Not a Surprise, but Helpful
The results are "not at all a surprise," Eric M. Ruderman, MD, from the Multidisciplinary Clinical Research Center in Rheumatology at Northwestern University Feinberg School of Medicine, Chicago, Illinois, told Medscape Medical News. "The takeaway from the study is we need to do a better job of psoriatic arthritis."
Here's the link to cut-n-paste the address into your browser:
I was going to open the link but it said I had to set up an account in medscape first. I screwed up doing that so I just gave up. Cheryl, could you possibly summarize what the article states in a comment here.
It sounds interesting and this is exactly why I'm not telling anybody at work I have PsA because I think it'll ruin my chances for getting a position upgrade!
Well huh. I read the article on my Facebook newsfeed page. I"liked" or joined livingwithpsoriaticarthritis.org on Facebook. That is how I could read it.
Here's the article:
Larry Hand
August 28, 2014For patients with psoriatic arthritis (PsA), older age, disease duration of 2 to 5 years, and worse physical function can negatively affect keeping a job, according to an article published online August 13 in Rheumatology.
Employer awareness and helpfulness, however, can have a positive influence on remaining employed, researchers write.
William Tillett, MBChD, PhD, a rheumatologist with the Royal National Hospital for Rheumatic Diseases, Bath, United Kingdom, and colleagues conducted a multicenter observational cohort study to examine associations among work disability, PsA, and social and demographic factors. They recruited 400 patients with PsA from 23 hospitals in the United Kingdom to answer questions from a work productivity and activity questionnaire.
Of those patients, 318 were of working age (18-65 years), with a mean age of 46.8 years. The mean disease duration was 5.8 years, and 49.9% were female. Of the working-age participants, 226 were employed.
The researchers found that for the 226 employed patients, the rate of absenteeism was 14%, the rate of presenteeism was 39%, and the rate of productivity loss was 46%. They also found that for every additional year of age, the risk of becoming unemployed increased by 1% (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.994 - 0.999; P = .02).
"However, PsA is a chronic disease and when considered over decades this effect becomes a clinically meaningful burden," the researchers write.
Disease duration of 2 to 5 years increased the risk for unemployment (OR, 0.41; 95% CI, 0.180 - 0.953; P = .03), and worse physical condition also increased the risk for unemployment (OR, 0.56; 95% CI, 0.343 - 0.926; P = .02).
If patients rated their employer as being helpful, the likelihood of remaining in their job strongly increased (OR, 15.10; 95% CI, 4.658 - 69.355; P ≤ .01). A positive effect remained even if a patient thought no help was required.
First Time
"To our knowledge this is the first time patient-reported employer helpfulness has been investigated in PsA," the researchers write. "We found that employer awareness and helpfulness exerts a positive influence on remaining in employment, even if patients perceive no help is required. This finding emphasizes the multifactorial influences upon WD and the importance of accounting for as many potentially confounding factors as possible."
For patients who remained on the job, the researchers found that greater global and joint-specific disease activity negatively influenced presenteeism and productivity loss (both P = .01) and that absenteeism was associated with worse joint activity (P ≤ .01).
"The key finding from our perspective in this first study of its type is the disconnect between predominantly disease-activity factors reducing productivity loss and then more social/demographic factors influencing final job loss," Dr. Tillett said to Medscape Medical News.
"This is relevant for the rationale for treatment on work productivity and employment and its economic justification, particularly if productivity loss due to disease can be ameliorated with effective treatment," he noted. "This leads to the next stage of the study, and we are soon to report prospective data examining the real-world effect of [disease modifying antirheumatic drugs] and [anti-tumor necrosis factor agents] on work productivity in the [United Kingdom]."
Not a Surprise, but Helpful
The results are "not at all a surprise," Eric M. Ruderman, MD, from the Multidisciplinary Clinical Research Center in Rheumatology at Northwestern University Feinberg School of Medicine, Chicago, Illinois, told Medscape Medical News. "The takeaway from the study is we need to do a better job of psoriatic arthritis."
He continued, "They looked at every level. It's not just about whether you're working or not working or on disability, it's the ability to be more productive at working, it's the ability to be more social at work. Those are generalizable questions. So I think it's useful. The next question is, 'Will intervention make a difference?' to see if changes in disease activity result in changes in productivity."
Improvement through change in disease activity "has all sorts of economic implications in terms of the cost of care," he added.
The finding regarding employer awareness and helpfulness is also important, he said. "Remaining at work is not just about the disease, it's also about the receptiveness of the employer to understand the situation. That's a really interesting point. That doesn't change what I do clinically, but at a societal level it certainly says that when you have somebody who is affected by disease, how you approach that person at work will actually make a difference in whether he will stay at work."
This research was supported by AbbVie and the National Institute for Health Research. Dr. McHugh has reported receiving grant support from AbbVie and honoraria from Pfizer; Dr. Kay has reported receiving honoraria from AbbVie and Pfizer. The other authors have disclosed no relevant financial relationships.
Rheumatology. Published online August 13, 2014. Abstract
Medscape Medical News © 2014 WebMD, LLC
Send comments and news tips to news@medscape.net.
Cite this article: Psoriatic Arthritis Factors Can Affect Employment Status. Medscape. Aug 28, 2014.
Such and interesting article, Cheryl! (And thanks for the tip on how to sign in.) I thought the article was very realistic, and I certainly believe that what they say about productivity is true, not only in the UK but elsewhere. I think back to the days when I was undiagnosed but still working: I get tired just thinking of it. For me, this disease caused productivity loss of 100%, because I packed it in thinking that I was just too tired and tooo old to continue. Now, diagnosed and on a biologic, I could easily cope with work, but of course it’s far too late to turn back the clock.
It will be interesting to see the results of the next study on the effect of biologics on wwork productivity.
Everyone should join medscape Its free and singularly the best source of "info" anywhere. better than google.
Yes Seenie, I am hoping that the biologicals will keep me working once it kicks in. I have contemplated how I would keep going and treatment gives me hope that I won't have to change professions, unless I really want to!
Thanks Lamb, I think I will join Medscape!
Oh, you are right, Sybil. Those of us with invisible illnesses take a beating!
And that’s a second from me for medscape - their daily news is worth a look too.
There is no question for me on productivity, and from my position, it seems almost ridiculous to ask the question - but hard data lets us persuade the regulators and insurance companies, so its great to see it being done.
When I first started biologics, I bought them out of my own money, fully paid, because if they worked, it would be cheaper than losing my job. They did, it was cheaper, and thence my Rhuemy was convinced enough to fill out the forms for the subsidy.
I can’t wait till they have some hard numbers for biologics (actually, I have a deep suspicion that the manufacturers have some pretty good numbers on productivity value for the biologics and that’s how they fix their price point…)
I have a friend who has RA. His doc told him, "We have to keep you working". He also informed him that once he retires Medicare will not pay for biologicals. So it seems that money is always the bottom line in our society (at least in the States).
