Background/Purpose: Chronic inflammatory diseases such as antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) substantially affects patients’ daily lives, including their ability to work. Although the management of AAV has improved, many patients still have to take sick leave or even stop working because of their diseases (i.e., absenteeism). Even for those remaining in paid work, patients may experience problems due to AAV resulting in productivity loss while at work (i.e., presenteeism). However, little has been reported on absenteeism and presenteeism in patients with AAV. We aimed to investigate the absenteeism and presenteeism in patients with AAV and associated factors.

Methods: Patients with AAV were defined and classified according to the European Medicines Agency algorithm. Patients were approached during their outpatient appointments in the three different university hospitals from November 2017 through February 2018. Some of the hospitalized patients were also eligible. Patients were asked to complete the Work Productivity and Activity Impairment–General Health (WPAI-GH) questionnaire, the 5-level EuroQoL 5-Dimensions Questionnaire (EQ-5D-5L), which is the generic measures of health-related quality of life (HRQoL), and other related demographic questionnaires. An EQ-5D-5L health state was converted to a single summary index by applying the formula and ranges from 0 to 1; 0 meaning death and 1 complete health. Physicians, who were blinded to the WPAI-GH and EQ-5D-5L results, completed the the Birmingham Vasculitis Activity Score (BVAS) and the Vasculitis Damage Index (VDI) simultaneously and record other medical information.

Results: A total of 92 patients with AAV (microscopic polyangiitis 42, granulomatosis with polyangiitis 24, eosinophilic granulomatosis with polyangiitis 22, renal limited AAV 3, and unclassified AAV 1) participated. In the study population, the mean age was 65.4, 60 were women, the mean disease duration was 5.5 years, the mean prednisolone dosage was 7.5 mg/day, the mean BVAS was 3.6, and the mean VDI was 1.6. The mean EQ-5D-5L index value was 0.755 and significantly lower than the value of the age- and sex-matched national norms (p < 0.01). A total of 25 (27%) patients worked for pay and significantly younger than those who did not work (p < 0.01). Of the 25 patients working for pay, 11 reported missing work due to their health problem, accounting for 17% of their working time (absenteeism) on average, and 32% of their work was impaired due to their health problem (presenteeism) on average. WPAI absenteeism was weakly to moderately correlated with the and BVAS and EQ-5D-5L scores (r = 0.24 and −0.61, respectively), whereas not with the VDI scores (r = 0.08). WPAI presenteeism was weakly to moderately correlated with the BVAS, VDI, and EQ-5D-5L scores (r = 0.39, 0.38, and −0.58, respectively). Patients with lower HRQoL status (low/high EQ-5D-5L scores by median) had significantly higher absenteeism (28%/17%, p = 0.01), and presenteeism (48%/32%, p = 0.002) than those with higher HRQoL status.

Conclusion: Work productivity assessed by absenteeism and presenteeism are associated with disease activity, damage, and HRQoL in patients with AAV.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-work-productivity-assessed-by-absenteeism-and-presenteeism-with-disease-activity-damage-and-health-related-quality-of-life-in-patients-with-anca-associated-vasculitis/