Determinants of work and social participation in patients with psoriatic arthritis in the Netherlands: an observational study

Abstract

Background Psoriatic arthritis can cause pain, disability, and permanent joint damage. This can lead to impairments in work and social participation. Little is known about the extent of these impairments in routine practice. With this study, we aim to examine the extent of work and activity impairment in (subgroups of) Dutch patients with psoriatic arthritis (PsA), and to examine determinants associated with this impairment. Methods This is an observational study using data collected from the electronic health records of PsA patients treated at the Sint Maartenskliniek, the Netherlands. Data about work and activity impairment were collected via the Work Productivity and Activity Impairment questionnaire. To compare our PsA-cohort with the Dutch general population, we used age- and sex-matched data derived from the Central Bureau of Statistics. Regression analyses were performed to examine determinants of work and activity impairment. Results In total, 246 patients were included, of which 126 (51.2%) were female. Mean age (S.D.) was 55.7 (13.2) years. Compared with the Dutch general population, work for pay (WFP) was significantly lower in PsA (52.9% versus 62.6%, P < 0.001). In PsA, younger age and better physical function were associated with WFP status (P < 0.05). Higher disease activity, worse physical function, and worse mental health-related quality of life were associated with both more work and activity impairment (P < 0.05). Furthermore, reaching low disease activity status (LDA) according to Psoriatic ArthritiS Disease Activity Score (PASDAS; ≤ 3.2) was associated with less work and activity impairment than reaching LDA according to DAS28-CRP (≤ 2.9) (P < 0.05). Conclusions In PsA patients, worse physical function was associated with a lower likelihood of having WFP, and higher work and activity impairment. PASDAS LDA as a goal for treat to target, compared to DAS28-CRP, appears to favour the reduction of work and activity impairment.

Female genital lichen sclerosus is connected with a higher depression rate, decreased sexual quality of life and diminished work productivity

“…Results from our study indicate that female genital LS exerts a negative impact on work productivity. Similar conclusions were drawn in other research on different chronic diseases: psoriasis, psoriatic arthritis and rheumatoid arthritis [ 21 – 23 ]. Moreover, Villacorta outlined that psoriasis influences economic burden and is also connected with indirect costs caused e.g.…”

Improvement in work productivity among psoriatic arthritis patients treated with biologic or targeted synthetic drugs: a systematic literature review and meta-analysis

“…Previous studies have demonstrated associations between productivity and response (minimal disease activity [MDA] or low disease activity according to PsA Disease Activity Score [PASDAS]) [ 10 , 40 ] and found greater improvements in productivity with bDMARDs than with csDMARDs [ 41 ]. Generally, the estimated effects of the b/tsDMARDs in the current analysis were similar with respect to improving a patient’s capacity to work and participate in leisure activities.…”

“…In particular, patients with PsA have reported its effect on individual activities and social participation, as well as physiological functioning as linked to the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) [ 4 , 5 ]. The consequences of PsA on work are important and include deleterious effects such as hours of missed work (absenteeism), diminished productivity while at work (presenteeism), and increased economic burden due to indirect costs [ 4 , 6 – 10 ].…”