Background Previous studies have shown that up to 24% of primary care patients are misdiagnosed as chronic low back pain (CLBP) while actually having axial spondyloarthritis (axSpA). It is well known that axSpA affects employment, sick leave and presenteeism. However little is known about the association between disease activity and work participation in newly diagnosed axSpA patients.
Objectives To examine the association between work productivity and disease activity in newly diagnosed axSpA patients.
Methods Our study population included patients (18-45 years) newly diagnosed with axSpA by the ASAS criteria from a Dutch cross-sectional study in primary care patients with CLBP. Disease activity was measured by BASDAI and ASDAS. Work participation assessed in the past 7 days using the Work Productivity and Activity Impairment (WPAI) questionnaire. Four sub scores (all percentages) can be derived; absenteeism (% work time lost), presenteeism (% productivity loss at work, score 0-10), work impairment (combines absenteeism and presenteeism) and activity impairment (% activity loss, score 0-10). Higher percentages indicates worse outcomes. Univariable logistic regressions were used to test for associations between covariates and ‘any restriction’ in each sub score of the WPAI.
Results 95 newly diagnosed axSpA patients participated (38% male, mean age 37 years), after screening for axSpA in primary care CLBP patients. (Table 1) Already 25 (26%) patients (all in working age) were not employed. In the employed patients 11% (n=7) reported absenteeism, 49% (n=34) reported presenteeism, 53% (n=37) reported work impairment. In all axSpA patients, 67% (n=62) reported activity impairment. The univariate logistic regression, distinguish no from “any” absenteeism, presenteeism, work and activity impairment shows that a higher ASDAS score is associated with increased presenteeism, work and activity impairment. (Figure 1) A higher BASDAI score is associated with increased work and activity impairment.
Conclusions Higher disease activity is associated with absenteeism and reduced work productivity in newly diagnosed axSpA patients. ASDAS seems to perform somewhat better than BASDAI.
Acknowledgements An unrestricted research grant was provided by AbbVie.
Disclosure of Interest None declared