics of working and not working patients were not different (p>0.05). Absenteeism was associated with low educational level (odds ratio [OR]=7.636; 95% confidence interval [CI]=1.782-32.723; p=0.006), morning stiffness (OR=1.545; 95% CI=1.118-2.134; p=0.008), BASDAI (OR=1.645; 95% CI=1.088-2.489; p=0.018), and ASQoL (OR=1.392; 95% CI=1.094-1.772; p=0.007). In the linear regression model, BASDAI (β=8.394; 95% CI=5.570-11.217; p<0.001), fatigue (β=6.656; 95% CI=3.015-10.298; p=0.001), pain (β=6.011; 95% CI=2.669-9.352; p=0.001), morning stiffness (β=6.108; 95% CI=3.949-8.268; p<0.001), BASFI (β=5.703; 95% CI=2.701-8.705; p< 0.001), ASQoL (β=3.209; 95% CI=1.781-4.637; p<0.001), and HAD-A (β=2.095; 95% CI=0.243-3.947; p=0.027) were significantly associated with presenteeism.
Conclusion: The percentage of absenteeism and presenteeism were high in working AS patients. Absenteeism was associated with low educational level, morning stiffness, and disease activity. Presenteeism was associated with patient-reported outcomes, including fatigue, pain, morning stiffness, function, anxiety, quality of life, and disease activity.
Supporting Institution
None
Project Number
Ethics Committee insert number: 09.2018.650
Thanks
The authors thank the Ankylosing Spondylitis Patient Society (ASHAD).
References
- Simone D, Al Mossawi MH, Bowness P. Progress in our understanding of the pathogenesis of ankylosing spondylitis. Rheumatology (Oxford) 2018; 57: 4-9.
- Boonen A, van der Linden SM. The burden of ankylosing spondylitis. J Rheumatol Suppl 2006; 78: 4-11.
- Krüger K, von Hinüber U, Meier F, et al. Ankylosing spondylitis causes high burden to patients and the healthcare system: results from a German claims database analysis. Rheumatol Int 2018; 38: 2121-31.
- Merino M, Braçe O, González-Domínguez A, Hidalgo-Vega Á, Garrido-Cumbrera M, Gratacós J. Social economic costs of ankylosing spondylitis in Spain. Clin Exp Rheumatol 2021; 39: 357-64.
- van Tubergen A, Black PM, Coteur G. Are patient-reported outcome instruments for ankylosing spondylitis fit for purpose for the axial spondyloarthritis patient? A qualitative and psychometric analysis. Rheumatology (Oxford) 2015; 54: 1842-51.
- Martindale J, Shukla R, Goodacre J. The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity. Best Pract Res Clin Rheumatol 2015; 29: 512-23.
- Boonen A, Chorus A, Miedema H, et al. Withdrawal from labour force due to work disability in patients with ankylosing spondylitis. Ann Rheum Dis 2001; 60: 1033-9.
- Barlow JH, Wright CC, Williams B, Keat A. Work disability among people with ankylosing spondylitis. Arthritis Rheum 2001; 45: 424-9.
- 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.
- Escorpizo R, Bombardier C, Boonen A, et al. Worker productivity outcome measures in arthritis. J Rheumatol 2007; 34: 1372-80.
- Ward MM, Kuzis S. Risk factors for work disability in patients with ankylosing spondylitis. J Rheumatol 2001; 28: 315-21.
- 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.
- Nikiphorou E, Ramiro S. Work Disability in Axial Spondyloarthritis. Curr Rheumatol Rep 2020; 22: 55.
- Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361-70.
- Calin A, Garrett S, Whitelock H, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 1994; 21: 2281-85.
- Duruöz MT, Doward L, Turan Y, et al. Translation and validation of the Turkish version of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. Rheumatol Int 2013; 33: 2717-22.
- Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics 1993; 4: 353-65.
- 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 (Oxford) 2010; 49: 812-9.
- Cakar E, Taskaynatan MA, Dincer U, Kiralp MZ, Durmus O, Ozgül A. Work disability in ankylosing spondylitis: differences among working and work-disabled patients. Clin Rheumatol 2009; 28: 1309-14.
- Macfarlane GJ, Shim J, Jones GT, Walker-Bone K, Pathan E, Dean LE. Identifying persons with axial spondyloarthritis at risk of poor work outcome: results from the British Society for rheumatology biologics. J Rheumatol 2019; 46: 145-52.
