Work Impairment Scores Research Articles

547 - Clinical burden and work productivity impairment in moderate-to-severe atopic dermatitis patients in the United States

Abstract Introduction/Background Atopic dermatitis (AD) is a common chronic condition affecting 5-10% of adults worldwide. AD symptoms (e.g., itching) can lead to sleep disturbances and affect daily activity and work productivity. Objectives With the evolving treatment landscape for moderate-to-severe AD, including advanced systemic therapies like biologics and Janus-kinase (JAK) inhibitors, a contemporary appraisal of the clinical burden and impairment in patients with moderate-to-severe AD in the United States (US) is warranted. Methods A web-based survey was conducted in June 2023 among US adults (≥ 18 years) with self-reported moderate-to-­severe AD or who had experience with systemic therapy, were diagnosed with AD for ≥ 1 year, and with inadequate response to topical treatments. Demographic and clinical characteristics (e.g., comorbidities, body regions ever affected by AD) at the time of the survey were summarized descriptively, along with productivity/activity burden (i.e., activity impairment, work impairment, absenteeism, presenteeism) using the Workers Productivity and Impairment Activity Index (WPAI). Analyses were reported overall and separately for White, Black, and Asian participants. Results 300 participants from all US regions completed the survey (White: 234 [78.0%], Black: 37 [12.3%], Asian: 16 [5.3%], Other/Unknown: 13 [4.4%]). Overall, participants’ mean age was 45 years, 70% were female, and 66% were employed. Half had experienced severe symptoms at any time (50%), and 52% had experience with systemic therapy. At the time of the survey, over 90% of participants were receiving treatment for AD, and 20% self-reported current symptoms as mild (moderate: 69%, severe: 11%). Approximately half reported AD affected their face (46%), neck (52%), or feet (54%) at any time. The most frequently reported comorbidities were anxiety (53%), depression (39%), high blood pressure (25%), allergic rhinitis (24%), and asthma (22%). Most participants (85%) reported some activity impairment due to AD with a mean activity impairment score of 37.6%. A majority (82%) of employed participants reported some work impairment due to AD with a mean overall work impairment score of 38.5%, absenteeism of 7.1% and presenteeism of 36.0%. Race-stratified analysis indicated that Black patients were diagnosed at a younger age, with a numerically higher proportion reporting severe disease (70%) and more affected by AD on the face (54%), neck (68%), and feet (62%) at any time compared to White and Asian patients. All race groups reported substantial activity impairment (33.0%-38.6%) and work impairment (27.2%-39.9%). Conclusions Moderate-to-severe AD is associated with a high disease burden with severity of symptoms across the US population, leading to substantial activity and productivity impairments. Given half of the patients in this study had never received systemic therapy, wider use of available treatment options may improve disease and symptom management, thereby reducing activity and work impairment.

On-demand Versus Continuous Maintenance Treatment With a Proton Pump Inhibitor for Mild Gastroesophageal Reflux Disease: A Prospective Randomized Multicenter Study.

It remains unclear which maintenance treatment modality is most appropriate for mild gastroesophageal reflux disease (GERD). We aimed to compare on-demand treatment with continuous treatment using a proton pump inhibitor (PPI) in the maintenance treatment for patients with non-erosive GERD or mild erosive esophagitis. Patients whose GERD symptoms improved after 4 weeks of standard dose PPI treatment were prospectively enrolled at 25 hospitals. Subsequently, the enrolled patients were randomly assigned to either an on-demand or a continuous maintenance treatment group, and followed in an 8-week interval for up to 24 weeks. A total of 304 patients were randomized to maintenance treatment (continuous, n = 151 vs on-demand, n = 153). The primary outcome, the overall proportion of unwillingness to continue the assigned maintenance treatment modality, failed to confirm the non-inferiority of on-demand treatment (45.9%) compared to continuous treatment (36.1%). Compared with the on-demand group, the GERD symptom and health-related quality of life scores significantly more improved and the overall satisfaction score was significantly higher in the continuous treatment group, particularly at week 8 and week 16 of maintenance treatment. Work impairment scores were not different in the 2 groups, but the prescription cost was less in the on-demand group. Serum gastrin levels significantly elevated in the continuous treatment group, but not in the on-demand group. Continuous treatment seems to be more appropriate for the initial maintenance treatment of non-erosive GERD or mild erosive esophagitis than on-demand treatment. Stepping down to on-demand treatment needs to be considered after a sufficient period of continuous treatment.

