The impact of comorbidities on productivity loss in asthma patients

Abstract

BackgroundHealth-related productivity loss is an important, yet overlooked, component of the economic burden of disease in asthma patients of a working age. We aimed at evaluating the effect of comorbidities on productivity loss among adult asthma patients.MethodsIn a random sample of employed adults with asthma, we measured comorbidities using a validated self-administered comorbidity questionnaire (SCQ), as well as productivity loss, including absenteeism and presenteeism, using validated instruments. Productivity loss was measured in 2010 Canadian dollars ($). We used a two-part regression model to estimate the adjusted difference of productivity loss across levels of comorbidity, controlling for potential confounding variables.Results284 adults with the mean age of 47.8 (SD 11.8) were included (68 % women). The mean SCQ score was 2.47 (SD 2.97, range 0–15) and the average productivity loss was $317.5 per week (SD $858.8). One-unit increase in the SCQ score was associated with 14 % (95 % CI 1.02–1.28) increase in the odds of reporting productivity loss, and 9.0 % (95 % CI 1.01–1.18) increase in productivity loss among those reported any loss of productivity. A person with a SCQ score of 15 had almost $1000 per week more productivity loss than a patient with a SCQ of zero.ConclusionsOur study deepens the evidence-base on the burden of asthma, by demonstrating that comorbidities substantially decrease productivity in working asthma patients. Asthma management strategies must be cognizant of the role of comorbidities to properly incorporate the effect of comorbidity and productivity loss in estimating the benefit of disease management strategies.

Impact of comorbid conditions on asthmatic adults and children

“…Diagnosis of VCD can be difficult to confirm as physical examination and spirometry may be normal between episodes 36 . It is also important to exclude significant upper airway • Cough or wheezing after consuming acidic drinks or food or after a large meal 11,16 • Hoarseness, predominance of nocturnal symptoms, symptom (heartburn, regurgitation) occurrence when changing position, unexplained dental decay 11,16 • Trialling PPI 8 • Specific examinations assessing GERD, such as impedance-pH monitoring and/or gastro-oesophageal endoscopy 12 • Not associated with any asthma phenotype 8 • Patient Health Questionnaire (PHQ-9) for depression 20…”

“…Asthma comorbid conditions are associated with substantial healthcare costs that are five times higher than costs attributable to asthma alone 9 . On top of the direct costs, asthma comorbid conditions are associated with worse asthma-related outcomes 5,10 , increased risk of work disability 11 and significant productivity losses 12 , further contributing to the burden of the disease.…”

“…• Specific examinations assessing GERD, such as impedance–pH monitoring and/or gastro-oesophageal endoscopy 12 …”

<p>Asthma impacts on workplace productivity in employed patients who are symptomatic despite background therapy: a multinational survey</p>

“…According to a recent Canadian study, suboptimal asthma control can lead to a projected total discounted societal cost of C$213.10 billion for the period 2014–2033 34. Another Canadian study also showed that the cost of comorbidities associated with asthma, and subsequent productivity impairment, was approximately C$1,000 per week per individual, with high comorbidity versus an asthma patient with no comorbidity 35. Uncontrolled asthma and comorbidities can therefore represent a significant resource burden.…”

Ashtma-Chronic obstructive pulmonary disease overlap syndrome (ACOS): current evidence and future research directions

“…Thus, asthma is also a common condition, responsible for considerable morbidity, healthcare utilization and costs, which include those costs caused by the days off work and decrease productivity of patients with uncontrolled asthma [6,7]. Asthma is also characterized by the presence of comorbidities which substantially affect the quality of life and the number of exacerbations [8].…”