The Effect of Chronic Pancreatitis on Employment

Abstract

Purpose: Patients with chronic pancreatitis (CP) often suffer debilitating symptoms leading to interruptions in their ability to work. The aim of this study was to evaluate the effect of chronic pancreatitis on employment status in patients presenting for clinical evaluation. Methods: Patients with established CP presenting for clinical evaluation at four U.S. pancreas centers – Dartmouth-Hitchcock Medical Center (NH), the University of Cincinnati (OH), Brigham and Women's Hospital (MA) and Mayo Clinic Rochester (MN) – were included. The diagnosis of CP was based on the evaluation of the treating clinician at each center. Patients with chronic pancreatitis evaluated in each institution's pancreas clinic between July 1st 2006 and October 31st 2007 were asked to complete a 72 item survey at the conclusion of one of their office visits. Completed surveys were mailed to the coordinating center (Dartmouth) anonymously where all data analysis was completed. The study was approved by the IRB at each institution. Results: 111 patient surveys were returned. Patients had a mean age of 50 years; 50% were male; 59% were married; 82% had finished high school. Only 37% were presently employed (73% currently full-time); 56% earned less than $25,000 (U.S.) per year (median personal income in the U.S $32,140); only 30% earned more than $50,000 (U.S.) per year. Given the ability to choose from 9 domains in which CP could affect their lives, 74% reported that their work lives were altered by CP; 60% reported an effect on their social lives; 46% reported an effect on their spouse/significant other relationships. Given the ability then to choose which of the 9 domains was most affected by CP, 28% reported difficulty in completing daily activities while 26% had difficulty in employment. In the week prior to completing the survey, the 37% of patients who were employed reported working a mean of 28.5 hours and being absent from their job a mean of 16.9 hours due to CP symptoms. The most important patient concerns were that CP symptoms would interfere with their professional lives (34%); would shorten their lifespan (22%); would be passed on to their children (18%); or would develop into cancer (13%). Conclusion: In the United States, patients with CP have high unemployment rates, below median personal income, and miss significant time at work due to their illness. The deleterious effect of their disease on employment status and personal life is of significant concern to patients. It is important for physicians to be more aware of these concerns.