Presenteeism and academic performance: a cross-sectional study among undergraduate university students

PurposePresenteeism is the productivity loss due to working with ill health. This paper aims to develop a presenteeism scale for students (PSS) and reveals its association with the academic achievement of undergraduate (Bachelor) students.Design/methodology/approachThis is a cross-sectional study based on a reputed public university in Bangladesh. The study collected data from 164 undergraduate students by relying upon the systematic random sampling technique.FindingsNearly 70 percent of the study population have reported some health problems, with male students reporting frustration (59.6 percent) and female students reporting migraine (61.2 percent) as the most prevalent issues. Predictors such as gender, living status, television and social media use, absenteeism, physical activity, BMI (body mass index), hygienic meal intake, exhaustion score and PSS score have significantly influenced presenteeism and reduced academic performance. As many students face multiple health issues, it is recommended that the issue of presenteeism on university campuses be addressed.Originality/valueThis study breaks from the conventional approach of studying presenteeism in business settings and expands knowledge in the education domain. Additionally, it examines the interconnection of primary health conditions, work impairment score, presenteeism and academic performance.

Anti-IL-5/5Ra biologics improve work productivity and activity in severe asthma: a RAPSODI registry-based cohort study

Introduction Severe asthma is associated with a serious disease burden, partially caused by limitations in activity and work impairment. Aims and objectives This study aims to relate treatment with biologics targeting IL-5/5Ra to work productivity and activity in the long term in a real-world context. Material and methods This is a registry-based multi-center cohort study evaluating data from adults with severe eosinophilic asthma included in the Dutch Register of Adult Patients with Severe Asthma for Optimal DIsease management (RAPSODI). Patients that started with anti-IL-5/5Ra biologics and completed the work productivity and activity improvement questionnaire, were included. Study and patient characteristics were compared between the employed and unemployed patients. Work productivity and activity impairment are related to accompanying improvements in clinical outcomes. Results At baseline, 91 of 137 patients (66%) were employed which remained stable throughout the follow-up period. Patients in the working age category were younger and had significantly better asthma control (p = 0.02). Mean overall work impairment due to health decreased significantly from 25.5% (SD2.6) to 17.6% (SD 2.8) during 12 months anti-IL-5/5Ra biologics treatment (P = 0.010). There was a significant association between ACQ6 and overall work improvement after targeted therapy (β = 8.7, CI 2.1–15.4, P = 0.01). The improvement of asthma control of 0.5 points on the asthma Control Questionnaire was associated with an overall work impairment of −9%. Conclusions Work productivity and activity in severe eosinophilic asthma improved after starting anti-IL-5/5Ra biologics. Clinically relevant improvement in asthma control was associated with an overall work impairment score of −9% in this study.

Ligelizumab improves sleep interference and disease burden in patients with chronic spontaneous urticaria.

