Background Economic indicators assume a growing importance in observational studies and clinical trials; costs related to absenteeism from work (indirect costs) are an essencial part of that equation. Spondyloarthritis (Spa), as chronic diseases, interfere with patients' quality of life, with high direct, indirect and intangible costs, often difficult to quantify.
The Work Productivity and Activity Impairment (WPAI) questionnaire evaluates absenteeism (total number of weekly hours lost at work because of the disease), limitation on labour performance (limitations, although attending work) and overall work impairment due to health.
Objectives To assess labour productivity and absenteeism in a cohort of patients with Spa and their relation with disease duration and activity, functional status, gender and age.
Methods Cross sectional study. Analyzed variables: gender, age and disease duration. WPAI was administered to all patients. BASDAI and BASFI were assessed in patients with axial spondyloarhritis (aSpa), as well as DAS28 in patients with peripheral spondyloarthritis (pSpa). Statistical analysis performed with SPSS® version 18.0.
Results aSpa - 38 patients were enrolled, 22 males and 16 females, with a mean age of 42.6±15.9 years old and a mean disease duration of 10.16±11.13 years. Mean BASDAI value was 4.36±2.32 and mean BASFI value was 3.67±2.55. Thirty patients were active and worked for pay (79%). WPAI – mean work time missed percent was 12.45±6% (absenteeism); WPAI – mean impairment while working due to health was 45±19%; WPAI – mean overall work impairment due to health was 51.3±18.44%. There was a statistically significant relation between BASDAI and BASFI and the work impairment indexes, as well as between WPAI – overall work impairment and older age (p<0.01). No relation was found between WPAI indexes and disease duration in aSpa.
pSpa – 42 patients were enrolled, 28 males and 14 females, with a mean age of 51.7±11.5 years old and a mean disease duration of 7.66±8.79 years. Mean DAS28 value was 2.5±1.1. Thirty one patients were active and worked for pay (73.8%). WPAI – mean work time missed percent was 7.98±7.2%; WPAI – mean impairment while working due to health was 30±14.6%; WPAI – mean overall work impairment due to health was 35.02±16.7%. There was a statistically significant relation between disease activity and all the work impairment indexes; neither statistically significant correlation between WPAI indexes and older age nor statistically significant difference between genders were identified. No relation was found between WPAI indexes and disease duration in pSpa.
Conclusions The results reached in this study are consistent with literature data. We identified a high percentage of patients with work impairment and absenteeism arising from disease activity, especially in aSpa group. In this cohort, we also verified that overall work impairment is due more to disability than to absenteeism.
The impact of rheumatic deseases in labour activity cannot be underestimated, particularly when talking about patients with spondyloarthritis, who are frequently young aged.
Haglund E, Bremander AB, Bergman S, Jacobsson LTH, Petersson IF; Work productivity in a population-based cohort of patients with spondyloarthritis; Rheumatology. 2013; 52(9):1708-1714
Disclosure of Interest None declared