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THU0613 Exploring the impact of health status and well-being of people with inflammatory arthritis on presenteeism in the workplace: a qualitative study
  1. CJ Jones1,
  2. K Payne1,
  3. B Gannon2,
  4. S Verstappen3
  1. 1Manchester Centre for Health Economics, The University of Manchester, Manchester, United Kingdom
  2. 2Mater Research Institute Chair in Health Economics, Centre for Business and Economics of Health, Brisbane, Australia
  3. 3Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Manchester, United Kingdom


Background Presenteeism can be defined as the reduction in work performance due to ill-health at the workplace. Musculoskeletal conditions, including inflammatory arthritis (IA), are one of the most common causes for presenteeism. There are no “gold standard” methods to identify, measure, or value the impact of presenteeism. Some evidence suggests the impact of presenteeism can be indirectly estimated using measures of health status and well-being.

Objectives To explore whether selected measures of health status and well-being, commonly used in economic evaluations are conceptually useful to capture those aspects of IA that are associated with presenteeism.

Methods A sample of individuals, aged 18 years and above, working in the UK with rheumatoid arthritis (RA), ankylosing spondylitis (AS), or psoriatic arthritis (PsA), was recruited via patient support groups. Semi-structured telephone interviews were designed to understand if, and how, RA, AS or PsA affects an individual's ability to work. Framework Analysis Methods were used and coding involved deductive and inductive approaches. A deductive approach was used to derive potential themes from measures of health status [EuroQol-5 Dimension-5 level (EQ5D-5L) and Short Form 6 Dimension (SF6D)], and well-being [(ICEpop CAPability measure for Adults (ICECAP-A)]. An inductive approach was used to generate other themes not captured by these measures.

Results Twenty-two employed individuals with RA (n=10), AS (n=9) or PsA (n=3) were interviewed; 82% were female and, of the 22 patients, 23% had a manual job. The majority of interviewees explained that symptoms of the conditions increase levels of presenteeism, including: pain; stiffness; fatigue; emotional mental health; mental clarity. These symptoms make completing activities at work difficult, which, in turn, affects an individual's capability to maintain a successful career. The ICECAP-A was found to be a useful measure to capture the overall impact of presenteeism resulting from RA, AS or PsA. The SF6D and EQ5D were more specific measures capturing particular symptoms and activities that increase levels of presenteeism (see Table 1).

Table 1

Two further themes were identified using inductive methods: mental clarity and feeling understood. The effect of mental clarity or feeling understood is not captured by any of the domains in EQ-5D-5l or SF6D. The ICECAP-A is potentially able to capture the impact of these themes in the respective domains ability to achieve and progress and ability to gain support.

Conclusions This study suggests that three existing measures (EQ5D, SF6D, and ICECAP-A) were successful, in different degrees, to capture the impact of presenteeism that result from the aspects and symptoms of IA. Potentially, these measures may be used in economic evaluations to capture the impact of presenteeism.

Acknowledgements This work was supported by Arthritis Research UK and the Medical Research Council [20665]

Disclosure of Interest None declared

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