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Better management of depressive symptoms may improve work disability in SLE patients
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A survey of patients with systemic lupus erythematosus showed employment requiring high levels of physical activity or cognitive attention were challenging for patients, and that management of depressive symptoms could reduce the incidence of work disability, absenteeism and lost productivity.
Researchers asked 344 patients with systemic lupus erythematosus (SLE) from six U.S. medical centers to complete a survey on work and domestic function; 321 age-matched controls without SLE were also recruited. The patient survey consisted of a 12-page questionnaire and contained only minor differences between the patient and control participant versions.
Tammy O. Utset, MD, MPH
An eight-page health history survey was also completed by the patients’ treating physicians. Data were collected between October 2009 and July 2010.
Patient and control surveys included demographics and questions about work productivity, absenteeism and presenteeism using the WHO Health and Work Performance Questionnaire (HPQ), lost productivity outside of the workplace using modified questions from the HPQ and other instruments, symptoms of fatigue using the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue), depression using the Center for Epidemiologic Studies Depression Scale Short Form (CES-D), cognitive impairment using a Brief Cognitive Symptoms Index (BCSI), and overall health-related quality of life (HRQoL).
Absolute absenteeism was defined as the number of hours missed from work due to health during the prior 7 days and was subtracted from the number of hours of work expected. Presenteeism was defined as the extent to which productivity has been reduced while at work due to health complaints during the prior 4 weeks. Work status was defined by the status of employment at the time of SLE diagnosis and at the time of survey completion.
On average, patients with SLE had 4.2 comorbidities compared with 1.5 comorbidities in the control participants. Additionally, HRQoL scores and FACIT fatigue, depressive symptoms, CES-D, HPQ and BCSI scores were worse in patients with SLE compared with their non-SLE peers, according to the researchers.
Patients with SLE were also significantly less likely to work full time (24% vs. 50%) despite a 49% full-time employment status at the time of diagnosis. Work disability at the time of survey was 31% in the SLE group vs. 4%. However, 18% of patients with SLE could not characterize their work status and selected “other.”
Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index scores correlated with work disability status among the SLE group, according to the researchers. – by Shirley Pulawski
Disclosure: The authors have no relevant financial disclosures.
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