Work participation in spondyloarthritis across countries: analysis from the ASAS-COMOSPA study

Manica, Santiago Rodrigues; Sepriano, Alexandre; Smolen, Josef S; Santos, Fernando P.; Putrik, Polina; Nikiphorou, Elena; Norton, Sam; Moltó, Anna; Dougados, Maxime; Heijde, Desirée van der; Landewé, Robert; Bosch, Filip E Van den; Boonen, Annelies

doi:10.1136/annrheumdis-2018-213464

Cited by 20 publications

(17 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As in the ASAS-COMOSPA study, we found significant between-country variation in work participation [8]. There were no significant differences in employment status, absenteeism, presenteeism, overall work impairment, or their predictive factors across SpA phenotypes.…”

Section: Discussionsupporting

confidence: 56%

“…There are remarkable differences in work status and productivity costs even between neighbouring European countries despite comparable quality of care for chronic diseases [3,4]. Worldwide, country-level socioeconomic factors (e.g., healthcare expenditure) are associated with employment in SpA [8]; these often overlooked contextual factors are essential for understanding widespread inequality in disease outcomes. A prior study reported associations between individual-level factors (e.g., gender and education) and employment status [8], but how country-level factors modify the effect of individual-level socioeconomic factors remains an unmet research need.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between individual and country-level socioeconomic factors and work participation in spondyloarthritis including psoriatic arthritis: analysis of the ASAS-perSpA study

Zhao

Nikiphorou

Boonen

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Objective. To examine whether associations between socioeconomic factors and work outcomes in spondyloarthritis (SpA) differ across axial (axSpA), peripheral SpA (pSpA) and psoriatic arthritis (PsA), and whether associations for individual-level socioeconomic factors are modified by country-level factors. Methods. Patients with a physician diagnosis of SpA within working age (18-65 years) were included. Associations between individual- (age, gender, education, marital status) and country-level factors (Human Development Index, Health Care Expenditure (HCE), Gross Domestic Product, percentage unemployed) with work outcomes (employment status, absenteeism, presenteeism) were assessed using multivariable mixed-effects models. Associations between individual factors and outcomes were compared according to SpA phenotypes and country-level factors using interaction terms. Results. A total of 3835 patients (mean age 42 years, 61% males) from 23 countries worldwide were included (66% axSpA, 10% pSpA, 23% PsA). Being employed was associated with gender (male vs. female OR 2.5; 95%CI 1.9-3.2), education (university vs. primary OR 3.7; 2.9-4.7), marital status (married vs. single OR 1.3; 1.04-1.6), and age in a non-linear manner. University (vs primary) education was associated with lower odds of absenteeism (OR 0.7; 0.5-0.7) and presenteeism (OR 0.5; 0.3-0.7). Associations were similar across SpA phenotypes. Higher HCE was associated with more favourable work outcomes, e.g., higher odds of employment (OR 2.5; 1.5-4.1). Gender discrepancy in odds of employment was greater in countries with lower socioeconomic development. Conclusion. Higher educational attainment and higher HCE were associated with more favourable work outcomes, independently of SpA phenotype. The disadvantageous effect of female gender on employment is particularly strong in countries with lower socioeconomic development.

show abstract

Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Association between individual and country-level socioeconomic factors and work participation in spondyloarthritis including psoriatic arthritis: analysis of the ASAS-perSpA study

Zhao

Nikiphorou

Boonen

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“… 25 For example, manual workers experience more impact from axSpA on presenteeism, but also experience more beneficial effect of bDMARDs on presenteeism. 26 Country of residence (likely reflecting social security regulations, including income substitution) is another contextual determinant of variation in employment and sick leave rates across countries, 27 28 and may cause effect modification of interventions. 29 OMERACT proposed a classification of 12 contextual factor domains potentially relevant for WP outcomes 30 31 ( table 3 ).…”