- de Hooge M, Ramonda R, Lorenzin M, et al. Work productivity is associated with disease activity and functional ability in Italian patients with early axial spondyloarthritis: an observational study from the SPACE cohort. Arthritis Res Ther 2016; 18: 265.
- Haglund E, Bremander A, Bergman S, Jacobsson LT, Petersson IF. Work productivity in a population-based cohort of patients with spondyloarthritis. Rheumatology (Oxford) 2013; 52: 1708-14.
- Nikiphorou E, Boonen A, Fautrel B, et al. How do clinical and socioeconomic factors impact on work disability in early axial spondyloarthritis? Five-year data from the DESIR cohort. Rheumatology (Oxford) 2022; 61: 2034-42.
- Nikiphorou E, Carvalho PD, Boonen A, et al. Sick leave in early axial spondyloarthritis: the role of clinical and socioeconomic factors. Five-year data from the DESIR cohort. RMD Open 2021; 7: e001685.
- Espahbodi S, Bassett P, Cavill C, Freeth M, Hole J, Sengupta R. Fatigue contributes to work productivity impairment in patients with axial spondyloarthritis: a cross-sectional UK study. Clin Exp Rheumatol 2017; 35: 571-8.
Abstract
Amaç: Ankilozan spondilitte (AS) çalışma durumunu ve iş verimliliği kaybıyla ilişkili faktörleri değerlendirmek.
Gereç ve Yöntem: Bu kesitsel çalışmaya 70 AS tanılı hasta dahil edildi.Yorgunluk, sabah tutukluğu ve ağrı visual analog skala (VAS) kullanılarak değerlendirildi. Hastalık aktivitesi, fiziksel fonksiyon, yaşam kalitesi, anksiyete ve depresyon sırasıyla Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI), Bath Ankilozan Spondilit Fonksiyonel İndeksi (BASFI), Ankilozan Spondilit Yaşam Kalitesi (ASQoL), Hastane Anksiyete ve Depresyonu (HAD) ölçeği kullanılarak değerlendirildi. AS’nin iş verimliliği üzerindeki etkisini belirlemek için İş Verimliliği ve Faaliyet Bozulması Anketini (WPAI) kullanıldı. Çalışan ve çalışmayan hastaların klinik ve demografik özellikleri karşılaştırıldı. Absenteeism ve presenteeism ile ilişkili faktörler, sırasıyla univariable lojistik ve doğrusal regresyon analizi kullanılarak değerlendirildi.
Bulgular: AS’li 70 hastanın (24 kadın, 46 erkek) yaş ortalaması 42,96 ± 7,83 yıl idi. Çalışan hasta oranı %65,7 idi. Presenteeism ve absenteeism oranları sırasıyla %60,21 ve %37’dir. Çalışan ve çalışmayan hastaların klinik ve demografik özellikleri farklı değildi (p>0.05). Absenteeism, düşük eğitim seviyesi (odds ratio [OR]=7,636; 95% confidence interval [CI]=1,782-32,723; p=0,006), sabah tutukluğu (OR=1,545; 95% CI=1,118-2,134; p=0,008), BASDAI (OR=1,645; 95% CI=1,088-2,489; p=0,018), ve ASQoL (OR=1,392; 95% CI=1,094-1,772; p=0,007) ile ilişkiliydi. Univariable linear regression modelinde, presenteeism BASDAI (β=8,394; 95% CI=5,570-11,217; p<0,001), yorgunluk (β=6,656; 95% CI=3,015-10,298; p=0,001), ağrı (β=6,011; 95% CI=2,669-9,352; p=0,001), sabah tutukluğu (β=6,108; 95% CI=3,949-8,268; p<0,001), BASFI (β=5,703; 95% CI=2,701-8,705; p< 0,001), ASQoL (β=3,209; 95% CI=1,781-4,637; p<0,001), ve anksiyete (β=2,095; 95% CI=0,243-3,947; p=0,027) ile ilişkili bulundu.
Sonuç: Çalışan AS hastalarında absenteeism ve presenteeism yüzdesi yüksekti. Absenteeism, düşük eğitim düzeyi, sabah tutukluğu, hastalık aktivitesi ile ilişkiliydi. Presenteeism, yorgunluk, ağrı, sabah tutukluğu, fonksiyon, anksiyete, yaşam kalitesi ve hastalık aktivitesi dahil olmak üzere hasta tarafından bildirilen sonuçlarla ilişkiliydi.
