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

William Tillett; Gavin Shaddick; Ayman Askari; Annie Cooper; Paul Creamer; Gavin Clunie; Philip S Helliwell; Lesley Kay; Eleanor Korendowych; Suzanne Lane; Jonathan Packham; Ragai Shaban; Lyn Williamson; Neil McHugh

doi:10.1093/rheumatology/keu264

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.

Affiliations

¹ Royal National Hospital for Rheumatic Diseases, Department of Mathematics, University of Bath, Bath, Department of Rheumatology, Robert Jones and Agnes Hunt Hospital, Shropshire, Department of Rheumatology, Royal Hampshire County Hospital, Winchester, Department of Rheumatology, North Bristol NHS Foundation Trust, Bristol, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, NIHR Leeds Biomedical Research Unit, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Department of Rheumatology, Ipswich Hospital NHS Trust, Ipswich, Haywood Rheumatology Centre, Stoke-on-Trent, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon and University of Bath, Department of Pharmacy and Pharmacology, Bath, UK. w.tillett@nhs.net.
² Royal National Hospital for Rheumatic Diseases, Department of Mathematics, University of Bath, Bath, Department of Rheumatology, Robert Jones and Agnes Hunt Hospital, Shropshire, Department of Rheumatology, Royal Hampshire County Hospital, Winchester, Department of Rheumatology, North Bristol NHS Foundation Trust, Bristol, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, NIHR Leeds Biomedical Research Unit, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Department of Rheumatology, Ipswich Hospital NHS Trust, Ipswich, Haywood Rheumatology Centre, Stoke-on-Trent, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon and University of Bath, Department of Pharmacy and Pharmacology, Bath, UK.
³ Royal National Hospital for Rheumatic Diseases, Department of Mathematics, University of Bath, Bath, Department of Rheumatology, Robert Jones and Agnes Hunt Hospital, Shropshire, Department of Rheumatology, Royal Hampshire County Hospital, Winchester, Department of Rheumatology, North Bristol NHS Foundation Trust, Bristol, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, NIHR Leeds Biomedical Research Unit, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Department of Rheumatology, Ipswich Hospital NHS Trust, Ipswich, Haywood Rheumatology Centre, Stoke-on-Trent, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon and University of Bath, Department of Pharmacy and Pharmacology, Bath, UK. Royal National Hospital for Rheumatic Diseases, Department of Mathematics, University of Bath, Bath, Department of Rheumatology, Robert Jones and Agnes Hunt Hospital, Shropshire, Department of Rheumatology, Royal Hampshire County Hospital, Winchester, Department of Rheumatology, North Bristol NHS Foundation Trust, Bristol, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, NIHR Leeds Biomedical Research Unit, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, Department of Rheumatology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Department of Rheumatology, Ipswich Hospital NHS Trust, Ipswich, Haywood Rheumatology Centre, Stoke-on-Trent, Department of Rheumatology, Queen Alexandra Hospital, Portsmouth, Department of Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon and University of Bath, Department of Pharmacy and Pharmacology, Bath, UK.

PMID: 25125591
DOI: 10.1093/rheumatology/keu264

Abstract

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