Evaluating loss of productivity in patients with rheumatoid arthritis and its relationship to clinical parameters

Evaluating loss of productivity in patients with rheumatoid arthritis and its relationship to clinical parameters

Aim: This study investigated loss of productivity of working women and housewives with rheumatoid arthritis (RA) and analyzed the correlation of this loss with disease activity parameters and health-related quality of life.Material and Methods: The study enrolled consecutive patients presenting to rheumatology outpatient clinic between April 2016 and September 2016 who met the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) RA classification criteria. Disease activity with the Disease Activity Score (DAS-28) as it pertains to C-reactive protein (CRP), functional status with the Duruöz hand index, activities of daily life with the Health Assessment Questionnaire (HAQ), and health-related quality of life with the short-form 36 (SF-36) questionnaire.Results: This study included 82 RA patients (56 women, 26 men) who were followed in our rheumatology outpatient clinic, and 29 healthy controls (24 women, 5 men) who were patient accompanists and patient visitors. We found no difference between housewives and employed women with RA in terms of disease activity, productivity in daily activities, anxiety, or depression, but patients with RA had higher pain, fatigue, and anxiety scores than healthy controls. Loss of productivity in daily activities was found to be correlated with disease activity and fatigue.Conclusions: In conclusion, disease activity, quality of life, and functional status are equally important in RA patients who work as housewives or in the workforce. Emotional status has an impact, especially on increasing productivity and participation in daily life, and doctors should also examine their patients from this perspective.