BackgroundChronic spontaneous urticaria (CSU) negatively impacts patients' sleep, thereby reducing health‐related quality of life (HRQoL). Half of patients with inadequately controlled CSU report sleep interference often or every night, which can lead to depression, anxiety, social, and work‐related problems.MethodsThis randomized, double‐blind, placebo‐controlled Phase 2b core study (NCT02477332) included adult patients ≥18 years with moderate to severe CSU inadequately controlled with H1‐antihistamines. The current analysis includes patients randomized to receive ligelizumab 72 or 240 mg, omalizumab 300 mg or placebo every 4 weeks (q4w) for five injections over 20 weeks with treatment‐free follow‐up for 24 weeks. Patients could enter the open‐label extension study (NCT02649218) from Week 32 onwards if their weekly urticaria activity score was ≥12, which included an open‐label treatment (52 weeks of ligelizumab 240 mg q4w) and a 48‐week post‐treatment follow‐up. Weekly Sleep Interference Scores (SIS7, range 0 [no interference]–21 [substantial interference]), Weekly Activity Interference Score (AIS7), Dermatology Life Quality Index (DLQI) scores, and Overall Work Impairment were assessed.ResultsMean baseline SIS7 scores were balanced between the treatment arms for ligelizumab 72 mg (n = 84) and 240 mg (n = 85), omalizumab 300 mg (n = 85), and placebo (n = 43). By Week 12, patients experienced large improvements in sleep interference, with least square mean (standard error) changes from baseline (CFB) in SIS7 of −7.84 (0.58), −7.55 (0.61), −6.98 (0.60), and −5.85 (0.81), respectively. By Week 12, CFB in AIS7 were −8.25 (0.57), −8.25 (0.59), −7.30 (0.60), and −5.62 (0.79), DLQI scores were −9.79 (0.77), −9.93 (0.81), −8.35 (0.79), and −6.99 (1.11), and Overall Work Impairment scores were −28.96 (3.73), −30.76 (3.71), −25.74 (3.91), and −20.13 (5.10) for ligelizumab 72 and 240 mg, omalizumab 300 mg and placebo, respectively. Improvements in each patient‐reported outcome were sustained with ligelizumab 240 mg treatment during the extension study.ConclusionsLigelizumab showed effective and sustained responses in managing sleep interference in patients with CSU, and numerically higher responses than with omalizumab and placebo. Treating the symptoms of CSU with ligelizumab improved disease burden, HRQoL, and markedly improved sleep quality.

Work Outcomes after Intensity-Modulated Proton Therapy (IMPT) versus Intensity-Modulated Photon Therapy (IMRT) for Oropharyngeal Cancer.

PurposeWe compared work outcomes in patients with oropharyngeal cancer (OPC), randomized to intensity-modulated proton (IMPT) versus intensity-modulated photon therapy (IMRT) for chemoradiation therapy (CRT).Patients and MethodsIn 147 patients with stage II-IVB squamous cell OPC participating in patient-reported outcomes assessments, a prespecified secondary aim of a randomized phase II/III trial of IMPT (n = 69) versus IMRT (n = 78), we compared absenteeism, presenteeism (i.e., the extent to which an employee is not fully functional at work), and work productivity losses. We used the work productivity and activity impairment questionnaire at baseline (pre-CRT), at the end of CRT, and at 6 months, 1 year, and 2 years. A one-sided Cochran-Armitage test was used to analyze within-arm temporal trends, and a χ2 test was used to compare between-arm differences. Among working patients, at each follow-up point, a 1-sided Wilcoxon rank-sum test was used to compare work-productivity scores.ResultsPatient characteristics in IMPT versus IMRT arms were similar. In the IMPT arm, within-arm analysis demonstrated that an increasing proportion of patients resumed working after IMPT, from 60% (40 of 67) pre-CRT and 71% (30 of 42) at 1 year to 78% (18 of 23) at 2 years (P = 0.025). In the IMRT arm, the proportion remained stable, with 57% (43 of 76) pre-CRT, 54% (21 of 39) at 1 year, and 52% (13 of 25) working at 2 years (P = 0.47). By 2 years after CRT, the between-arm difference between patients who had IMPT and those who had IMRT trended toward significance (P = 0.06). Regardless of treatment arm, among working patients, the most severe work impairments occurred from treatment initiation to the end of CRT, with significant recovery from absenteeism, presenteeism, and productivity impairments by the 2-year follow-up (P < 0.001 for all). Higher magnitudes of recovery from absenteeism (at 1 year, P = 0.05; and at 2 years, P = 0.04) and composite work impairment scores (at 1 year, P = 0.04; and at 2 years, P = 0.04) were seen in patients treated with IMPT versus those treated with IMRT.ConclusionIn patients with OPC receiving curative CRT, patients randomized to IMPT demonstrated increasing work and productivity recovery trends. Studies are needed to identify mechanisms underlying head and neck CRT treatment causing work disability and impairment.

