Background Spondyloarthritis (SpA) causes impaired function, activity limitation, decreased health related quality of life and work disability. Little is known of the relations between registered sick leave and self-reported productivity limitations and associations with disease severity, functioning and general health.
Objectives To study self reported productivity at work and registered sick leave and associated factors expected to influence the productivity and sick leave in patients with SpA also related to subgroups.
Methods A questionnaire survey was performed in 2009 including all health care seeking subjects aged ≥18 years with a diagnosis of SpA (according to specified ICD 10 codes during the years 2003 to 2007) in the Skane Region, Sweden (n=3711) identified by a regional health care register. The questionnaires included self-reported presenteeism (from the WPAI questionnaire) defined as the percentage reduced productivity while working (0-100), 0=no impact on productivity level). Register data of sick leave from a 3 month period including the survey response date was obtained from the Swedish Social Insurance Agency. Evaluated possible associated factors were age, disease duration, disease activity (BASDAI) physical function (BASFI), health related quality of life (EQ5D), anxiety (HAD-A), depression (HAD-D) and ASES pain and symptom.
Results Response rate was 77% whereof 684 patients (18%) declined participation and 2167 (58%), returned the questionnaire. Out of these, 1821 SpA patients in working age (18-67 years), mean age 50 years and 48% men were included in the analysis. Disease duration was mean 13 years (SD 10), mean EQ5D score was 0.75 (SD 0.16), BASDAI mean 4.4 (SD 2.2) and BASFI mean 3.0 (SD 2.4).
Self-reported productivity limitation at work was mean 43% (95% CI 40-45) with statistically non-significant differences between men and women and between disease subgroups. Sick leave levels ranged from 0-91 days per three months, mean 20 days (95% CI 19-21). Patients with the subtype psoriatic arthritis had the lowest level of sick leave days (table).
In correlation analysis, factors associated with self-reported productivity limitation in patients with SpA were EQ5D r= -0.47 (p<0.001), BASDAI r=0.55 (p<0.001), BASFI r=0.55 (p<0.001), while none of the studied variables correlated to sick leave (r <0.07).
Conclusions Self reported productivity loss at work was associated with lower levels of health-related quality of life, increased self-reported disease activity and impaired function while there were no associations with registered levels of sick leave. The results indicate that self reported productivity and sick leave capture different dimensions of work and absence in patients with SpA.
Disclosure of Interest None Declared
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