Abstract

Background: Work disability is an important functional outcome measure in psoriatic arthritis (PsA) and includes unemployment and loss of work productivity. Objectives: The aim of this study is to investigate the working status and the factors associated with work productivity in patients with PsA. Methods: Patients with PsA according to Classification Criteria for Psoriatic arthritis (CASPAR) were included in the study consecutively, without sample selection. Data about age, sex, disease duration (month) were noted. Disease activity was assessed with DAPSA (Disease activity in Psoriatic arthritis) and BASDAI (Bath ankylosing Spondylitis Disease activity index). The Health assessment Questionnaire (HAQ) was used to evaluate physical disability. The Psoriatic arthritis Quality of Life (PsAQoL) scale was used to assess the quality of life. Fatigue and stiffness were assessed on the Visual analogue Scale (VAS). Anxiety and depression were evaluated with HAD (Hospital anxiety and Depression) scale. Assessing work disability, we asked some questions to the patients including employment status, and early retirement, changing or reducing work due to PsA. We used WPAI: PsA (Work Productivity and activity Impairment Questionnaire) to evaluate the impact of PsA on work productivity. WPAI: PSA consists of six questions and gives four scores: the percentage of absenteeism (work time missed due to PsA), the percentage of presenteeism (reduced productivity at work due to PsA), an overall work impairment (combines absenteeism and presenteeism) and percentage of impairment in daily activities. The association between WPAI: PsA scores and HAQ, PsAQoL, HAD, fatigue and stiffness was determined by Spearman’s correlation coefficient. The Mann Whitney-U test was used to compare the means of groups. The descriptive analysis was done for demographic data. P Results: The mean age of 60 patients (38 female, 22 male) with PsA was 48.13 (SD: 11.53) years. The median (min-max) duration of disease was 36 (3-384) months. 63.33% of the patients were not working and 57.89% of these patients were housewives, and 23.68% were retired. 11.66% of the patients with PsA were unemployed. There were no patients who were retired early due to the disease. Percentage of the stopping work, changing work or reducing working hours due to PsA was 3.3%, 6.7% and 10%, respectively. There was no significant difference between the working and not-working groups of patients according to the disease duration, DAPSA, BASDAI and HAQ scores (p>0.05). The mean age was higher in the non-working group (p There was no absenteeism in 63.3% of patients. The mean percentage of the presenteeism was 36 (SD: 30.79) and the mean percentage of the overall work impairment was 41 (SD: 34.06). There were no significant correlations between WPAI: PsA scores and age, disease duration, DAPSA score (p>0.05). Presenteeism and overall work impairment had significant moderate correlations with fatigue (rho: 0.639, p: 0.001; rho: 0.607, p: 0.003), morning stiffness (rho: 0.424, p: 0.049; rho: 0.484, p: 0.023), HAQ (rho: 0.532, p: 0.011; rho: 0.551, p: 0.008), PsAQoL (rho: 0.481, p: 0.023; rho: 0.510, p: 0.015), HAD depression (rho: 0.650, p: 0.001; rho: 0.634, p: 0.002), and HAD anxiety scores (rho: 0.486, p: 0.022; rho: 0.527, p: 0.012), respectively. Conclusion: Psoriatic arthritis can cause loss of work productivity. The severity of work impairment is associated with fatigue, stiffness, physical disability, depression, anxiety and health-related quality of life. In our study population, the percentage of housewives and retired was high and the rate of unemployment was 11.66%. This is a preliminary study and will continue in larger patient populations. Disclosure of interests: Didem Erdem: None declared, Halise Hande Gezer: None declared, Sevtap acer Kasman: None declared, Mehmet Tuncay Duruoz Grant/research support from: abvie, Speakers bureau: Novartis, aMGEN, abdi Ibrahim, Ilko

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