Predictors of presenteeism, absenteeism and job loss in patients commencing methotrexate or biologic therapy for rheumatoid arthritis
Predictors of presenteeism, absenteeism and job loss in patients commencing methotrexate or biologic therapy for rheumatoid arthritis
Objectives: work is an important health outcome. This study aimed to identify predictors of work loss, absenteeism and presenteeism over 1 year in RA patients commencing treatment with MTX or biologics.
Methods: patients aged 18–65 years in full/part-time employment from two UK prospective cohorts were included: MTX-starters = Rheumatoid Arthritis Medication Study; and biologic-starters = Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate. Presenteeism and absenteeism were assessed using the RA-specific Work Productivity Survey at baseline, and 6 and 12 months. Potential predictors including baseline age, gender, clinical measures (e.g. disability, pain, fatigue), psychological distress, occupation and EULAR response from baseline to 6 months were investigated.
Results: a total of 51/463 MTX-starters and 30/260 biologic-starters left work over 12 months. Higher baseline psychological distress in MTX-starters [odds ratio (OR) 1.1 (95% CI: 1.0, 1.1)] and higher disability in biologic-starters [OR 3.5 (95% CI: 1.4, 8.6)] predicted work loss. Some 16.1% of patients reported sick-leave, which was predicted by disability [OR (95% CI): MTX-starters: 1.5 (0.9, 2.3); biologic-starters: 2.4 (1.1, 5.2)]. Median presenteeism scores were very low (minimal interference) in both cohorts. Higher fatigue for MTX starters [incidence rate ratio 1.2 (95% CI: 1.0, 1.4)] and higher disability in biologic-starters (incidence rate ratio 1.4 (95% CI: 1.1, 1.7)] predicted presenteeism. Good EULAR response was associated with lower absenteeism and presenteeism in both cohorts.
Conclusion: patients with RA still face significant limitations regarding their ability to work. Disability and EULAR response were the main predictors of work outcomes, emphasizing the need to control the disease and the importance of function in enabling work participation.
absenteeism, disability, presenteeism, rheumatoid arthritis, work, work disability
2908-2919
Gwinnutt, James M.
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Leggett, Sarah
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Lunt, Mark
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Barton, Anne
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Hyrich, Kimme L.
bf2bc52a-6d8a-4ca3-9266-8e471155fad9
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Verstappen, Suzanne MM
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1 October 2020
Gwinnutt, James M.
a3eb718a-3353-42ca-822b-44cb2d72eb07
Leggett, Sarah
8bdbb4c9-39f4-4f43-9e26-c009e8b8f796
Lunt, Mark
d8ac296a-c589-4d9d-b4c4-9f3f219b772c
Barton, Anne
70cfdc4a-5e46-4708-a283-ce3484d16fa4
Hyrich, Kimme L.
bf2bc52a-6d8a-4ca3-9266-8e471155fad9
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Verstappen, Suzanne MM
fa24ec7c-401e-4f46-9777-9e661016d7f7
Gwinnutt, James M., Leggett, Sarah, Lunt, Mark, Barton, Anne, Hyrich, Kimme L., Walker-Bone, Karen and Verstappen, Suzanne MM
(2020)
Predictors of presenteeism, absenteeism and job loss in patients commencing methotrexate or biologic therapy for rheumatoid arthritis.
Rheumatology, 59 (10), .
(doi:10.1093/rheumatology/keaa027).
Abstract
Objectives: work is an important health outcome. This study aimed to identify predictors of work loss, absenteeism and presenteeism over 1 year in RA patients commencing treatment with MTX or biologics.
Methods: patients aged 18–65 years in full/part-time employment from two UK prospective cohorts were included: MTX-starters = Rheumatoid Arthritis Medication Study; and biologic-starters = Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate. Presenteeism and absenteeism were assessed using the RA-specific Work Productivity Survey at baseline, and 6 and 12 months. Potential predictors including baseline age, gender, clinical measures (e.g. disability, pain, fatigue), psychological distress, occupation and EULAR response from baseline to 6 months were investigated.
Results: a total of 51/463 MTX-starters and 30/260 biologic-starters left work over 12 months. Higher baseline psychological distress in MTX-starters [odds ratio (OR) 1.1 (95% CI: 1.0, 1.1)] and higher disability in biologic-starters [OR 3.5 (95% CI: 1.4, 8.6)] predicted work loss. Some 16.1% of patients reported sick-leave, which was predicted by disability [OR (95% CI): MTX-starters: 1.5 (0.9, 2.3); biologic-starters: 2.4 (1.1, 5.2)]. Median presenteeism scores were very low (minimal interference) in both cohorts. Higher fatigue for MTX starters [incidence rate ratio 1.2 (95% CI: 1.0, 1.4)] and higher disability in biologic-starters (incidence rate ratio 1.4 (95% CI: 1.1, 1.7)] predicted presenteeism. Good EULAR response was associated with lower absenteeism and presenteeism in both cohorts.
Conclusion: patients with RA still face significant limitations regarding their ability to work. Disability and EULAR response were the main predictors of work outcomes, emphasizing the need to control the disease and the importance of function in enabling work participation.
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RAMS and BRAGGSS work producitivity resubmission clean for PURE
- Accepted Manuscript
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Predictors of presenteeism, absenteeism
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Accepted/In Press date: 2 January 2020
e-pub ahead of print date: 25 February 2020
Published date: 1 October 2020
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Publisher Copyright:
© 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology.
Keywords:
absenteeism, disability, presenteeism, rheumatoid arthritis, work, work disability
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Local EPrints ID: 439701
URI: http://eprints.soton.ac.uk/id/eprint/439701
ISSN: 1462-0324
PURE UUID: 2c1fb052-0e35-406e-b277-a65bbbf9f276
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Date deposited: 30 Apr 2020 16:30
Last modified: 17 Mar 2024 05:31
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Contributors
Author:
James M. Gwinnutt
Author:
Sarah Leggett
Author:
Mark Lunt
Author:
Anne Barton
Author:
Kimme L. Hyrich
Author:
Suzanne MM Verstappen
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