___

  • Soósová SM, Macejová Z, Zamboriová M, et al. Anxiety and depression in slovak patients with rheumatoid arthritis. J Ment Health 2017;26:21-7.
  • Murphy LB, Sacks JJ, Brady TJ, et al. Anxiety and depression among US adults with arthritis: prevalence and correlates. Arthritis Care Res (Hoboken) 2012;64:968-76.
  • Covic T, Cumming SR, Pallant JF, et al. Depression and anxiety in patients with rheumatoid arthritis: Prevalence rates based on a comparison of the depression, anxiety and stress scale (DASS) and the hospital, anxiety and depression scale (HADS). BMC Psychiatry 2012;12:6.
  • Hogrefe JF, Marengo MF, Schneerberger EE, et al. Valor de corte de HAQ para predecir discapacidad laboral en pacientes con artritis reumatoidea. Revista Argentina de Reumatología 2009;2:23-27.
  • Maldonado Ficco H, Pérez Alamino RS, Dal Para F, et al. La discapacidad laboral está relacionada con la presencia de artritis y no con un diagnóstico específico. Revista Argentina de Reumatología, supplement 1, p. 17, 2011.
  • De Croon EM, Sluiter JK, Nijssen TF, et al. Predictive factors of work disability in rheumatoid arthritis: a systematic literature review. Ann Rheumatic Dis 2004;63:1362-7.
  • Sokka T, Pincus T. Markers for work disability in rheumatoid arthritis. J Rheumatol 2001;28:1718-22.
  • Burton W, Morrison A, Maclean R, et al. Systematic review of studies of productivity loss due to rheumatoid arthritis. Occup Med (Lond) 2006;56:18-27.
  • Geuskens GA, Hazes JM, Barendregt PJ, et al. Predictors of sick leave and reduced productivity at work among persons with early inflammatory joint conditions. Scand J Work Environ Health 2008;34:420-9.
  • Chaparro del Moral R, Rillo OL, Casalla L, et al. Work productivity in rheumatoid arthritis: relationship with clinical and radiological features. Arthritis 2012;2012:137635.
  • Mau W, Thiele K, Lamprecht J. [Trends of work force participation of patients with rheumatic diseases: results from German social insurance data and the national database of the German collaborative arthritis centers]. Z Rheumatol 2014;73:11-9.
  • Olofsson T, Petersson IF, Eriksson JK, et al. Predictors of work disability during the first 3 years after diagnosis in a national rheumatoid arthritis inception cohort. Ann Rheum Dis 2014;73:845-53.
  • McWilliams DF, Varughese S, Young A, et al. Work disability and state benefit claims in early rheumatoid arthritis: the ERAN cohort. Rheumatology (Oxford) 2014;53:473-81.
  • Maksymowych WP, Gooch KL, Wong RL, et al. Impact of age, sex, physical function, health-related quality of life, and treatment with adalimumab on work status and work productivity of patients with ankylosing spondylitis. J Rheumatol 2010;37:385-92.
  • Reilly MC, Gooch KL, Wong RL, et al. Validity, reliability and responsiveness of the Work Productivity and Activity Impairment Questionnaire in ankylosing spondylitis. Rheumatology (Oxford) 2010;49:812-9.
  • Prasad M, Wahlqvist P, Shikiar R, et al. A review of selfreport instruments measuring health-related work productivity: a patient reported outcomes perspective. Pharmacoeconomics 2004;22:225-44.
  • Osterhaus JT, Purcaru O. Discriminant validity, responsiveness and reliability of the arthritis-specificWork Productivity Survey assessing workplace and household productivitywithin and outside the home in patients with axial spondyloarthritis, including nonradiographic axial spondyloarthritis and ankylosing spondylitis. Arthritis Res Ther 2014;16:R164.
  • Zhang W, Bansback N, Kopec J, et al. Measuring time in put loss among patients with rheumatoid arthritis: validity and reliability of the valuation of lost productivity questionnaire. J Occup Environ Med 2011;53:530-6.
  • Zhang W, Bansback N, Boonen A, et al. Development of a composite questionnaire, the evaluation of lost productivity, to value productivity losses: application in rheumatoid arthritis. Value Health 2012;15:46-54.
  • Beaton DE, Tang K, Gignac MA, et al. Reliability, validity, and responsiveness of five at-work productivity measures in patients with rheumatoid arthritis or osteoarthritis. Arthritis Care Res (Hoboken) 2010;62:28-37.
  • Tang K, Beaton DE, Boonen A, et al. Measures of work disability and productivity: rheumatoid arthritis specific work productivity survey (WPS-RA), work place activity limitations scale (WALS), work instability scale for rheumatoid arthritis (RA-WIS), work limitations questionnaire (WLQ) and work productivity and activity impairment questionnaire (WPAI). Arthritis Care Res (Hoboken) 2011;63:S337-49.
  • Bru Morón C, Casalla L, Chaparro del Moral R, et al. Productividad laboral en pacientes con artritis reumatoidea. Estudio preliminar, Revista Argentina de Reumatología, supplement 2009. p. 1-28.
  • Reilly Associates, Health Outcomes Research. Work Productivity and Activity Impairment Questionnaire. 2002. Available from: http://www. reillyassociates.net/WPAI_SHP. html. Accepted article: September 25, 2011.
  • Aydemir Ö, Güvenir T, Küey L, Ark. Hastane Anksiyete ve Depresyon Ölçeği Türkçe Formunun Geçerlik Güvenilirlik Çalışması. Türk Psikiyatri Dergisi 1997;8:280-7.
  • Küçükdeveci AA, Sahin H, Ataman S, et al. Issues in crosscultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum 2004;51:14-9.
  • Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). 1. Conceptual framework and item selection. Med Care 1992;30:473-83.
  • Burton W, Morrison A, Maclean R, et al. Systematic review of studies of productivity loss due to rheumatoid arthritis. Occup Med (Lond) 2006;56:18-27.
  • Wallenius M, Skomsvoll JF, Koldingsnes W, et al. Comparison of work disability and health-related quality of life between males and females with rheumatoid arthritis below the age of 45 years. Scand J Rheumatol 2009;38:178-83.
  • Mattila K, Buttgereit F, Tuominen R. Impact of morning stiffness on working behaviour and performance in people with rheumatoid arthritis. Rheumatol Int 2014;34:1751-8.
  • Westhoff G, Buttgereit F, Gromnica-Ihle E, et al. Morning stiffness and its influence on early retirement in patients with recent onset rheumatoid arthritis. Rheumatology (Oxford) 2008;47:980-4.
  • Puolakka K, Kautiainen H, Möttönen T, et al. Predictors of productivity loss in early rheumatoid arthritis: a 5-year follow up study. Ann Rheum Dis 2005;64:130-3.
  • Tiippana-Kinnunen T, Paimela L, Peltomaa R, et al. Work disability in Finnish patients with rheumatoid arthritis: a 15-year follow-up. Clin Exp Rheumatol 2014;32:88-94.
  • Sokka T, Kautiainen H, Möttönen T, et al. Work disability in rheumatoid arthritis 10 years after the diagnosis. J Rheumatol 1999;26:1681-5.
  • Allaire S, Wolfe F, Niu J, et al. Contemporary prevalence and incidence of work disability associated with rheumatoid arthritis in the US. Arthritis Rheum 2008;59:474-80.
  • Sokka T, Kautiainen H, Pincus T, et al. Work disability remains a major problem in rheumatoid arthritis in the 2000s: data from 32 countries in the QUEST-RA study. Arthritis Res Ther 2010;12:R42.
  • Centers for Disease Control and Prevention. About arthritis disabilities and limitations. 2012. Available from: http:// www.cdc.gov/arthritis/data_statistics/disabilitieslimitations.htm. Accepted article: September 30, 2014.
  • Sokka T. Work disability in early rheumatoid arthritis. Clin Exp Rheumatol 2003;21:S71-4.
  • Allaire S, Wolfe F, Niu J, et al. Evaluation of the effect of anti-tumor necrosis factor agent use on rheumatoid arthritis work disability: the jury is still out. Arthritis Rheum 2008;59:1082-9.
  • Maldonado Cocco JA, Citera G, Reumatología, Ediciones Azzurras, Buenos Aires, Argentina, 1 st edition, 2010.