AB0684 COMPARATIVE ANALYSIS OF PATIENT-REPORTED OUTCOMES AMONG EMPLOYED AND UNEMPLOYED PATIENTS WITH AXIAL SPONDYLOARTHRITIS. RESULTS OF THE SPANISH ATLAS 2017
Authors: M. Garrido-Cumbrera, J. Gratacos-Masmitja, E. Collantes-Estévez, P. Zarco Montejo, C. Sastré, J. Correa-Fernández, P. Plazuelo-Ramos, V. Navarro-Compán
Journal: Annals of the Rheumatic Diseases (2020)

Background: Unemployment is associated with poorer disease outcomes in chronic conditions. Current high rates of unemployment in Spain may lead to a higher burden of disease in axial spondyloarthritis (axSpA) patients. Objectives: To evaluate the differences in sociodemographic factors and patient-reported outcomes (PROs) between employed and unemployed axSpA patients in the same sample. Methods: Data from 680 unselected patients of the Spanish Atlas of Axial Spondyloarthritis from an online survey were collected in 2016 were analysed. Active workforce participants were divided into employed and unemployed according to International Labour Organization (ILO) standards. Socio-demographic characteristics, and Patient-reported Outcomes (PROs) [BASDAI (0-10), spinal stiffness (3-12), functional limitation (0-54) and psychological distress (0-12, General Health Questionnaire GHQ-12)] were compared between employed and unemployed participants. The Χ 2 test was used for qualitative variables and the Mann-Whitney test for quantitative variables. Results: In total, 415 (63.6%) patients were categorised in the active population, of which 325 (78.3%) were employed and 90 (21.6%) unemployed (Table 1). 62.8% (N = 86) of unemployed patients declared that axSpA was the cause of their joblessness. Compared to the unemployed, the employed patients had a higher percentage of university studies (47.1% vs 23.3%; p=0.001) and higher income level per family member (€890.4 vs €358.5; p&lt;0.001). In relation to PROs, the unemployed presented greater disease activity (6.3±1.9 vs 5.2±1.9; p&lt;0.001) and spinal stiffness (7.8±2.3 vs 6.5±2.6), worst functional limitation (45.0±8.4 vs 40.6±10.1; p&lt;0.001) and more psychological distress (7.6±4.2 vs 4.9±4.3; p&lt;0.001). In addition, a higher proportion of unemployed participants self-reported anxiety (27.8% vs 16.0%; p=0.011) and depression (23.3% vs 10.2%; p=0.001) (Table 2). Table 1. Employment status of Spanish Atlas survey respondents Population N % Employment status N % Active population* 415 63.6 Employed 325 78.3 Unemployed 90 21.6 Total 415 100.0 Inactive population 238 36.4 Temporary sick leave 63 26.5 Permanent sick leave 64 26.9 Retired 63 26.5 Homemakers 29 12.2 Students 9 3.8 Early retirement 10 4.2 Total 238 100.0 Total 653 100.0 *According to the ILO Table 2. Association between sociodemographic characteristics and PROs comparing employed and unemployed axSpA patients Employed (N = 325 ) Mean ± SD or n (% ) Unemployed (N = 90 ) Mean ± SD or n (% ) p-value Sociodemographic Age (years) 42.9 ± 8.6 42.0 ± 9.1 0.513 Gender (Male) 159 (48.9) 36 (40.0) 0.133 Education level (University) 153 (47.1) 21 (23.3) 0.001* Marital status (Married) 231 (71.1) 54 (60.0) 0.051 Monthly Income (€) 890.4 ± 592.3 358.5 ± 377.7 &lt;0.001* PROs Diagnostic Delay (years) 7.7 ± 7.6 8.0 ± 6.5 0.319 BASDAI (0-10) 5.2 ± 1.9 6.3 ±1.9 &lt;0.001* Spinal Stiffness (3-12) 6.5 ± 2.6 7.8 ± 2.3 &lt;0.001* Global Limitation Index (0-54) 40.6 ± 10.1 45.0 ± 8.4 &lt;0.001* GHQ-12 (0-12) 4.9 ± 4.3 7.6 ± 4.2 &lt;0.001* Anxiety 52 (16.0) 25 (27.8) 0.011* Depression 33 (10.2) 21 (23.3) 0.001* Sleep disorder 50 (15.4) 18 (20.0) 0.295 Conclusion: The Spanish Atlas results show significant differences between employed and unemployed patients with axSpA, with greater disease activity, spinal stiffness, functional limitation, and poorer mental health in those who are unemployed. Acknowledgments: Funded by Novartis Pharma AG &amp; Novartis Farmacéutica S.A. Disclosure of Interests: Marco Garrido-Cumbrera: None declared, Jordi Gratacos-Masmitja Grant/research support from: a grant from Pfizzer to study implementation of multidisciplinary units to manage PSA in SPAIN, Consultant of: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Eduardo Collantes-Estévez Grant/research support from: ROCHE and Pfizer., Speakers bureau: ROCHE, Lilly, Bristol and Celgene., Pedro Zarco Montejo Grant/research support from: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Carlos Sastré Employee of: YES; I´m Medical Advisor in Novartis Spain, José Correa-Fernández: None declared, Pedro Plazuelo-Ramos: None declared, Victoria Navarro-Compán Consultant of: Abbvie, Lilly, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, MSD, Lilly, Novartis, Pfizer, UCB