A cross‐sectional study on factors associated with poor work outcomes in patients with axial spondyloarthritis in Singapore

Goh, Yihui; Kwan, Yu Heng; Leung, Ying Ying; Fong, Warren; Cheung, Peter

doi:10.1111/1756-185x.13696

Cited by 15 publications

(21 citation statements)

References 31 publications

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“…Disease duration, BASFI and ASQoL were found to be related to work outcomes in this study, which concurs with studies done in Western (27,29) and Asia populations (28). The current study showed no significant difference was found between disease activity (such as BASDAI or ASDAS) and work outcomes, which was inconsistent with other studies (27,28) and the reason may be that only patients with BASDAI ≥4 were included in this study. However, controlling disease activity is still of importance to improve work outcomes in AS patients.…”

Section: Discussionsupporting

confidence: 66%

“…Besides, many other reasons including economic setting and social security system may contribute to this difference. Factors such as age (25), ethnicity (26), disease duration, disease activity (27,28), physical function (28,29), and quality of life (28) were reported to significantly affect work outcomes in other studies. Disease duration, BASFI and ASQoL were found to be related to work outcomes in this study, which concurs with studies done in Western (27,29) and Asia populations (28).…”

Section: Discussionmentioning

confidence: 81%

“…Factors such as age (25), ethnicity (26), disease duration, disease activity (27,28), physical function (28,29), and quality of life (28) were reported to significantly affect work outcomes in other studies. Disease duration, BASFI and ASQoL were found to be related to work outcomes in this study, which concurs with studies done in Western (27,29) and Asia populations (28). The current study showed no significant difference was found between disease activity (such as BASDAI or ASDAS) and work outcomes, which was inconsistent with other studies (27,28) and the reason may be that only patients with BASDAI ≥4 were included in this study.…”

Section: Discussionmentioning

confidence: 81%

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Cost of Illness, Quality of Life, and Work Outcomes in Active Ankylosing Spondylitis Patients Treated With Adalimumab in China

Xie

Liao

et al. 2020

Front. Public Health

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Objectives: To access the cost of illness, quality of life and work limitation in active ankylosing spondylitis (AS) patients using adalimumab in China.Methods: A prospective study was performed in 91 patients with active AS in China. Adult patients (aged ≥ 18 years) fulfilled the 1984 New York modified criteria of AS with the Bath Ankylosing Spondylitis Disease Activity Index ≥ 4 were enrolled. All participants received adalimumab (40 mg per 2 weeks) therapy and completed questionnaires about disease characteristics, quality of life and cost. Only patients with pay-work completed the Work Limitation Questionnaire and Work productivity and activity impairment questionnaire in AS. Factors associated with work outcomes were evaluated.Results: A total of 91 patients with mean age of 30 years old (87.8% males) and mean disease duration of 10 years received adalimumab treatment for 24 weeks. The annual estimated cost of each patient was $37581.41 while the direct cost accounted for 84.6%. Seventy-eight percent of patients have a paid job with average work productivity loss of 0.28 measured by work limitation questionnaire, absenteeism and presenteeism were 10.22 and 43.86%, respectively, with a mean work productivity loss of 47.92% measured by Work productivity and activity impairment questionnaire in AS. Patients experienced significantly greater improvements after adalimumab treatment in presenteeism, absenteeism, work productivity, and quality of life.Conclusions: The cost of AS patients with adalimumab therapy was high in China. Disease activity, physical function, quality of life, and work outcomes improved significantly after therapy.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 81%

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Cost of Illness, Quality of Life, and Work Outcomes in Active Ankylosing Spondylitis Patients Treated With Adalimumab in China

Xie

Liao

et al. 2020

Front. Public Health

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“…Secondly, as this was a cross-sectional study, we were not able to determine whether patients had higher levels of PA before the onset of disease. Thirdly, smokers and patients with lower educational levels might have been over-represented in our study due to the small sample size, as the proportion of smokers and distribution of educational levels in this study differed from our previous cohorts [ 30 , 31 ]. Repeating the study with larger sample size will be needed.…”

