Work disability in a multi‐ethnic Malaysian systemic lupus erythematosus cohort: A cross‐sectional study

Abstract

Aim To determine the prevalence of work disability (WD) among patients with systemic lupus erythematosus (SLE) and its associated factors. Method This was a cross‐sectional study involving SLE patients aged 18‐56 years from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Employment history was obtained from clinical interviews. WD was defined as unemployment, interruption of employment or premature cessation of employment due to SLE at any time after the diagnosis. SLE disease characteristics, presence of organ damage and Safety of Estrogens in Lupus Erythematosus National Assessment—SLE Disease Activity Index (SLEDAI) flare index were determined from the medical records. Self‐reported quality of life (QoL) was performed using the Medical Outcomes Study Short Form‐36 (SF‐36). Demographic factors, disease characteristics, and QoL were compared between patients with and without WD using statistical analyses. Results A total of 215 patients were recruited and the majority were Malay (60.5%), followed by Chinese (33.5%), Indian (4.5%) and others (n = 4, 1.9%). The prevalence of WD was 43.2% (n = 93) with 22.3% (n = 48) patients were unemployed at the time of study. Over half the patients with WD (n = 51, 54.8%) had onset of disability at <5 years from diagnosis. Patients with WD had significantly lower health‐related QoL. The independent factors associated with WD were SLEDAI score at diagnosis, frequency of flare, Systemic Lupus International Collaborating Clinics score, being married, had lower education and lupus nephritis. Conclusion We found a high rate of WD in patients with SLE and it was significantly associated with SLE‐related factors, in particular higher disease activity, presence of renal involvement and organ damage.

Social impact of disease parameters and damage accrual in adult Brazilian patients with childhood-onset Systemic Lupus Erythematosus

“…25 Interestingly, a similar rate (44%) of cSLE patients with no paid job has been described in the Dutch population, a high-income country. 26 High rates of unemployment were also described in SLE patients from Germany (49%) 27 and Malaysia (22%), 28 and a job loss rate of 49% was reported after an average disease duration of 13 years in the United States. 29…”

“…25 Interestingly, a similar rate (44%) of cSLE patients with no paid job has been described in the Dutch population, a high-income country. 26 High rates of unemployment were also described in SLE patients from Germany (49%) 27 and Malaysia (22%), 28 and a job loss rate of 49% was reported after an average disease duration of 13 years in the United States. 29 However, in our study, most of the unemployed subjects reported that have never worked before due to limitation caused by disease flares or organ damage, such as fatigue, pain, movement restriction, hemodialysis, and frequent medical appointments.…”

Social Disparities and Incapability to Work Due to Illness or Disability among Working-Age Population in Thailand

“…Email: drwongsa@gmail.com All of circumstances might be involved by health and sick leave 12 . As same as diabetes [13][14][15] , cardiovascular disease 14,16 , cancer 14,17 , obesity 14 , back or neck pain 14,18 , Systemic Lupus Erythematosus (SLE) 19 , mental health problems and chronic pain 20 were considered as prolong illness among them. Moreover, work disability in patients with SLE was associated in particular higher disease activity, presence of renal involvement and organ damage 19 .…”

“…As same as diabetes [13][14][15] , cardiovascular disease 14,16 , cancer 14,17 , obesity 14 , back or neck pain 14,18 , Systemic Lupus Erythematosus (SLE) 19 , mental health problems and chronic pain 20 were considered as prolong illness among them. Moreover, work disability in patients with SLE was associated in particular higher disease activity, presence of renal involvement and organ damage 19 . Previous studies reported factors associated with absence to work or disability were working hours, working place away from home, no autonomy in planning task as well as fatigue during working was one of the risk of sickness that lead to absence from wok or work disability 21 .…”

Work disability and musculoskeletal disease

“…How many of these elements contribute to any one individuals’ work status will vary across the life of the individual as well as where (and when) they live. The study by Abu Baker et al contributes to our knowledge in this area by examining the experience of a cohort of Malaysian patients with systemic lupus erythematosus. This is quite a specific population to study, and yet given the variables involved in determining work disability, it is important for Malaysia to understand what is happening in their own population and socio‐political environment.…”