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Instrument assessed, predicted gout patients’ future sick leave
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A Work Instability Scale could identify patients with gout who had a higher risk for future work absenteeism, according to study results.
In a longitudinal, cohort study, researchers in New Zealand evaluated 176 patients (median age, 60 years; 73% men) who had gout for less than 10 years. Patients reported sick leave for the previous 3 months at baseline and at 1-year follow-up. Disease characteristics, including C-reactive protein and serum urate levels, were measured at baseline, as was self-reported health status. A Rasch model was used to test the internal and construct validity of the Work Instability Scale (WIS) scores.
One-year follow-up data were available for 133 patients who had a median disease duration of 5 years. Forty-seven percent of the patients were employed, with the others retired, unemployed or work disabled. Thirty-five percent of the patients not working were aged 64 or younger.
Satisfactory internal, construct and predictive validity was shown by the WIS instrument. Median WIS scores were lower (better) for patients in managerial and professional occupations compared with manual occupations (0 vs. 5.5; P<.0001). At follow-up, 7% of working patients reported sick leave in the previous 3 months.
“Among the follow-up cohort who were working at baseline, sick leave reported in the 3 months before baseline was associated with a trend to increased likelihood of sick leave being reported in the 3 months before the 12-month follow-up [OR=3.9; 95% CI, 0.84-18.16],” the researchers reported.
A receiver operating characteristic curve indicated that a WIS baseline score of 4.5 presented the best combined sensitivity (88%) and specificity (72%) for predicting at least one sick day in the next 9 to 12 months.
“The WIS instrument appears to be a useful predictor of future sick leave,” the researchers reported. “Workers in manual occupations with gout tend to have higher levels of work instability that is not related to gout severity. Such findings imply a clinical need for workplace counseling and job modification in addition to medical management of the disease.”
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