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J Rheumatol. 2010 Sep;37(9):1805-14. doi: 10.3899/jrheum.100123. Epub 2010 Jul 1.

Productivity loss due to presenteeism among patients with arthritis: estimates from 4 instruments.

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Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital and School of Population and Public Health, University of British Columbia, Vancouver, British Columbia.



To estimate and compare lost work hours attributable to presenteeism, defined as reduced productivity while working, in individuals with osteoarthritis (OA) or rheumatoid arthritis (RA), according to 4 instruments.


In our prospective study, 250 workers with OA (n = 130) or RA (n = 120) were recruited from community and clinical sites. Lost hours due to presenteeism at baseline were estimated using the Health and Labor Questionnaire (HLQ), the Work Limitations Questionnaire (WLQ), the World Health Organization's Health and Work Performance Questionnaire (HPQ), and the Work Productivity and Activity Impairment Questionnaire (WPAI). Only those respondents working over the past 2 weeks were included. Repeated-measures ANOVA was used to compare the lost-time estimates, according to each instrument.


Of the 212 respondents included in the analyses, the frequency of missing and "0" values among the instruments was different (17% and 61% for HLQ, 8% and 5% for WLQ, 1% and 16% for HPQ, 0% and 27% for WPAI, respectively). The average numbers of lost hours (SD) per 2 weeks due to presenteeism using HLQ, WLQ, HPQ, and WPAI were 1.6 (3.9), 4.0 (3.9), 13.5 (12.5), and 14.2 (16.7). The corresponding costs for the 2-week period were CAN$30.03, $83.05, $284.07, and $285.10. The differences in the lost-hour estimates according to instruments were significant (p < 0.001).


Among individuals with arthritis, estimates of productivity losses while working vary widely according to the instruments chosen. Further research on instrument design and implications for a standardized approach to estimate lost time due to presenteeism is needed.

[Indexed for MEDLINE]

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