Section: Discussionmentioning

confidence: 86%

Physical activity in patients with axial spondyloarthritis in a multi-ethnic south-east Asian country

et al. 2021

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Background Patients with axial spondyloarthritis (axSpA) may experience spinal stiffness and pain, leading to reduced physical function and quality of life. Despite the benefits of physical activity (PA) and exercise, previous studies have demonstrated lower levels of PA among patients with axSpA. This study aims to examine the patterns of PA among patients with axSpA compared to the general population in a multi-ethnic Asian country. Methods This was a cross-sectional study conducted between May 2016 and Jan 2017. Consecutive patients with axSpA were recruited at an outpatient rheumatology clinic at Singapore General Hospital, the largest tertiary hospital in Singapore. Controls were based on a previous cross-sectional study. PA was assessed using the Global Physical Activity Questionnaire (GPAQ). Results Seventy-four patients with axSpA were recruited and compared with 2679 controls. Lower proportion of patients with axSpA met the WHO recommendations for PA (axSpA = 77.0%, controls = 89.7%, p < 0.001). More patients with axSpA had high level of sedentary activity compared to controls (axSpA = 56.8%, controls = 36.1%, p < 0.001). Levels of PA did not differ between patients with inactive versus active axSpA disease (p = 0.91). Conclusions Proportion of patients with axSpA meeting the WHO recommendations for PA differed significantly from the general population, and level of PA did not differ between patients with active and inactive axSpA disease. Higher levels of sedentary activity were seen in patient with axSpA compared to the general population, highlighting the need for interventions to promote PA among patients with axSpA.

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“…1 It has a significant negative impact on quality of life and work productivity. 2 Conventional therapy, as jointly recommended by the European League Against Rheumatism (EULAR) and the Assessment of Spondyloarthritis International Society (ASAS), includes non-steroidal anti-inflammatory drugs (NSAIDs), and biologics if patients have shown inadequate response to NSAIDs. 3 However, biologics are costly, and their high cost may result in sub-optimal treatment for some patients.…”

Section: Introductionmentioning

confidence: 99%

Facilitators of and barriers to implementing a traditional Chinese medicine collaborative model of care for axial spondyloarthritis: a qualitative study

Kwan

Fong

Ang³

et al. 2021

Acupunct Med

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Background: Conventional therapy may be inadequate for many patients with axial spondyloarthritis (axSpA). Traditional Chinese medicine (TCM) may be a viable alternative, but its effectiveness for axSpA is unknown. We are currently conducting a pragmatic randomised controlled trial (RCT) to investigate the effectiveness of a TCM collaborative model of care (TCMCMC), which combines usual rheumatologic care with acupuncture for patients with axSpA. This nested qualitative sub-study aims to identify facilitators of and barriers to the implementation of the TCMCMC. Methods: We conducted individual in-depth interviews with participants who had completed the acupuncture regimen to elicit opinions on the facilitators of and barriers to the implementation of the TCMCMC. The interviews were transcribed and analysed using thematic analysis. Results: Twelve participants were included, with data saturation occurring after 10 interviews. The analysis revealed both a number of important ‘facilitators’ and ‘barriers’. Facilitators to the implementation of the TCMCMC included effectiveness of TCM to relieve symptoms, inadequacy of conventional treatment and positive social perceptions of TCM. Barriers included scepticism towards TCM, inability of TCM to provide instant relief, needle-related discomfort, variable effectiveness of TCM influenced by physicians’ skills and experience and the high cost of TCM. Recommendations to overcome barriers included further patient education about TCM. Conclusion: Policymakers should take into account the various feasibility factors identified in this study when developing and implementing a TCMCMC. Trial registration number: NCT03420404 (ClinicalTrials.gov)

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A cross‐sectional study on factors associated with poor work outcomes in patients with axial spondyloarthritis in Singapore

Cited by 15 publications

References 31 publications

Cost of Illness, Quality of Life, and Work Outcomes in Active Ankylosing Spondylitis Patients Treated With Adalimumab in China

Cost of Illness, Quality of Life, and Work Outcomes in Active Ankylosing Spondylitis Patients Treated With Adalimumab in China

Physical activity in patients with axial spondyloarthritis in a multi-ethnic south-east Asian country

Facilitators of and barriers to implementing a traditional Chinese medicine collaborative model of care for axial spondyloarthritis: a qualitative study

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