Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Patients with Rheumatoid
arthritis (RA) experience declining functional ability, quality of life,
employment and work productivity. Such outcomes have been described in
homogeneous, mostly Caucasian cohorts. Our objective was to characterize
baseline determinants of employment, absenteeism, presenteeism,
work productivity loss (WPL), and activity impairment (AI) in Latinos with RA
in the US. We further explored longitudinal predictors of both maintenance of
employment, as well as of regaining employment over time.
Methods: We assessed 303 Latinos with RA and
regular follow up in a single center between 2011 and 2014. Evaluator outcomes-
including global disease activity (EGA), swollen and tender joints, sedimentation
rate (ESR)- and patient reported outcomes such as global activity (PGA),
disability (Health Assessment Questionnaire, HAQ-DI), pain, fatigue, and depression
(Patient Health Questionnaire, PHQ9) were recorded at baseline and follow-up
visits, at a median of 2 years. A Work Productivity and Activity Impairment
(WPAI) questionnaire was completed at both times. Linear and logistic regression
models evaluated predictors of outcomes of interest at baseline. Cox regression
models assessed survival of employment, regaining employment, and their
determinants longitudinally.
Results: At
baseline, 77 (25%) patients were employed; they were younger, had lower ESR,
prednisone use and numbers of concurrent synthetic disease modifying agents-DMARDs
(all <0.05). They also had lower PGA, disability, pain, fatigue, and
activity impairment (all <0.05). Higher HAQ-DI, DMARD numbers, and pain negatively
associated with employment (table 1). Fatigue and HAQ-DI strongly predicted presenteeism and WPL in those employed, while pain and PGA
additionally predicted AI in all. Those remaining employed (68%) had lower depression
scores; employment survival was further predicted by decrease in tender joints,
fatigue, and EGA. Those gaining employment (11%) were significantly younger, with
lower baseline HAQ-DI and greater changes in HAQ-DI (all, p<0.05).
Conclusion: Few Latinos
with RA are gainfully employed. HAQ-DI is a durable predictor of baseline
employment, work productivity loss and activity impairment; its change- in
those unemployed- further determines who regains employment. Patient-reported
outcomes such as fatigue, pain, and PGA significantly and differentially
contribute to several aspects of work productivity and activity impairment.
Table 1: Independent, multivariate contributors to Employment, Absenteeism, Presenteeism, Work Productivity Loss and Activity
Impairment in Latinos with RA in the US
|
Employment |
Absenteeism |
Presenteeism |
Work Productivity Loss |
Activity Impairment |
||||||
|
Univariate Factors |
OR (95% CI) |
p |
B (95% CI) |
p |
B (95% CI) |
p |
B (95% CI) |
p |
B (95% CI) |
p |
|
Age |
0.98 (0.95-1.01) |
0.2 |
-0.04 (-0.07,-0.008)
|
0.02
|
– |
– |
– |
– |
– |
– |
|
SJC |
1.13 (1.05-1.21) |
0.001
|
– |
– |
0.11 (-1.46-1.67) |
0.89 |
-0.26 (-2.02-1.50) |
0.77 |
-1.08 (-1.05-0.89) |
0.87 |
|
n-DMARD |
0.67 (0.49-0.92) |
0.01
|
– |
– |
– |
– |
– |
– |
– |
– |
|
Fibromyalgia |
0.50 (0.16-1.57) |
0.24 |
1.52 (0.21-2.83) |
0.02
|
– |
– |
5.31 (-16.36-27.0) |
0.63 |
2.98 (-3.44-9.40) |
0.36 |
|
HAQ-DI |
0.49 (0.29-0.83) |
0.008
|
-0.22 (-0.75-0.32) |
0.42 |
9.48 (1.47-17.52) |
0.02
|
9.61 (0.85-18.38) |
0.03
|
11.93 (8.39-15.47) |
0.000
|
|
Pain |
0.55 (0.31-0.98) |
0.04
|
-0.56 (-1.15-0.03) |
0.06 |
-7.22 (-15.76-1.32) |
0.1 |
-6.21 (-15.3-2.9) |
0.18 |
6.20 (2.0-10.4) |
0.004
|
|
PGDA |
1.07 (0.89-1.30) |
0.46 |
0.19 (-0.007-0.38) |
0.06 |
2.02 (-0.61-4.65) |
0.13 |
2.07 (-0.93-5.06) |
0.17 |
1.84 (0.46-3.21) |
0.009
|
|
Fatigue |
1.99 (0.85-1.16) |
0.94 |
0.10 (-0.09-0.28) |
0.3 |
4.34 (1.78-6.91) |
0.001
|
4.94 (2.16-7.71) |
0.001
|
1.08 (-0.05-2.21) |
0.06 |
To cite this abstract in AMA style:
Karpouzas GA, Draper T, Hernandez E, Moran R, Ormseth S. Predictors of Employment, Work Productivity Loss, Activity Impairment, and Regaining Employment in Latinos with Rheumatoid Arthritis in the United States [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/predictors-of-employment-work-productivity-loss-activity-impairment-and-regaining-employment-in-latinos-with-rheumatoid-arthritis-in-the-united-states/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/predictors-of-employment-work-productivity-loss-activity-impairment-and-regaining-employment-in-latinos-with-rheumatoid-arthritis-in-the-united-states/