AB0417 WORK IMPAIRMENT AND PREDICTORS OF WORK INCAPACITY AMONG PRIMARY SJOGREN’S SYNDROME PATIENTS
Authors: D. Khalifa, A. Guiga, W. Ben Yahiya, A. Atig, N. Ghannouchi
Journal: Annals of the Rheumatic Diseases (2020)

Background: Primary Sjogren’s syndrome (PSS) is a prevalent rheumatic disorder affecting exocrine glands but also other systems. It alters quality of life of affected patients and increases work incapacity and general activity impaiment. Objectives: The purpose of this study was to assess the influence of PSS on work among affected patients and determine predictors of work incapacity. Methods: A cross-sectional study was conducted in the internal medicine department. Adult patients diagnosed with PSS and fulfilling the EULAR criterea for the diagnosis were included. Clinical and biological data was collected from medical files and during medical visits. Disease activity was calculated using the ESSDAI score. Work incapacity was assessed by the Work productivity and activity impairment for general health questionnaire (WPAI-GH) from which four dimensions can be calculated and expressed in percentages by the following scores: 1) percent work time missed due to health = Q2/(Q2 + Q4) for those who were currently employed; 2) percent impairment while working due to health = Q5/10 for those who were currently employed and actually worked in the past seven days; 3) percent overall work impairment due to health Q2/(Q2 + Q4) + ((1 - Q2/(Q2 + Q4)) × (Q5/10)) for those who were currently employed; 4) percent activity impairment due to health Q6/10 for all respondents. Results: Eighty patients were randomly asked to fill out the questionnaire. Response rate was of 62.5%. Total number of enrolled patients was 50. The median age was 56.5 years (min=22, max=60). Patients were mainly women with female to male ratio of 11.5:1. The median age of diagnosis was 50.5 years (min=18, max=59). Mean duration of the disease was 6 years ± 3.76. Sicca syndrome was the most prevalent clinical feature affecting the eyes in 84% of the cases and the mouth in 90% of the cases. Arthralgia was present in 88% of the cases. 65.1% of patients had an active disease. Anti Ro antibodies were positive in 38%, anti La in 28% and rheumatoid factor in 50% of cases. 36% of the patients were unemployed. Percentage of work time missed due to health for those who were employed in the past 7 days was 2.44% (Q1=0;Q2=5.26). Mean percentage of impairment while working due to health for those who were employed and actually worked in the past 7 days was 20.56±18.25%. Percentage of overall work impairment due to health for those who were currently employed and actually worked was 25.87±19.58%, and the percentage of overall activity impairment due to health for all respondents was 26.6±18.36%. Analytic statistics showed no correlation between employment status and age, duration of disease, gender or seropositivity. However, all unemployed patients had ocular symptoms vs 75% of those employed (p value=0.04). The first dimension was correlated with the presence of dry mouth (p value=0.07) but with weak statistical significance. Second and third dimensions weren’t associated to any general, clinical or laboratory feature. Fourth dimension was significantly correlated to the presence of dry eyes (p value=0.019) and gender (p value=0.001). Conclusion: PSS is associated with high unemployment rates in Tunisia, high impairment rates while working and high rates of overall impairment. This high prevalence may be explained by gender and the presence of dry eyes and dry mouths. This work highlights the importance of managing sicca symptoms as they alter different aspects of quality of life like work. References: [1]Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. PharmacoEconomics. nov 1993;4(5):353‑ 65. [2]Mandl T, Jørgensen TS, Skougaard M, Olsson P, Kristensen L-E. Work Disability in Newly Diagnosed Patients with Primary Sjögren Syndrome. J Rheumatol. févr 2017;44(2):209‑15. Disclosure of Interests: : None declared