Systemic lupus erythematosus in a multiethnic US cohort LUMINA (XLI): factors predictive of self-reported work disability

Abstract

Objective: To examine the risk factors for self-reported work disability in patients from the LUpus in MInorities: NAture vs. Nurture cohort with systemic lupus erythematosus (SLE). Methods: Patients with SLE of Hispanic (Texas and Puerto Rico), African American and Caucasian ethnicity were studied. Work disability was defined by patients' self-report. Only patients known to be employed at the baseline visit were included. The probabilities of self-reporting work disability over time were examined by the Kaplan-Meier method; differences between ethnic groups were examined by the log-rank test. The relationship of baseline socioeconomic-demographic, clinical, behavioural and psychological features with work disability was examined by standard statistical tests. Variables with p(0.10 in these analyses were examined by logistic regression. Results: The rate of self-reported work disability among the 273 patients studied was 19% at 5 years; it was numerically higher for the African Americans (25%) than for the Hispanics from Texas (19%) and the Caucasians (18%). The rate for the Hispanics from Puerto Rico was 7% at 2 years; 5-year rates could not be estimated for this ethnic subgroup (shorter follow-up in the cohort). In the regression analysis, age, male sex, poverty, total disease duration, disease activity and damage accrual were predictors of work disability. Conclusions: The rate of work disability was 19% at 5 years. Patients with SLE with more severe disease and with lower socioeconomic status are at high risk of becoming disabled. The toll SLE imposes could possibly be reduced in patients at risk if, in addition to medical treatment, services needed to overcome their disadvantageous socioeconomic status are provided.

Employment and disability issues in systemic lupus erythematosus: A review

“…In both studies, the majority of patients who self-reported work disability were also receiving formal benefits. Disability or work status has been associated with demographic factors, including lower levels of education (10 -12,15) and older age (14,15), higher physical job demands (10,15), disease activity (10,11,14) and disease damage (13,14), and clinical features including neurologic symptoms, fatigue, and joint symptoms (4,5,13).…”

Work disability in systemic lupus erythematosus

“…The SF-36 is widely used as a generic instrument for measuring perceived health status in lupus patients and other chronic conditions. Both the physical and mental components of the SF-36 were significantly associated with work disability in the LUMINA (LUpus in MInorities, NAture versus nurture) study (2) in the bivariate analysis, but were not retained in the multivariate analysis. However, in our study, physical and mental limitations remained significant in predicting work disability in individuals with lupus.…”

“…Of the 38 (37%) patients who left the work force, 16 reported that their disease was the contributing factor (1). The few existing studies of employment in patients with lupus demonstrate that this disease affects work, including loss of employment, reduced working hours, and reduced performance or productivity (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Prevalence estimates of those experiencing work loss within 5 years of diagnosis range from 15% to 40% (2,6,10).…”

“…Worse SF-36 scores have been shown to be associated with a greater likelihood of incurring work disability cost in patients with osteoarthritis (31), as well as with a greater income loss in individuals with RA (32). Although the SDI was an important risk factor for work disability in previous studies (2,9), this variable was not retained in the multivariate analysis. The SDI measures accumulated damage that has occurred since the onset of SLE, resulting from either the disease or its complications.…”

Η Συχνότητα Των Ρευματικών Νόσων Στο Νομό Μαγνησίας

“…Οι δηµοσιεύσεις αναφερόνταν σε σύνολο 9.886 πασχόντων από ΣΕΛ και µε συνέντευξη ερωτήθηκαν σχετικά µε την ανικανότητα-ικανότητα για εργασία.΄Ετσι βρέθηκε ότι ο επιπολασµός της ανικανότητας προς εργασία ήταν 20-40% και από αυτούς το 46 % ( 95% CI 40%-52% ) ήταν ικανοί προς εργασία, ενώ το 34% ( 95% CI 24% -44%) ήταν ανίκανοι προς εργασία. Επίσης, βρέθηκε ότι η νόσος συσχετιζόταν µε ψυχο-κοινωνικούς παράγοντες, όπως ηλικία, εθνικότητα, κοινωνικοοικονοµική κατάσταση, µόρφωση, δραστηριότητα και διάρκεια νόσου, πόνο κόπωση, άγχος και νευρολογικές καταστάσεις (Bertoli AM et al 2007, Da Costa et al 1999, Benitha R et al 2007. Επίσης στην ίδια µελέτη βρέθηκε ότι η ανικανότητα προς εργασία του ΣΕΛ, έχει πολύ υψηλό κόστος για την ∆ηµόσια υγεία.…”