Predictors of Work Productivity in a Population Based Cohort of Individuals with Spondyloarthritis

• Background: Spondyloarthritis (SpA) often causes work disability and predictors concerning the ability to stay productive while at work are scarcely studied in this group.Objectives: The aim was to study predictors of reduced productivity while at work and possible differences between gender and the SpA subgroups (Ankylosing Spondylitis (AS), Psoriatic Arthritis (PsA) and Undifferentiated SpA (USpA)) in a defined cohort in southern Sweden.Methods: 1253 out of 1773 health care seeking individuals with SpA age 18-67 years (identified by a health care register in southern Sweden) responded to a questionnaire survey in 2009 and to the follow-up in 2011, 2,5 years later. Self-reported presenteeism, defined as reduced productivity at work (0-100%, 0= no reduction) due to SpA, individual´s characteristics, lifestyle factors, disease duration, health related quality of life (EQ-5D), disease activity (BASDAI), physical function (BASFI), self-efficacy pain and symptom (ASES), anxiety (HADa), depression (HADd) were measured. The main outcome productivity at work was dichotomized based on mean value, with values over 25% regarded as a reduced productivity. The Pearson's correlation coefficient and multivariate logistic regression analyzes were used to study predictors of reduced productivity.Results: At follow up 757 individuals reported that they were working and of those 720 responded to the productivity question. The mean age was 50 years and 49% were men. Based on the health care register 177 (24.6%) were diagnosed with AS, 373 (51.8%) with PsA and 170 (23.6%) with USpA. The mean reduction of productivity was 25% (95% CI 23%>27%) (n=720), women reported higher reduction than men (mean 28% vs. 22%, p<0.001). In the multiple logistic regression analyzes a reduced productivity at follow-up was predicted by a reduced productivity at baseline (OR 1.04, 95% CI 1.03-1.05). Other predictors (controlled for age, sex, disease subgroup and productivity at baseline) were low education level (OR 2.14, 95% CI 1.51-3.04), smoking (1.73; 1.22-2.45), worse score in quality of life (EQ-5D) (0.22; 0.003-0.14), worse disease activity (BASDAI) (1.47; 1.29-1.67), lower physical function (BASFI) (1.42;1.27-1.58), lower self-efficacy (ASES) pain (0.97; 0.97-0.98) and symptom (0.97; 0.96-0.98), higher score of anxiety (HADa) (1.09; 1.05-1.14) and depression (HADd) (1.15; 1.08-1.22). Disease duration, absenteeism and physical activity level had no predictive value.Conclusions: Reduced productivity at follow-up was not only predicted by productivity 2,5 years earlier, but also by other aspects of the individuals whole life situation. These different factors could be of clinical importance in order to influence the ability to maintain productivity at work in individuals with SpA.Disclosure of Interest: E. Haglund Grant/research support from: The project was supported by an unrestricted grant from Abbott., I. Petersson Grant/research support from: The project was supported by an unrestricted grant from Abbott., A. Bremander Grant/research support from: The project was supported by an unrestricted grant from Abbott., S. Bergman Grant/research support from: The project was supported by an unrestricted grant from Abbott.

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MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences (hsv//eng)

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