Absenteeism and Presenteeism in Rheumatoid Arthritis, Axial Spondyloarthritis, and Psoriatic Arthritis: Relationship with Fatigue and Clinical Parameters

Year 2021, Volume: 54 Issue: 2, 313 - 320, 31.08.2021

İsmihan Sunar , Yeşim Garip , Şebnem Ataman

https://doi.org/10.20492/aeahtd.940851

Abstract

Aim: Rheumatic diseases cause economic burden due to apparently costs along with indirect costs including productivity loss. This study aims to assess work productivity in axial spondyloarthritis (SpA), rheumatoid arthritis (RA), and psoriatic arthritis (PsA), and determine its relation with fatigue, disease activity, depression, and quality of life.
Material and Method: This cross-sectional study included 42 SpA, 36 PsA, 34 RA patients, and 30 controls. The number of swollen and tender joints, erythrocyte sedimentation rate, and C-reactive protein were recorded. Disease activity was determined by the Bath Ankylosing Spondylitis Disease Activity Index for SpA, Disease Activity in Psoriatic Arthritis for PsA, and Disease Activity Score-28 for RA. The Stanford Health Assessment Questionnaire, Short Form-36, Fatigue Symptom Inventory, and Beck Depression Inventory were performed. Pain was measured using the Visual Analog Scale. The Work Productivity and Activity Impairment scale was administered for work productivity. Logistic regression analysis was used to determine factors affecting work productivity. Correlations were assessed by Spearman’s correlation coefficient.
Results: The rate of employment was 83.3% in SpA, 52.8% in PsA, 61.8% in RA, and 93.3% in controls. The percentage of absenteeism was higher in SpA and PsA. Percentage of presenteeism, percent total work impairment caused by health problems, and percent activity impairment due to health problems were higher in SpA, PsA, and RA patients than controls (p<0.05). Regression analysis revealed the impact of functionality on percentage of absenteeism and presenteeism; and pain severity on absenteeism (p<0.001, p=0.02, and p=0.02 respectively). Age, gender, and disease activity had no impact on absenteeism or presenteeism (p>0.05).
Conclusion: We have found high percentage of presenteeism in all patient groups and high percentage of absenteeism in SpA and PsA patients compared to controls. We observed impact of functionality on percentage of absenteeism and presenteeism; whereas pain affected the percentage of absenteeism.

Keywords

presenteeism, rheumatoid arthritis, spondyloarthritis, absenteeism, work productivity, psoriatic arthritis

Supporting Institution

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Project Number

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Thanks

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Romatoid Artrit, Aksiyel Spondiloartrit ve Psöriatik Artritte İş Gücü Kaybı: Yorgunluk ve Diğer Klinik Parametrelerle İlişkisi

Abstract

Amaç
Romatizmal hastalıklar doğrudan maliyetlerin yanısıra iş gücü kaybına bağlı indirekt maliyetler ile de ekonomik yüke neden olurlar. Bu çalışmada Romatoid Artrit (RA), Aksiyel Spondiloartrit (SpA) ve Psöriatik Artrit (PsA) hastalarında iş gücü kaybının değerlendirilmesi ve yorgunluk, hastalık aktivitesi, depresyon ve hayat kalitesi ile ilişkisinin araştırılması amaçlanmıştır.
Gereç ve yöntem
Bu kesitsel vaka-kontrol çalışmasına 42 SpA, 36 PsA, 34 RA hastası ve 30 sağlıklı kontrol dahil edilmiştir. Hassas ve şiş eklem sayısı, eritrosit sedimentasyon hızı (ESH), C-Reaktif protein düzeyleri kaydedildi. Hastalık aktivitesinin belirlenmesi amacıyla RA hastalarında DAS28 (Disease Activity Score 28), SpA hastalarında BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), PsA için ise DAPSA (Disease Activity in Psoriatic Arthritis for PsA) kullanıldı. Tüm hasta gruplarına fonksiyonel durum, hayat kalitesi, yorgunluk ve depresyonun değerlendirilmesi için HAQ (The Stanford Health Assessment Questionnaire), Short Form-36 (SF-36), Yorgunluk Semptom Envanteri (Fatigue Symptom Inventory) ve Beck Depresyon anketi uygulandı. Ağrı görsel analog skala ile, iş gücü kaybı ise WPAI (Work Productivity and Activity Impairment) ile değerlendirildi.
Bulgular
Çalışma oranı SpA hastalarında %83.33, PsA’da %52.8, RA’da %61.8 ve kontrollerde %93.3 olarak belirlendi. Işte var olamama sorunu (presenteeism) ve işe devamsızlık (absenteeism) SpA ve PsA hastalarında kontrollerden daha yüksekti. İşte var olamama yüzdesi, sağlık problemlerine bağlı toplam iş gücü kaybı ve sağlık problem nedenli aktivite bozukluk yüzdeleri RA, PsA ve SpA hastalarında kontrollerden yüksekti (p<0.05). Regresyon analizi fonksiyonelliğin presenteeism ve absenteeism üzerine, ağrı şiddetinin ise absenteeism üzerine etkisi olduğunu gösterdi (sırasıyla p<0.001, p=0.02, ve p=0.02). Yaş, cinsiyet ve hastalık aktivitesinin absenteeism ve presenteeism üzerinde etkisi olmadığı görüldü (p>0.05).
Sonuç
Çalışmamızda kontrollerle kıyaslandığında RA, SpA ve PsA hastalarında yüksek işte var olamama sorunu ve SpA ve PsA hastalarında artmış işe devamsızlık yüzdesi saptadık. Fonksiyonel kapasitenin işe devamsızlık ve iste var olamama sorunu üzerine, ağrı düzeyinin ise işe devamsızlık üzerine etkisi olduğu gözlendi.

Keywords

presenteeism, romatoid artrit, psöriatik artrit, iş gücü, absenteeism, spondiloartrit

Project Number

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