173 Impact of Clinical Severity on Absenteeism and Presenteeism in Patients with Hidradenitis Suppurativa

Abstract

Hidradenitis suppurativa (HS) negatively impacts patients’ quality of work and productivity. To determine how HS Hurley staging, Physician Global Assessment(PGA) and Severity Assessment of Hidradenitis Suppurativa (SAHS) relate to absenteeism and presenteeism in patients with HS. A cross-sectional study, run from Dec 2018-Apr 2019. Eligibility: age 12+ and a clinical visit for HS. Exclusions: declined involvement; English or French illiteracy and unemployed. Severity of HS was assessed using Hurley staging, PGA, SAHS. Absenteeism and presenteeism in the 4 weeks preceding the clinical encounter were evaluated by absenteeism and presenteeism modules of iMTA Productivity Cost Questionnaire(iPCQ). Poisson regressions were used to investigate the impact of each clinical HS severity measure (VAS,PGA,SAHS or Hurley Stage) on the number of missed work days, worked days with bothersome physically/psychologically, and the quantity of work measured on a scale of 0 ‘not able to work’ -10 ‘doing work normally’.Adjustment was done for surgical intervention in the past 4 weeks. For absenteeism, a statistically significant effect on the number of missed work days for Hurley (p = 0.002), SAHS (p < 0.001), PGA (p = 0.004) and VAS (p = 0.025). Comparing to ‘Mild disease’ on SAHS, the expected number of absent days for ‘Moderate disease’ increases by about 3.6 days (1.1, 11.0) and for ‘Severe disease’ increases by about 4.8 days (1.4, 16.8).[Note: (-1.3, 4.3) is the 95% confidence interval]. For presenteeism, a statistically significant effect on the number of symptomatic worked days for Hurley (p < 0.001), PGA (p < 0.001), SAHS, (p < 0.001) and VAS (p < 0.001). Comparing to ‘Mild disease’ on SAHS, the expected number of worked days bothered by ‘Moderate disease’ increases by about 1.6 days (-1.4, 3.5) and for ‘Severe disease’ increases by about 2.0 (-1.1, 4.5). The clinical severity of HS assessed by Hurley staging, VAS, PGA and SAHS impacts the quantity and quality of patients’ work. Presenteeism is more frequent than absenteeism; SAHS is a good clinical predictor for both outcomes.