Section: Resultsmentioning

confidence: 99%

EULAR Points to Consider (PtC) for designing, analysing and reporting of studies with work participation as an outcome domain in patients with inflammatory arthritis

et al. 2021

Self Cite

View full text Add to dashboard Cite

BackgroundClinical studies with work participation (WP) as an outcome domain pose particular methodological challenges that hamper interpretation, comparison between studies and meta-analyses.ObjectivesTo develop Points to Consider (PtC) for design, analysis and reporting of studies of patients with inflammatory arthritis that include WP as a primary or secondary outcome domain.MethodsThe EULAR Standardised Operating Procedures were followed. A multidisciplinary taskforce with 22 experts including patients with rheumatic diseases, from 10 EULAR countries and Canada, identified methodologic areas of concern. Two systematic literature reviews (SLR) appraised the methodology across these areas. In parallel, two surveys among professional societies and experts outside the taskforce sought for additional methodological areas or existing conducting/reporting recommendations. The taskforce formulated the PtC after presentation of the SLRs and survey results, and discussion. Consensus was obtained through informal voting, with levels of agreement obtained anonymously.ResultsTwo overarching principles and nine PtC were formulated. The taskforce recommends to align the work-related study objective to the design, duration, and outcome domains/measurement instruments of the study (PtC: 1–3); to identify contextual factors upfront and account for them in analyses (PtC: 4); to account for interdependence of different work outcome domains and for changes in work status over time (PtC: 5–7); to present results as means as well as proportions of patients reaching predefined meaningful categories (PtC: 8) and to explicitly report volumes of productivity loss when costs are an outcome (PtC:9).ConclusionAdherence to these EULAR PtC will improve the methodological quality of studies evaluating WP.

show abstract

“…[2][3][4] Even more important than work disability is perhaps thinking of prequels to this often irreversible outcome, such as presenteeism and sick leave (SL). [5][6][7][8][9] The findings of studies to date that have sought to examine specifically SL, vary widely in the literature and across countries. [10][11][12] SL is to a large extent an individual's decision and also driven by the social security system of a country, aside from a disease-driven outcome; in this regard, personal contextual…”

Section: Introductionmentioning

confidence: 99%

Sick leave in early axial spondyloarthritis: the role of clinical and socioeconomic factors. Five-year data from the DESIR cohort

et al. 2021

Self Cite

View full text Add to dashboard Cite

ObjectivesTo investigate the occurrence of sick leave (SL) and the impact of clinical and socioeconomic factors on SL in early axial spondyloarthritis (axSpA).MethodsPatients with a clinical diagnosis of axSpA from the DEvenir des Spondyloarthrites Indifférenciées Récentes (DESIR) cohort with work-related data and up to 5-year follow-up were studied. Incidence, time to first SL and potential role of baseline and time-varying clinical and socioeconomic factors (age, gender, ethnicity, education, job type, marital and parental status) were analysed. Univariable analyses, followed by collinearity and interaction tests, guided subsequent multivariable time-varying Cox survival model building.ResultsIn total, 704 axSpA patients were included (mean (SD) age 33.8 (8.6); 46% men). At baseline, 80% of patients were employed; of these, 5.7% reported being on SL. The incidence of SL among those at risk during the study period (n=620, 88%) was 0.05 (95% CI 0.03 to 0.06) per 1000 days of follow-up. Mean (SD) time to first SL was 806 (595) days (range: 175–2021 days). In multivariable models, male gender (HR 0.41 (95% CI 0.20 to 0.86)) and higher education (HR 0.48 (95% CI 0.24 to 0.95)) were associated with lower hazard of SL, while higher disease activity (HR 1.49 (95% CI 1.04 to 2.13)), older age, smoking and use of tumour necrosis factor inhibitors were associated with higher hazard of SL.ConclusionsIn this early axSpA cohort of young, working-age individuals, male gender and higher education were independently associated with a lower hazard of SL, whereas older age and higher disease activity were associated with higher hazard of SL. The findings suggest a role of socioeconomic factors in adverse work outcomes, alongside active disease.

show abstract

Work participation in spondyloarthritis across countries: analysis from the ASAS-COMOSPA study

Abstract: Higher education level and higher country SE welfare are associated with a higher likelihood of keeping patients with SpA employed. Absenteeism and presenteeism are only associated with clinical but not with individual-level or country-level SE factors.

Cited by 20 publications

References 28 publications

Association between individual and country-level socioeconomic factors and work participation in spondyloarthritis including psoriatic arthritis: analysis of the ASAS-perSpA study

Association between individual and country-level socioeconomic factors and work participation in spondyloarthritis including psoriatic arthritis: analysis of the ASAS-perSpA study

EULAR Points to Consider (PtC) for designing, analysing and reporting of studies with work participation as an outcome domain in patients with inflammatory arthritis

Sick leave in early axial spondyloarthritis: the role of clinical and socioeconomic factors. Five-year data from the DESIR cohort

Contact Info

Product

Resources

About