Work Loss in Patients With Celiac Disease: A Population-based Longitudinal Study

Abstract

BACKGROUND & AIMS:Celiac disease (CD) affects around 1% of the population worldwide. Data on work disability in patients with CD remain scarce. We estimated work loss in patients with CD, including its temporal relationship to diagnosis. METHODS:Through biopsy reports from Sweden's 28 pathology departments, we identified 16,005 working-aged patients with prevalent CD (villus atrophy) as of January 1, 2015, and 4936 incident patients diagnosed with CD in 2008 to 2015. Each patient was matched to up to 5 general-population comparators. Using nationwide social insurance registers, we retrieved prospectively recorded data on compensation for sick leave and disability leave to assess work loss in patients and comparators. RESULTS:In 2015, patients with prevalent CD had a mean of 42.5 lost work days as compared with 28.6 in comparators (mean difference, 14.7; 95% confidence interval [CI], 13.2-16.2), corresponding to a relative increase of 49%. More than one-half of the work loss (60.1%) in patients with CD was derived from a small subgroup (7%), whereas 75.4% had no work loss. Among incident patients, the annual mean difference between patients and comparators was 8.0 days (range, 5.4-10.6 days) of lost work 5 years before CD diagnosis, which grew to 13.7 days (range, 9.1-18.3 days) 5 years after diagnosis. No difference in work loss was observed between patients with or without mucosal healing at follow-up. CONCLUSIONS:Patients with CD lost more work days than comparators before their diagnosis, and this loss increased after diagnosis. Identifying patients with an increased risk of work loss may serve as a target to mitigate work disability, and thereby reduce work loss, in patients with CD.

Utilization and Effectiveness of eHealth Technology in the Follow‐up of Celiac Disease

“…Future cost-benefit analyses of eHealth versus standard follow-up of CD should also include long-term costs, which largely depend on the successful prevention of comorbidities and complications to CD (3). It is also unknown if eHealth may reduce work loss in CD (4).…”

“…Over the past few decades, there has been a rise in the prevalence of CD, which today affects about 1% of the population worldwide (2). The disease is associated with various intestinal and extra-intestinal manifestations, including impaired growth and quality of life (QoL) (2), as well as increased costs on individual and societal levels (3,4). A strict gluten-free diet (GFD) is a cumbersome but effective treatment that can alleviate symptoms and achieve mucosal healing in CD (5).…”

Psychometric validation of the celiac disease-specific quality of life survey (CD-QOL) in adults with celiac disease in the United States

“…Research suggests that adults with CeD miss significantly more work days than adults in the general population [ 26 ]. Participants reported the number of work or school days missed in the past 12 months due to illness from gluten exposure and CeD, respectively.…”

Diagnostic Delay in Coeliac Disease: A Survey among Danish Patients

“…Te long diagnostic delay can be a potential burden both for the patient and society, resulting in more health-care contacts and expenses, sick-leaves, etc. [10][11][12][13], as well as slower improvement after the start of treatment and an increased risk of health complications [5,7,8]. Te diagnostic delay can be divided into patient delay, referring to the duration of symptoms prior to the frst doctor visit, and doctor delay referring to the time from the frst doctor visit until the time of diagnosis.…”