MSKDs often co-occur with other chronic diseases. In the context of multimorbidity, presence of an MSKD amplifies the impact on physical health, and to a lesser extent on health care costs, but not on mental health.

Test-retest results of 4 out of 5 global measures were good, and the correlations between these were moderate. The latter probably reflect differences in the concepts, recall periods, and references used in the measures, which implies that some measures are probably not interchangeable.

BackgroundChronic diseases and multimorbidity are increasingly common among persons in working age. This study explores the impact of type, number and combinations of chronic diseases with focus on the role of MSKD on (1) adverse work status (i.e. work disability (WD), economic unemployment (UE) or receiving a living allowance (LA)) and on (2) the occurrence of sick leave.MethodsSubjects participating in a Dutch household survey, who were ≤65 years and could have paid work, provided data on socio-demographics and nine physician diagnosed chronic diseases. To explore the independent association of each chronic disease, of multimorbidity and of MSKD in context of multimorbidity with 1) work status (employed, WD, LA, UE) and 2) sick leave (SL) in those employed, multinomial logistic regressions and logistic regressions were used, respectively.ResultsAmong 5396 subjects, MSKD was the most common morbidity (17%), multimorbidity occurred in 755/5396 (14%), 436/755 (61%) of subjects with multimorbidity had an MSKD. For MSKD the odds of WD, LA and UE were 2.06 [95% CI 1.56;2.71], 2.15[1.18;3.91] and 1.35[0.94;1.96], respectively, compared to being employed and the odds of SL in MSKD were 2.29[1.92;2.73]. Mental diseases had a stronger impact on all these outcomes. The odds for adverse work outcomes increased strongly with an increasing number of diseases. When an MSKD was part of multimorbidity, an additional impact on the association with WD and SL was observed.ConclusionsMultimorbidity has a stronger impact on all work outcomes compared to single chronic diseases. The presence of the MSKD in the context of multimorbidity amplifies the chance of WD or SL.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1365-4) contains supplementary material, which is available to authorized users.

Overall, patients across countries agree that the construct of work productivity in the last 7 days can accurately reflect the impact of disease while at work. Some current constructs to assess at-work productivity are not interchangeable between languages.

BackgroundWe aimed to explore whether country of residence or specific country characteristics are associated with work outcomes in rheumatoid arthritis (RA).MethodsData from the 17 countries participating in the Comorbidities in RA (COMORA) study were used. Work outcomes were measured by the Work Productivity and Activity Impairment Questionnaire, addressing employment (yes/no), absenteeism (percentage of time; 3 categories) and presenteeism (percentage of at-work productivity restrictions; 4 categories). Contribution of country of residence, gross domestic product (GDP), Human Development Index (HDI), unemployment rate, social protection expenditures (SPE) or world region to work outcomes was investigated in adjusted (ordered) logistic regressions.ResultsThe patients (n = 2395) were younger than 60 years; mean age 48 (SD 9.2) years, 1972 (84%) female and 1065 (45%) employed. Large country differences were found. Taking the country with the best work outcome as reference, Moroccan patients had the lowest odds of being employed (OR 0.2 (95% CI 0.1; 0.3) vs. Germany) and highest odds of absenteeism (OR 13.2 (3.6; 48.3) vs. Japan). Patients in Taiwan had the highest odds of presenteeism (OR 13.0 (5.5; 30.9) vs. Venezuela). All country indices except SPE were associated with work outcomes. For example, patients in low-GDP countries had lower odds of employment (OR 0.6 (0.5; 0.8)), higher odds of absenteeism (OR 2.8 (2.0; 4.1)), but lower odds of presenteeism (OR 0.5 (0.4; 0.7)) compared to higher-GDP countries.ConclusionSubstantial differences in work outcomes among patients with RA were observed between countries. Lower economic wealth and human development of countries were associated with worse employment and higher absenteeism, but lower presenteeism.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-017-1421-y) contains supplementary material, which is available to authorized users.