Keywords
Project Number
Ethics Committee insert number: 09.2018.650
References
- Simone D, Al Mossawi MH, Bowness P. Progress in our understanding of the pathogenesis of ankylosing spondylitis. Rheumatology (Oxford) 2018; 57: 4-9.
- Boonen A, van der Linden SM. The burden of ankylosing spondylitis. J Rheumatol Suppl 2006; 78: 4-11.
- Krüger K, von Hinüber U, Meier F, et al. Ankylosing spondylitis causes high burden to patients and the healthcare system: results from a German claims database analysis. Rheumatol Int 2018; 38: 2121-31.
- Merino M, Braçe O, González-Domínguez A, Hidalgo-Vega Á, Garrido-Cumbrera M, Gratacós J. Social economic costs of ankylosing spondylitis in Spain. Clin Exp Rheumatol 2021; 39: 357-64.
- van Tubergen A, Black PM, Coteur G. Are patient-reported outcome instruments for ankylosing spondylitis fit for purpose for the axial spondyloarthritis patient? A qualitative and psychometric analysis. Rheumatology (Oxford) 2015; 54: 1842-51.
- Martindale J, Shukla R, Goodacre J. The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity. Best Pract Res Clin Rheumatol 2015; 29: 512-23.
- Boonen A, Chorus A, Miedema H, et al. Withdrawal from labour force due to work disability in patients with ankylosing spondylitis. Ann Rheum Dis 2001; 60: 1033-9.
- Barlow JH, Wright CC, Williams B, Keat A. Work disability among people with ankylosing spondylitis. Arthritis Rheum 2001; 45: 424-9.
- 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.
- Escorpizo R, Bombardier C, Boonen A, et al. Worker productivity outcome measures in arthritis. J Rheumatol 2007; 34: 1372-80.
- Ward MM, Kuzis S. Risk factors for work disability in patients with ankylosing spondylitis. J Rheumatol 2001; 28: 315-21.
- 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.
- Nikiphorou E, Ramiro S. Work Disability in Axial Spondyloarthritis. Curr Rheumatol Rep 2020; 22: 55.
- Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361-70.
- Calin A, Garrett S, Whitelock H, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 1994; 21: 2281-85.
- Duruöz MT, Doward L, Turan Y, et al. Translation and validation of the Turkish version of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. Rheumatol Int 2013; 33: 2717-22.
- Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics 1993; 4: 353-65.
- 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 (Oxford) 2010; 49: 812-9.
- Cakar E, Taskaynatan MA, Dincer U, Kiralp MZ, Durmus O, Ozgül A. Work disability in ankylosing spondylitis: differences among working and work-disabled patients. Clin Rheumatol 2009; 28: 1309-14.
- Macfarlane GJ, Shim J, Jones GT, Walker-Bone K, Pathan E, Dean LE. Identifying persons with axial spondyloarthritis at risk of poor work outcome: results from the British Society for rheumatology biologics. J Rheumatol 2019; 46: 145-52.
- de Hooge M, Ramonda R, Lorenzin M, et al. Work productivity is associated with disease activity and functional ability in Italian patients with early axial spondyloarthritis: an observational study from the SPACE cohort. Arthritis Res Ther 2016; 18: 265.
- Haglund E, Bremander A, Bergman S, Jacobsson LT, Petersson IF. Work productivity in a population-based cohort of patients with spondyloarthritis. Rheumatology (Oxford) 2013; 52: 1708-14.
- Nikiphorou E, Boonen A, Fautrel B, et al. How do clinical and socioeconomic factors impact on work disability in early axial spondyloarthritis? Five-year data from the DESIR cohort. Rheumatology (Oxford) 2022; 61: 2034-42.
- Nikiphorou E, Carvalho PD, Boonen A, et al. Sick leave in early axial spondyloarthritis: the role of clinical and socioeconomic factors. Five-year data from the DESIR cohort. RMD Open 2021; 7: e001685.
- Espahbodi S, Bassett P, Cavill C, Freeth M, Hole J, Sengupta R. Fatigue contributes to work productivity impairment in patients with axial spondyloarthritis: a cross-sectional UK study. Clin Exp Rheumatol 2017; 35: 571-8.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles [en] Araştırma Makaleleri [tr] |
| Authors | |
| Project Number | Ethics Committee insert number: 09.2018.650 |
| Publication Date | September 26, 2022 |
| Published in Issue | Year 2022 Volume: 3 Issue: 3 |
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