Total costs and predictors of costs in patients with systemic lupus erythematosus

Sutcliffe, Nurhan; Clarke, A.; Taylor, Rebecca J.; Frost, Chris; Isenberg, DA

doi:10.1093/rheumatology/40.1.37

Cited by 105 publications

(121 citation statements)

References 22 publications

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“…Total indirect costs and absenteeism rates are scarcely comparable across different chronic diseases given the wide variability in measurement methods across studies. Nevertheless, annual missed workdays estimate in our sample was 25%, as compared to 1.8-7% for diabetes, 7.5% for lupus erythematosus, 9.5% for depression, and 1.7 and 2.5% for men and women with migraine, respectively (percentages calculated from published data assuming standard 44 work weeks per year) [31,32,33,34,35,36,37]. …”

Section: Discussionmentioning

confidence: 63%

Work Ability and Labor Supply after Kidney Transplantation

et al. 2014

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Background: The vocational rehabilitation after kidney transplantation (KTX) is suboptimal. We sought to evaluate correlates of occupational outcomes after KTX. Methods: We included 336 working-age patients with at least one creatinine assessment in the 3-month screening period. We collected clinical information from medical records. All subjects answered a self-administered questionnaire, and a follow-up questionnaire was mailed to each participant after 6 months. Study outcomes were the Work Ability Index (WAI) and labor supply (the number of days each patient worked in the follow-up period). We estimated the glomerular filtration rate (eGFR) with the Modification of Diet in Renal Disease Study equation. Results: The mean eGFR was 52.76 ± 23.68 ml/min/1.73 m². The age-standardized employment-to-population ratio was 62%. Comorbidities, self-reported work ability, gender, age, health insurance type, and time since transplant were associated with employment status at baseline. The WAI (38.79 ± 5.88) was associated with the severity of renal impairment, work attachment and comorbidities. After 6 months, labor supply (mean 19.4 ± 9.7 weeks) was associated with WAI item 1 (ρ = 0.22; p = 0.03); eGFR was significantly associated with labor supply, and this association was slightly stronger in patients with physically demanding jobs. Conclusions: We identified modifiable factors associated with poor occupational outcomes in kidney transplant recipients. Consistent with labor supply theory, our results suggest that health care coverage plays a key role in employment decisions after KTX independent of possible confounders. Additionally, our study provides the rationale to further evaluate the implications of renal function-preserving strategies for indirect cost savings and self-reported ability to work after transplant.

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Section: Discussionmentioning

confidence: 63%

Work Ability and Labor Supply after Kidney Transplantation

et al. 2014

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“…Although many European studies have shown SLE may result in loss of employment, [26][27][28][29][30] only a few have shown that SLE reduces overall productivity outside of paid employment. 31,32 As SLE occurs predominantly in women of childbearing age, frequently responsible for childcare and housework, productivity losses outside of paid employment are particularly important to understand and quantify. [33][34][35] This analysis has limitations commonly associated with survey-based/observational studies.…”

Section: Discussionmentioning

confidence: 99%

Limitations of current treatments for systemic lupus erythematosus: a patient and physician survey

Strand

Galateanu

Pushparajah

et al. 2013

Lupus

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An independent cross-sectional survey assessed systemic lupus erythematosus (SLE) disease and treatment burden. Variables included medication classes prescribed, disease activity, flare occurrences, treatment satisfaction, and validated measures of health-related quality of life (HRQoL), fatigue and work productivity. Of 886 eligible patients (mean age 41.3 years, 89% female), 515 completed the survey. One-third reported moderate-to-severe disease activity, and 31% had flared in the last 12 months. Higher severity of disease activity (moderate-to-severe) was associated with 2 medication classes prescribed and treatment regimens that included corticosteroids (CS) (both p < 0.0001). Patients receiving CS reported lower EQ-5D scores (p ¼ 0.0019) and higher fatigue levels (p < 0.001), and both patients (p ¼ 0.0019) and physicians (p ¼ 0.0001) were less likely to report satisfaction with treatment regimens including CS. Among responders eligible for work (n ¼ 456), severity of disease activity (moderate-tosevere vs. mild) was associated with unemployment (52.9% vs. 40.8%; p ¼ 0.0189), greater impairment in work productivity (36% vs. 21%; p ¼ 0.0003) and participation in daily activities (41% vs. 21%; p < 0.0001). This survey confirms that SLE and current treatment options substantially impair patients' health status and work productivity. Physician-and patientreported satisfaction with current treatment regimens, despite poorly controlled disease activity, indicate they are resigned to the limitations of available SLE treatment regimens. Lupus (2013) 22, 819-826.

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“…The authors conclude that SLE has a considerable impact on the health system and society. Improving disease activity and physical health, as well as the prevention of organ damage can significantly reduce costs in SLE (14). In 2001, Clarke et al compared the direct and indirect costs of care for SLE patients in Canada, USA and UK.…”

Section: Cost-of-illness Studies In Slementioning

confidence: 99%