Accommodations and Adaptations to Overcome Workplace Disability in Inflammatory Bowel Disease Patients: A Systematic Review

Paulides, Emma; Gearry, Richard B.; Boer, Nanne K H de; Mulder, Chris J.; Bernstein, Çharles N.; McCombie, Andrew

doi:10.1159/000495293

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…The majority of patients relate these problems to fatigue [ 4 , 5 ]. Patients who struggle with IBD-related problems at work often experience increased stress levels and impaired quality of life which is why, in certain cases, accommodations to the workplace are needed in order to cope with their illness and (in)ability to work [ 4 , 6 ]. Job satisfaction is an important factor influencing work performance, and poor work satisfaction might even lead to desertion from the organization [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Impaired Quality of Working Life in Inflammatory Bowel Disease Patients

et al. 2020

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Background Work-related aspects are important determinants of health for inflammatory bowel disease (IBD) patients. Aims We aimed to describe quality of working life (QWL) in IBD patients and to assess variables that are associated with QWL. Methods Employed IBD patients of two tertiary and two secondary referral hospitals were included. QWL (range 0-100) was measured using the Quality of Working Life Questionnaire (QWLQ). Work productivity (WP), fatigue, and health-related quality of life (HRQL) were assessed using the Work Productivity and Activity Impairment questionnaire, Multidimensional Fatigue Inventory, and Short Inflammatory Bowel Disease Questionnaire, respectively. Active disease was defined as a score > 4 for the patient-reported Harvey-Bradshaw index in Crohn's disease (CD) or Simple Clinical Colitis Activity Index in ulcerative colitis patients. Results In total, 510 IBD patients were included (59% female, 53% CD, mean age 43 (SD 12) years). The mean QWLQ score was 78 (SD 11). The lowest subscore (54 (SD 26)) was observed for "problems due to the health situation": 63% reported fatigue-related problems at work, 48% agreed being hampered at work, 46% had limited confidence in their body, and 48% felt insecure about the future due to their health situation. Intermediate/strong associations were found between QWL and fatigue (r = − 0.543, p < 0.001), HRQL (r = 0.527, p < 0.001), WP loss (r = − 0.453, p < 0.001) and disease activity (r = − 0.331, p < 0.001). Independent predictors of impaired QWL in hierarchical regression analyses were fatigue (B = − 0.204, p < 0.001), WP loss (B = − 0.070, p < 0.001), and impaired HRQL (B = 0.248, p = 0.001). Conclusions IBD-related problems at work negatively influence QWL. Fatigue, reduced HRQL, and WP loss were independent predictors of impaired QWL in IBD.

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Section: Introductionmentioning

confidence: 99%

Impaired Quality of Working Life in Inflammatory Bowel Disease Patients

et al. 2020

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“…Specifically, the improvement in work productivity, amounting to over 40% overall is an important finding for patients with UC of working age. Over 90% of people with IBD who have symptoms during their working life require workplace accommodations to enable them to work, yet many found them difficult to arrange or did not ask for them [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristics, clinical outcomes and patient-reported outcomes of patients with ulcerative colitis receiving tofacitinib: a real-world survey in the United States and five European countries

