AB1235 Work productivity among workers with axial spondyloarthritis
Authors: C.A. Lopes, F.M. Pimentel-Santos, M. Mateus, J.C. Branco
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Axial Spondyloarthritis (axSpA) usually starts in early adulthood and the lifetime impact of the disease can be considerable. Pain, stiffness, sleep disturbances contribute to health-related quality of life reduction with significant impact in work productivity. Absenteeism and presenteeism are still responsible for high costs associated with the disease. <h3>Objectives</h3> Assess absenteeism, presenteeism, work and daily-activities impairment and their related associated factors in patients with axSpA. <h3>Methods</h3> Cross-sectional postal, unicenter, non-interventional study. Patients fulfilling the Assessment of Spa International Society Classification criteria for axSpA under working age were included. Two groups were defined: A) patients under current anti-TNF; B) patients under conventional therapy. Quantitative and qualitative surveys were performed: Work Productivity and Activity Impairment Questionnaire in SpA (WPAI); participants' experiences of working and their perceptions of how their condition had affected their work capacity and workplace relationships were recorded. The questionnaires were applied through a telephone call, after consent of the participant and respecting anonymity. <h3>Results</h3> 60 patients were included (table 1). No significant differences were found between the two groups. They worked on average 42±14.7 hours per week (h/w) and missed 2.3±4.1 h/w due to axSpA. Mean absenteeism, presenteeism, work and activities impairment due to axSpA were 6.8%, 32%, 35% and 41%, respectively. The univariable analysis showed correlations between absenteeism and Visual Analogue Scale physician (phVAS) (p=0.027); presenteeism and Anquilosing Spondylitis disease activity score – C reactive protein (ASDAS-CRP) (p=0.002), Bath AS Disease Activity Index (BASDAI) (p=0.03), Bath AS Functional Index (BASFI) (p=0.02), VAS patient (pVAS) and phVAS (p=0.01, p=0.006), erythrocyte sedimentation rate (ESR) (p=0.03), CRP (p=0.024); percent overall work impairment and ASDAS-CRP (p=0.002), BASDAI (p=0.019), BASFI (p=0.026), pVAS and phVAS (p=0.016, p=0.01), ESR (p=0.03) and CRP (p=0.03); percent activity impairment and BASDAI (p=0.006), BASFI (p=0.004), pVAS (p=0.0004) and phVAS (p=0.007). No correlation was found between work productivity and anti-TNF medication, education or marital status. Regression analysis revealed that BASDAI, BASFI, phVAS, pVAS and CRP accounted for 63% of the variance of presenteeism, with 10 points increase in phVAS resulted in an increase of 17% in presenteeism (p=0.046). Over time, 95% had already gone to work sick: economic reasons (60%), not liking staying at home even sick (43%) and importance of work (35%) were the major reasons to presenteeism. Overall, 63% considered that the disease can limit their projects or career progression; 56% had already cancelled or postponed work; 20% had already changed jobs and 15% stated that had already felt discriminated. <h3>Conclusions</h3> Presenteeism, impairment of work productivity and activity were correlated with disease activity and physical functioning, with the increase of VAS physician resulting in increase in presenteeism. Economic reasons were the major factors to presenteeism and the majority of patients considered that the disease can limit their projects or career progression. <h3>Disclosure of Interest</h3> None declared