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Identifying persons with axial spondyloarthritis at risk of poor work outcome: results from the British Society for Rheumatology Biologics Register

Identifying persons with axial spondyloarthritis at risk of poor work outcome: results from the British Society for Rheumatology Biologics Register
Identifying persons with axial spondyloarthritis at risk of poor work outcome: results from the British Society for Rheumatology Biologics Register
Objective: Firstly to test the hypothesis that, amongst working patients with axSpA, those who report issues with reduced productivity at work (presenteeism)
are at higher risk of work absence (absenteeism), and patients who report absenteeism are at higher risk of subsequently of leaving the workforce. Secondly to identify characteristics of workers at high risk of poor work outcome.

Methods: The British Society for Rheumatology Biologics Register in Ankylosing Spondylitis has recruited patients meeting ASAS criteria for axSpA from eighty-three centres. Data collection involves clinical and patient reported measures at recruitment and annually thereafter, including the Work Productivity and Activity Impairment scale. Generalised Estimating Equations were used to identify factors associated with poor work outcomes.

Results: Of the 1188 participants in this analysis who were working at recruitment, 79% reported some presenteeism and 19% some absenteeism in the past week due to their axSpA. Leaving employment was most strongly associated with previous absenteeism (Risk Ratio 1.02per % increase in absenteeism, 95% CI
1.01, 1.03) which itself was most strongly associated with previous presenteeism, a labour intensive job and peripheral joint involvement. High disease activity, fatigue, a labour intensive job and poorer physical function were all independently associated with future presenteeism.

Conclusion: Clinical and patient reported factors along with aspects of work are associated with an increased risk of axSpA patients having a poor outcome in relation to work. This study has identified modifiable factors as targets, facilitating patients with axSpA to remain productive in work.
0315-162X
145-152
MacFarlane, Gary J.
e17bbdb7-9d82-42ac-8a0a-09bf10885e3c
Shim, Joanna
e2666d72-5c28-4fe4-acdc-a740b9beef45
Jones, Gareth T.
4a081913-b60d-4916-996f-298cfd47cd88
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Pathan, Ejaz
15fa4ea6-da3c-4cdd-9c72-b242568af661
Dean, Linda E.
bd89ba28-3cfc-41b0-ac80-d0cf3a997ab5
MacFarlane, Gary J.
e17bbdb7-9d82-42ac-8a0a-09bf10885e3c
Shim, Joanna
e2666d72-5c28-4fe4-acdc-a740b9beef45
Jones, Gareth T.
4a081913-b60d-4916-996f-298cfd47cd88
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Pathan, Ejaz
15fa4ea6-da3c-4cdd-9c72-b242568af661
Dean, Linda E.
bd89ba28-3cfc-41b0-ac80-d0cf3a997ab5

MacFarlane, Gary J., Shim, Joanna, Jones, Gareth T., Walker-Bone, Karen, Pathan, Ejaz and Dean, Linda E. (2019) Identifying persons with axial spondyloarthritis at risk of poor work outcome: results from the British Society for Rheumatology Biologics Register. The Journal of Rheumatology, 46 (2), 145-152. (doi:10.3899/jrheum.180477).

Record type: Article

Abstract

Objective: Firstly to test the hypothesis that, amongst working patients with axSpA, those who report issues with reduced productivity at work (presenteeism)
are at higher risk of work absence (absenteeism), and patients who report absenteeism are at higher risk of subsequently of leaving the workforce. Secondly to identify characteristics of workers at high risk of poor work outcome.

Methods: The British Society for Rheumatology Biologics Register in Ankylosing Spondylitis has recruited patients meeting ASAS criteria for axSpA from eighty-three centres. Data collection involves clinical and patient reported measures at recruitment and annually thereafter, including the Work Productivity and Activity Impairment scale. Generalised Estimating Equations were used to identify factors associated with poor work outcomes.

Results: Of the 1188 participants in this analysis who were working at recruitment, 79% reported some presenteeism and 19% some absenteeism in the past week due to their axSpA. Leaving employment was most strongly associated with previous absenteeism (Risk Ratio 1.02per % increase in absenteeism, 95% CI
1.01, 1.03) which itself was most strongly associated with previous presenteeism, a labour intensive job and peripheral joint involvement. High disease activity, fatigue, a labour intensive job and poorer physical function were all independently associated with future presenteeism.

Conclusion: Clinical and patient reported factors along with aspects of work are associated with an increased risk of axSpA patients having a poor outcome in relation to work. This study has identified modifiable factors as targets, facilitating patients with axSpA to remain productive in work.

Text
BSRBR AS predicting work outcomes (Journal of Rheumatology main) - Accepted Manuscript
Restricted to Repository staff only until 27 October 2019.
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Accepted/In Press date: 8 August 2018
e-pub ahead of print date: 1 February 2019

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Local EPrints ID: 422931
URI: https://eprints.soton.ac.uk/id/eprint/422931
ISSN: 0315-162X
PURE UUID: 77ca7e2f-4f5d-49a3-b899-28ab34992a38
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459

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Date deposited: 08 Aug 2018 16:30
Last modified: 14 May 2019 00:35

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