Abstract
The aim was to investigate whether secular trends in sickness absence (SA) were present in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) receiving their diagnosis between 2002 and 2011. A repeated cross-sectional study design was used. Patients were identified in the Skåne Healthcare Register (SHR). A washout period of 18 months was applied. The general population seeking health care was used as a reference cohort. SA data from 2003 to 2012 were obtained from the Swedish Social Insurance Agency and converted into net days of SA per year. Within diagnosis and sex, the average number of net days of SA during the calendar year following diagnosis was calculated and plotted against calendar year together with the corresponding SA of the age-standardized reference population. Linear regression on aggregated data, within diagnosis and sex, was applied to formally investigate differences in secular trends among patients and referents. There were 3173 patients and 992,502 referents. Among men diagnosed with AS, the average amount of SA declined by 8.1 net days per year in patients as compared with 2.4 in the referents (p = 0.01). Among PsA patients, the average amount of SA declined by 11.7 net days per year in women as compared with 2.7 in the referents (p < 0.001) and by 7.6 net days per year in men as compared with 1.9 in the referents (p < 0.001). Secular trends of declining SA were present among AS and PsA patients. Trends were also present among the referents, although not at all of the same magnitude.
Highlights
Spondyloarthritis and its comorbidities are associated with impaired physical function [1], and reduced quality of life [2]
Besides the comorbidities typically related to spondyloarthritis, studies have reported increased risks of cardiovascular disease and associated risk factors in ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients [3,4,5], and depression in AS patients [6]
Patients were identified in the Skåne Healthcare Register (SHR), which contains all in- and out-patient visits to public and private health-care providers for 1.3 million individuals residing in southern Sweden, by searching for ICD-10 codes related to AS and PsA (i.e., M45, L40.5, and M07.0-3)
Summary
Spondyloarthritis and its comorbidities are associated with impaired physical function [1], and reduced quality of life [2]. Besides the comorbidities typically related to spondyloarthritis, studies have reported increased risks of cardiovascular disease and associated risk factors in ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients [3,4,5], and depression in AS patients [6]. The consequences of AS and PsA impact on several aspects of affected individuals’ lives and restrict patients’ ability to participate in society, resulting in reduced work productivity and increased sickness absence (SA) [7, 8]. The diseases have the potential to impair patients’ work ability throughout a large part of their working life, imposing financial consequences for the individual patient as well as society. The cost of AS patients in rheumatologic care in southern Sweden has been shown to be three times higher than that of reference subjects from the general population, and the most important cost item is that related to sickness absence [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
