Factors influencing work disability in psoriatic arthritis: first results from a large UK multicentre study

Rheumatology (Oxford). 2015 Jan;54(1):157-62. doi: 10.1093/rheumatology/keu264. Epub 2014 Aug 13.


Objective: The aim of this study was to determine the extent to which structural damage, clinical disease activity, demographic and social factors are associated with work disability (WD) in PsA.

Methods: Four hundred patients fulfilling CASPAR (Classification Criteria for Psoriatic Arthritis) criteria for PsA were recruited from 23 hospitals across the UK. Demographic, socio-economic, work, clinical and radiographic data were collected. WD was assessed with the Work Productivity and Activity Impairment Specific Health Problem (WPAI-SHP) questionnaire reporting WD as a percentage of absenteeism (work time missed), presenteeism (impairment at work/reduced effectiveness) and work productivity loss (overall work impairment/absenteeism plus presenteeism). Logistic and linear regressions were conducted to investigate associations with WD.

Results: Two hundred and thirty-six participants of any age were in work. Absenteeism, presenteeism and productivity loss rates were 14% (s.d. 29.0), 39% (s.d. 27.2) and 46% (s.d. 30.4), respectively. Ninety-two (26%) participants of working age were unemployed. Greater age, disease duration of 2-5 years and worse physical function were associated with unemployment. Patients reported that employer awareness and helpfulness exerted a strongly positive influence on remaining in employment. Higher levels of global and joint-specific disease activity and worse physical function were associated with greater levels of presenteeism and productivity loss among those who remained in work.

Conclusion: Reduced effectiveness at work was associated with measures of disease activity, whereas unemployment, considered the endpoint of WD, was associated with employer factors, age and disease duration. A longitudinal study is under way to determine whether treatment to reduce disease activity ameliorates WD in the real-world setting.

Keywords: employment; psoriatic arthritis; work disability.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism*
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Arthritis, Psoriatic* / physiopathology
  • Arthritis, Psoriatic* / psychology
  • Cohort Studies
  • Disability Evaluation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Activity / physiology
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Unemployment / psychology
  • United Kingdom
  • Work Capacity Evaluation*
  • Young Adult