Background The average age at onset of axial spondyloarthritis (axSpA) is between 20 and 40 years, an age group wherein work plays an important role in a person's life. However very little is known about work participation in axSpA patients. Chronic low back pain (CLBP) is often the first symptom of axSpA, therefore it would be interesting to know whether axSpA patients, both Ankylosing Spondylitis and non-radiographic axSpA (nr-axSpA), differ from CLBP patients, without axSpA, in work participation.
Objectives To assess the impact of axSpA patients (both AS and nr-axSpA) compared to CLBP patients on work participation, expressed in absenteeism and presenteeism.
Methods For this study we used all patients of the cross-sectional CaFaSpA 2 study.(1) Primary care patients (18-45 years) having CLBP were invited to participate. Participants were examined on the presence of axSpA (AS and nr-axSpA) based on the ASAS criteria. Demographics, Roland Morris Disability Questionnaire (RMDQ), BASDAI and ASDAS were collected. The work participation during the past 7 days was measured by the Work Productivity and Activity Impairment (WPAI) questionnaire.(2) Four sub scores were derived; percentage of absenteeism (a patient is unable to attend their work), percentage of presenteeism (reduced productivity while at work), overall percentage of work impairment (combines absenteeism and presenteeism) and percentage of impairment in activities performed outside of work.
Results In total 579 patients participated, (41% male, mean age 35.9 years (SD 7.0)). None of the patients had ever been referred to the rheumatologist or diagnosed with axSpA. Of all patients, 412 patients (71.2%) were employed. In the working population the mean absenteeism was 6.2%, mean presenteeism was 26.0%, mean work impairment was 29.7%. In Table 1 the results of AS, nr-axSpA and non-specific CLBP patients are shown.
Conclusions To the best of our knowledge is this the first study that looked into the absenteeism and presenteeism in axSpA patients. AS patients have more absenteeism, presenteeism, work and activity impairment than nr-axSpA and CLBP patients. Non-specific CLBP patients have more worse work outcomes than nr-axSpA patients.
van Hoeven L., et al. EULAR 2013 poster.
Reilly MC et al, PharmacoEconomics 1993; 4(5):353-65.
Disclosure of Interest : L. Van Hoeven: None declared, A. Boonen: None declared, M. Hazes: None declared, A. Weel Grant/research support: Unrestricted grant from Abbvie