Work participation in spondyloarthritis across countries: analysis from the ASAS-COMOSPA study

Santiago Rodrigues Manica*, Alexandre Sepriano, Sofia Ramiro, Fernando Pimentel Santos, Polina Putrik, Elena Nikiphorou, Sam Norton, Anna Molto, Maxime Dougados, Desiree van der Heijde, Robert B. M. Landewe, Filip E. van den Bosch, Annelies Boonen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objectives To explore the role of individual and country level socioeconomic (SE) factors on employment, absenteeism and presenteeism in patients with spondyloarthritis (SpA) across 22 countries worldwide. Methods Patients with a clinical diagnosis of SpA fulfilling the ASAS classification criteria and in working age (<= 65 years) from COMOSPA were included. Outcomes of interest were employment status, absenteeism and presenteeism, assessed by the Work Productivity and Activity Impairment Specific General Health questionnaire. Three multivariable models were built (one per outcome) using mixed-effects binomial (for work status) or ordinal regressions (for absenteeism and presenteeism), with country as random effect. The contribution of SE factors at the individual-level (eg, gender, education, marital status) and country-level (healthcare expenditure (HCE) per capita, Human Development Index (HDI) and gross domestic product per capita) SE factors, independent of clinical factors, was assessed. Results In total, 3114 patients with SpA were included of which 1943 (62%) were employed. Physical function and comorbidities were related to all work outcomes in expected directions and disease activity also with absenteeism and presenteeism. Higher education (OR 4.2 (95% CI 3.1 to 5.6)) or living in a country with higher HCE (OR 2.3 (1.5 to 3.6)) or HDI (OR 1.9 (1.2 to 3.3)) was positively associated with being employed. Higher disease activity was associated with higher odds for absenteeism (OR 1.5 (1.3 to 1.7)) and presenteeism (OR 2.1 (1.8 to 2.4)). No significant association between individual-level and country-level SE factors and absenteeism or presenteeism was found. Conclusions Higher education level and higher country SE welfare are associated with a higher likelihood of keeping patients with SpA employed. Absenteeism and presenteeism are only associated with clinical but not with individual-level or country-level SE factors.
Original languageEnglish
Pages (from-to)1303-1310
Number of pages8
JournalAnnals of the Rheumatic Diseases
Volume77
Issue number9
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • 3 EUROPEAN COUNTRIES
  • SOCIETY CLASSIFICATION CRITERIA
  • ANKYLOSING-SPONDYLITIS
  • SICK LEAVE
  • PERIPHERAL SPONDYLOARTHRITIS
  • AXIAL SPONDYLOARTHRITIS
  • FOLLOW-UP
  • PRODUCTIVITY
  • PRESENTEEISM
  • COSTS

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