Objectives To examine the extent and cost of work disability among patients with gout compared with matched population controls and to analyse predictors of work disability.
Methods A regional cohort study using data from Swedish national and regional registries from January 2000 through December 2012, including 4571 patients with gout of working age, with a first recorded diagnosis of gout in the years 2003–2009 and 22 482 population controls, matched by age, sex and place of residence. Differences in baseline characteristics (educational level, income, previous employment and comorbidities) and the number of work-loss days (absenteeism) due to sick leave and disability pension for 3 years after identification were calculated. Predictors for new-onset work absenteeism (>90 days/year) in a subset were determined by conditional logistic regression.
Results Patients with gout (median age 53 years) had significantly more comorbidities, lower income and lower level of education than matched controls. The average work absentee rate during the 3-year follow-up period was higher among patients with gout than controls, 22% and 14%, respectively (P<0.0001). New-onset absenteeism was in multivariate analyses significantly predicted by gout (OR 1.47; 95% CI 1.23 to 1.75). Other variables independently related to new-onset absenteeism were education ≤12 years, previous unemployment and history of sick leave, in addition to several comorbidities (renal disease, cardiovascular disease, alcohol abuse and obesity).
Conclusions Gout is associated with substantially higher work absenteeism and costs for society due to productivity loss, after adjusting for associated comorbidities and socioeconomic differences. Whether more intensive treatment of gout is cost-effective needs to be addressed in future studies.
- economic evaluations
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Handling editor Tore K Kvien
Contributors All authors were involved in the conception and design of the study. LJ and MD contributed to the acquisition of the data. All authors contributed to analysis and interpretation of the data and take responsibility for the integrity of the data and the accuracy of the analyses. All authors participated in the drafting of the manuscript or revised it critically for intellectual content. All authors approved the final version to be published.
Funding This study was supported by grants from The University of Gothenburg and The Swedish Rheumatism Association.
Competing interests None declared.
Ethics approval Ethical Review Board of Gothenburg, Sweden.
Provenance and peer review Not commissioned; externally peer reviewed.
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