The impact of hidradenitis suppurativa on work productivity and performance: a systematic review and meta-analysis

Abstract

Background Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder affecting the skinfold regions. There is growing appreciation of the need for socioeconomic factors to be included in multidisciplinary assessments of HS. However, knowledge regarding HS and workplace function is limited. Objectives To assess the relationship between HS and workplace function. Methods Cinahl, Embase, MedLine, PsycInfo and PubMed were systematically searched to collect data from studies in which validated surveys of workplace function were administered to HS patients. Results Out of 1,932 publications, twelve studies were included in this review and seven reported sufficient data for meta-analysis. Included studies encompassed 5,187 HS patients and no controls. All studies employed the Work Productivity and Activity Impairment questionnaire, reporting percentage scores for absenteeism, presenteeism, total work productivity impairment (TWPI) and total activity impairment (TAI). Pooled mean scores for HS were calculated as 10.17% (95%CI 8.68–11.66) for absenteeism, 31.13% (95%CI 25.02–37.23) for presenteeism, 34.25% (95%CI 29.37–39.14) for TWPI, and 42.23% (95%CI 38.56–45.89) for TAI. Significant heterogeneity was identified and most studies were of ‘poor’ to ‘fair’ quality. Conclusions Current evidence suggests considerable impairment of workplace functioning in HS patients. Our findings point to a significant unmet treatment need with respect to improving working capability in HS. The extant literature is inadequate to reliably assess the mechanisms underlying this effect or to comparatively assess the capabilities of HS therapies to improve workplace function.