Assessment of work disability in seronegative spondyloarthritis. 2010

S Rohekar, and J Pope
St. Joseph's Health Care, Department of Rheumatology, London, Ontario, Canada. sherry.rohekar@sjhc.london.on.ca

OBJECTIVE Seronegative spondyloarthropathy (SpA) such as ankylosing spondylitis (AS) affects patients during their working years and may contribute to work disability (WD). We determined the prevalence of WD (not working due to illness) and limitations in work productivity in AS using surveys, including the Work Limitations Questionnaire (WLQ). METHODS This cross sectional study consisted of 203 patients with SpA received a mailed questionnaire asking about work status, the WLQ, HAQ, BASDAI, BASFI, BAS-G and Functional Comorbidity Index. Relationships between WD, WLQ, demograghics and disease activity were assessed through bivariate correlations and independent t-tests. RESULTS Response rate was 40%; 64% had AS; 18.5% were work disabled. Those with WD were significantly older than non-WD, and had significantly higher scores on BASFI, BAS-G and patient global assessment of health. WD also had significantly more comorbid diseases than non-WD. WD prevalence was not associated with current longer duration of disease, higher HAQ scores or higher BASDAI scores. Using the WLQ, the average decrease in work productivity attributable to health was 8.3%. Decreases in time management (37.3%), physical demands (28.5%), mental-interpersonal demands (23.0%) and output (33.1%) were noted. Reduced productivity was not associated with demographic factors. Productivity loss for those still working was highly correlated (r>0.6) with the HAQ, BASFI, BASDAI, and BAS-G. Subjects with primary AS had less WD than those with other SpA (related to psoriasis, inflammatory bowel disease or reactive arthritis). WD was associated with older age and, HAQ scores and self-reported function on the BASFI. Losses in work productivity in those still working were highly correlated with the HAQ, BASFI, BASDAI and BAS-G. AS had less work disability than other SpA. Adjusting for gender, age, and duration of diseased did not affect the results. CONCLUSIONS WD occurred in 18.5% of SpA, and work productivity (in those working) was reduced by 8.3%. WD was associated with older age and greater SpA disease activity. Losses in work productivity were highly correlated with currently used clinical outcome measures such as HAQ, BASFI, BASDAI and BAS-G.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009864 Ontario A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D004185 Disability Evaluation Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits. Disability Evaluations,Evaluation, Disability,Evaluations, Disability
D004651 Employment The state of being engaged in an activity or service for wages or salary. Employment Termination,Employment Status,Labor Force,Occupational Status,Status, Occupational,Underemployment,Labor Forces,Status, Employment,Termination, Employment
D005260 Female Females
D006304 Health Status The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. General Health,General Health Level,General Health Status,Level of Health,Overall Health,Overall Health Status,General Health Levels,Health Level,Health Level, General,Health Levels,Health Status, General,Health Status, Overall,Health, General,Health, Overall,Level, General Health,Levels, General Health,Status, General Health,Status, Health,Status, Overall Health
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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