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Abstract
Background: Work disability (WD) and presenteeism (decreased at-work productivity) are often caused by arthritis, leading to major impact on individuals’ quality of life and cost to society.
Objectives: Our study objective was to identify the determinants of presenteeism in workers with inflammatory arthritis.
Methods: Baseline data from the randomized controlled trial of an employment intervention, the Making-it-WorkTMprogram, were used. Participants were recruited from British Columbia, Alberta and Ontario. Inclusion criteria: diagnosis of inflammatory arthritis, currently employed, age 18-59, and having concerns about arthritis affecting ability to work. The primary outcome, presenteism, was assessed using the% impaired while at work subscale of the Work Productivity and Activity Impairment scale for Specific Health Problem (WPAI-SHP). First, the association between potential explanatory variables and WPAI was assessed in bivariate analyses. Variables evaluated included: 1) sociodemographic variables: age, gender, ethnicity, marital status, education, children under age 19; 2) disease variables: IA diagnosis, disease duration, number of limiting comorbidities, global assessment of disease activity (VAS), joint pain (VAS), Disease activity [Rheumatoid Arthritis Disease Activity Index (RADAI)], physical function (HAQ II), Fatigue [VAS, Global Fatigue Index from the Multidimensional Assesment of Fatigue (MAF)], Sleep quality [Insomnia Severity Index (ISI), Depression (Patient Health Questionnaire – PHQ-9); 3) work variables: physical demand, job autonomy, difficulty commuting to/from work, job spillover, job strain, psycho-social work characteristics [Job Content Questionnaire (JCQ) decision latitude, physical and psychological job demands, social support at work], self-employment, family support of decision to work, importance of working. Variables correlated with WPAI-SHP at p ≤ 0.20 were selected for inclusion in the multivariable linear regression analysis, using stepwise selection with alpha of 0.15.
Results: The sample included 565 participants [49% with RA, 17% PsA, 14% SLE, 20% AS] with median (IQR) arthritis duration of 7(3-15) years; mean (SD) age 45.6 (10) years; 43% were 50 years or older; 78% were females; 76% had completed post secondary education; 17% were self-employed. Multivariable linear regression analyses revealed that age < 30 (vs.age 30-49, p=0.067; vs. age ≥ 50, p=0.266), having more fatigue (GFI-MAF) (p<0.001), job strain (p=0.011), job spill over (p=0.002), disease activity (RADAI) (p<0.001), poor family support for working (p=0.049), poor physical function (HAQ II) (p=0.077) and commuting difficulty (p=0.081) were associated with greater impairment in work productivity.
Conclusion: This study identified important sociodemographic, disease and work-related factors associated with reduced productivity at work in people with inflammatotry arthritis. These results provide useful information to health professionals counselling patients on dealing with employment issues.
References [1] Carruthers, et al.
[2] “Employment and arthritis: making it work” a randomized controlled trial evaluating an online program to help people with inflammatory arthritis maintain employment (study protocol). BMC Medical Informatics and Decision Making 2014 14:59
Disclosure of Interests: André Luquini: None declared, Diane Lacaille Grant/research support from: Bristol-Myers Squibb and Eli Lilly Canada, Eric C. Sayre: None declared, Rebecca Schnurr-Howsam: None declared