et al. 2023

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Background To describe variations in treatment patterns, clinical outcomes, patient-reported outcomes (PRO), and physician and patient satisfaction in patients with moderate-to-severe ulcerative colitis (UC) treated with tofacitinib in a real-world setting. Methods Data were drawn from the Adelphi UC Disease Specific Programme™, a point-in-time survey of physicians and their consulting patients in the US and Europe. For inclusion in this analysis, gastroenterologists completed medical record forms for the next seven consecutive consulting patients with confirmed UC, plus a further two patient record forms for patients treated with tofacitinib. Those same patients then completed a patient-reported questionnaire. Results Gastroenterologists (n = 340) provided data for 2049 patients with UC, including 642 patients receiving tofacitinib. Physicians’ most frequent reason for choosing tofacitinib was overall efficacy (71.3% of patients). The proportion of patients in remission increased with length of treatment, from 13.7% at [0, 4) weeks to 68.3% at [52+] weeks. Both physicians and patients reported that the Mayo components of stool frequency and blood in stool were reduced with time on treatment. Improvement in symptoms (bloody diarrhea, abdominal pain/cramps, urgency, rectal bleeding, fatigue/tiredness) was reported in the first weeks of treatment, and increased with time. At week [52+], mean score reductions from treatment initiation to current in overall symptom severity, pain, and fatigue were 2.2 (to a current mean score of 1.1), 2.2 (to 0.9), and 2.1 (to 1.0), respectively. Comparing patients at weeks [0, 4) and [52+] (all PROs, p < 0.0001), the increase in EQ-5D-5L index total score was 0.29 points and in SIBDQ total score was 20.5 points; percent reductions in WPAI absenteeism was 34.4%, presenteeism 26.8%, overall work impairment 40.9% and activity impairment was 28.3%. These changes reached the thresholds for minimally clinically important differences. The majority of physicians (91.9%) and patients (93.5%) were satisfied with tofacitinib at week [52+]. Conclusion Patients with moderate-to-severe UC treated with tofacitinib show considerable improvement in symptoms and quality of life from tofacitinib initiation to one year and beyond, with high rates of remission. Physicians and patients report satisfaction with UC control at recommended doses in a mostly biologic experienced population.

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“…Furthermore, respondents mentioned that their work is not supportive or that they were afraid to even ask. This demonstrates the relevance of improved resources to inform employees and employers about the disease, possibilities for workplace accommodations, and practical strategies to request them [17, 18].…”

Section: Discussionmentioning

confidence: 99%

Overcoming Workplace Disability in IBD Patients: An Observational Study

Paulides¹,

Daker²,

Frampton³

et al. 2020

Inflamm Intest Dis

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Background: Inflammatory Bowel Disease (IBD) can have considerable effects on employment outcomes because of its disabling character. Goals: We aimed to investigate the impact of IBD in the workplace and to better understand the need for accommodations and adaptations. Study: Between November 2017 and March 2018, IBD patients were recruited from outpatient clinics in Christchurch Hospital, New Zealand. The survey assessed employment, the need for workplace accommodations and the difficulty arranging it, insurance, and disability using the item-reduced Inflammatory Bowel Disease Disability Index for self-report (IBD-DI-SR). Data were analyzed using descriptive statistics and multivariate logistic regression modeling. Results: One hundred twenty-three patients were included (response rate 64%), 112 of whom reported that they experienced symptoms while working (60% female, 71% Crohn’s disease, mean age 41.9 years). Ninety-one percent needed at least 1 workplace accommodation when symptoms were most severe. Almost half of the patients who needed an accommodation had difficulty arranging it. The most needed accommodations were time to go to medical appointments (71%) and easy access to a suitable toilet (71%). Being female, having less effective medication, and being distressed were associated with the need for 2 or more accommodations, difficulty in arranging accommodations, and not asking for needed accommodation. Conclusions: Many IBD patients need accommodations at work while symptomatic in order to overcome workplace disability, which can be difficult to arrange. Improved resources are needed to inform employees and employers about the disease, the possibilities for workplace accommodations, and practical strategies to request them.

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Accommodations and Adaptations to Overcome Workplace Disability in Inflammatory Bowel Disease Patients: A Systematic Review

Cited by 10 publications

References 17 publications

Impaired Quality of Working Life in Inflammatory Bowel Disease Patients

Impaired Quality of Working Life in Inflammatory Bowel Disease Patients

Characteristics, clinical outcomes and patient-reported outcomes of patients with ulcerative colitis receiving tofacitinib: a real-world survey in the United States and five European countries

Overcoming Workplace Disability in IBD Patients: An Observational Study

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