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Higher education, economic status linked to reduced work loss in SpA
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Higher education and better national socioeconomic welfare are associated with a greater likelihood that patients with spondyloarthritis will maintain employment, according to findings published in the Annals of the Rheumatic Diseases.
“It is well known that inflammatory rheumatic diseases, including spondyloarthritis (SpA) have a negative impact on work participation — e.g.; unemployment, sick leave, lack of productivity,” Santiago Rodrigues Manica, MD, of Egas Moniz Hospital, told Healio Rheumatology. “There have been some observational studies regarding this at a country level, and comparing three neighbor countries — France, Belgium and the Netherlands. However, there was still an important gap to fill. There was a need for a study across different regions of the world with a large sample of patients, with the whole spectrum of SpA that could provide data regarding the socio-demographic and clinical factors behind work participation.”
To determine the impact of both individual and national socioeconomic factors on employment, absenteeism and presenteeism among patients with SpA, the researchers focused on 3,114 participants from the ASAS-COMOSPA study, a large, cross-sectional, multicenter trial of adults with SpA in 22 countries across Africa, Asia, Europe, North America and South America. For their study, the researchers included patients were of working age, defined as 65 years or younger.
Outcome measures included employment status, absenteeism and presenteeism, as determined by the Work Productivity and Activity Impairment Specific General Health questionnaire. Manica and colleagues developed multivariate models for each of the three outcomes, with mixed-effects binomial for work status, and ordinal regressions for absenteeism and presenteeism. Nation of residence was counted as a random effect. Individual socioeconomic factors were defined as gender, education and marital status. National-level factors included health care expenditure per capita, Human Development Index (HDI) and gross domestic product per capita.
According to the researchers, higher education (OR = 4.2; 95% CI, 3.1-5.6) and residence in a country with higher health care expenditures (OR = 2.3; 95% CI, 1.5-3.6) or HDI (OR = 1.9; 95% CI, 1.2-3.3) were positively associated with employment. At the individual level, increased disease activity was associated with a greater risk for absenteeism (OR = 1.5; 95% CI, 1.3-1.7) and presenteeism (OR = 2.1; 95% CI, 1.8-2.4). However, no significant association was found between individual-level and country-level socioeconomic factors and absenteeism or presenteeism.
“Even though association is not causality (specially in this cross-sectional study), all stakeholders in society, including policy makers, patients, physicians and employers, should be aware that a high education and a good net of social security may be important copying factors to keep patients employment,” Manica said. “A good control of the disease may lower sick leave and presenteeism, keeping patients who are employed more active and productive — and of course healthier with a more stable disease.” – by Jason Laday
Disclosure: The researchers report study funding from AbbVie, Pfizer and UCB.
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