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J Rheumatol. 2015 Jan;42(1):93-100. doi: 10.3899/jrheum.131287. Epub 2014 Nov 1.

Understanding limitations in at-work productivity in patients with active ankylosing spondylitis: the role of work-related contextual factors.

Author information

1
From the Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Research Institute Maastricht University, Maastricht, the Netherlands; Medical Department, Pfizer, Brussels; Department of Medical Informatics and Biostatistics, University of Liège, Liège; Department of Rheumatology, Ghent University, Ghent, Belgium.A. Boonen, Professor of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and the Caphri Research Institute Maastricht University; C. Boone, PharmD, Medical Advisor Inflammation, GIP, Medical Department, Pfizer; A. Albert, PhD, Professor Emeritus, Department of Medical Informatics and Biostatistics, University of Liège; H. Mielants, Professor of Rheumatology, Department of Rheumatology, Ghent University. a.boonen@mumc.nl.
2
From the Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Research Institute Maastricht University, Maastricht, the Netherlands; Medical Department, Pfizer, Brussels; Department of Medical Informatics and Biostatistics, University of Liège, Liège; Department of Rheumatology, Ghent University, Ghent, Belgium.A. Boonen, Professor of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and the Caphri Research Institute Maastricht University; C. Boone, PharmD, Medical Advisor Inflammation, GIP, Medical Department, Pfizer; A. Albert, PhD, Professor Emeritus, Department of Medical Informatics and Biostatistics, University of Liège; H. Mielants, Professor of Rheumatology, Department of Rheumatology, Ghent University.

Abstract

OBJECTIVE:

To explore the effect of health-related and contextual factors on presenteeism, absenteeism, and overall work productivity loss in patients with active ankylosing spondylitis (AS).

METHODS:

Consecutive patients with AS starting their first tumor necrosis factor inhibitor and in paid employment were eligible. Patients completed the Work Productivity and Activity Impairment (WPAI) questionnaire for AS to assess presenteeism, absenteeism, and overall work productivity loss in the previous 7 days. In addition, they answered questions about work characteristics (type, characteristics of workplace, satisfaction of contacts with colleagues, and importance of work in life) and health status [Bath AS Functional Index (BASFI), AS Disease Activity Score-C-reactive protein (ASDAS-CRP)]. Physicians assessed the Bath Ankylosing Spondylitis Metrology Index, presence of articular and extraarticular manifestations, comorbidities, and laboratory indicators of inflammation. Stepwise regression models were computed to determine which work-related and health-related factors contributed to WPAI outcomes.

RESULTS:

The study included 80 patients. The WPAI presenteeism, absenteeism, and overall work productivity loss scores were 49.1%, 30.2%, and 53.1%, respectively. Presenteeism was associated with higher BASFI, female sex, and poor quality of contact with colleagues. Absenteeism was associated with increasing age, current smoking status, higher ASDAS-CRP, and low importance of work for life. Overall work productivity loss was associated with female sex, higher BASFI, past adaptation of job because of illness, number of working hours, and manual profession.

CONCLUSION:

Both health-related and contextual factors contribute to work limitations in patients with AS and suggest additional opportunities for improvement by addressing the working environment.

KEYWORDS:

ABSENTEEISM; ANKYLOSING SPONDYLITIS; WORK

PMID:
25362661
DOI:
10.3899/jrheum.131287
[Indexed for MEDLINE]

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