P269 Real-world impact of biological therapies on work impairment and quality of life in Inflammatory Bowel Disease patients

Abstract Background Randomised controlled trials have reported improvement of work productivity and activity impairment (WPAI) as well as quality of life in biological-treated inflammatory bowel disease (IBD) patients. However, data beyond clinical trials are limited. Methods This multicentre prospective cohort study evaluated the effect of initiating biological or small molecule therapy on work impairment in IBD patients. Subjects completed the WPAI questionnaire and Short IBD questionnaire (SIBDQ) at biological therapy initiation and at week 26. Clinical disease activity was assessed using the Harvey Bradshaw Index and Simple Clinical Colitis Activity Index. Biochemical disease activity was assessed using C-reactive protein and faecal calprotectin. Data are presented as mean ± standard deviation. Results In total, 156 IBD patients were included for analysis (median age 40 years, 55% male, 55% Crohn’s disease). Of these patients, 28% started infliximab, 33% adalimumab, 19% vedolizumab, 18% ustekinumab, 1% tofacitinib and 1% golimumab. Concomitant medication use at baseline included 28% prednisone, 12% budesonide, 34% mesalamine, and 46% immunomodulator. At baseline, 58% had clinical disease activity and 58% had biochemical disease activity. In our cohort, 111 (71%) were employed and 17 (11%) patients reported partial or full occupational disability. The mean total work impairment at baseline was 52% ± 36%. During follow-up, 7 patients lost their job and 8 patients started employment. For the entire cohort, improvements in all WPAI domains were observed: mean 11%-points decrease in missed working hours, 4%-points decrease in impairment while working, 15%-points decrease in total work impairment and 15%-points decrease in total activity impairment. Parallel improvements were seen in SIBDQ scores (mean improvement 7.6 ± 11.3). At week 26, 66 (42%) patients achieved the minimal clinical important difference in total work impairment (improvement ≥7%-points). Patients with clinical disease activity at baseline and clinical response to the biological (n=32) showed a larger improvement in total work impairment compared with other subjects (n=86) (mean difference 29%-points versus 10%-points; p=0.036 (T-test)). Similarly, these patients showed greater improvement in SIBDQ scores compared to other subjects (mean 13.8 versus 5.4, respectively; p&amp;lt;0.001 (T-test)). Conclusion IBD patients experienced substantial work impairment prior to initiating biological treatment. Improved work impairment scores were seen after initiation of biological therapy and patients with clinical response showed even greater improvements. These results underline the importance of IBD disease control to improve work productivity and participation.

Long-term safety and effectiveness of adalimumab in Japanese patients with Crohn's disease: 3-year results from a real-world study.

Background/AimsCrohn’s disease is a chronic disorder; therefore, it is essential to investigate long-term safety and efficacy of treatments. This study assessed the safety and effectiveness of adalimumab for up to 3 years in Japanese patients with Crohn’s disease in real-world settings.MethodsThis was a multicenter, single-cohort, observational study of patients with Crohn’s disease. Safety assessments included incidence of adverse drug reactions. Effectiveness assessments included clinical remission, mucosal healing, and Work Productivity and Activity Impairment (WPAI).ResultsThe safety and effectiveness analysis populations comprised 389 and 310 patients, respectively. Mean (standard deviation) exposure to adalimumab in the safety analysis population was 793.4 (402.8) days, with a 58.1% retention rate. A total of 105 patients (27.0%) and 43 patients (11.1%) experienced adverse drug reactions and serious adverse drug reactions, respectively, with no patient reporting tuberculosis or hepatitis B. Infections and serious infections were reported in 37 patients (9.5%) and 17 patients (4.4%), respectively. Malignancy was reported as an adverse drug reaction in 2 patients (0.5%). Remission rate increased from 37.8% (98/259) at baseline to 73.9% (167/226) at week 4 and remained > 70% over 3 years. Proportion of patients without mucosal ulcerations increased from 2.7% (2/73) at baseline to 42.3% (11/26) between years > 2 to ≤ 3. WPAI improvement started at 4 weeks, with the overall work impairment score improving from 42.7 (n = 102) at baseline to 26.9 (n = 84) at 4 weeks.ConclusionsResults from this study confirm the long-term safety and effectiveness of adalimumab treatment in Japanese patients with Crohn’s disease in the real-world setting.

Workplace Violence Is Associated With Impaired Work Functioning in Nurses: An Italian Cross-Sectional Study.

Workplace violence against nurses is a widespread phenomenon that has been associated with many unfavorable individual and organizational outcomes. The aim of this study was to analyze the relationship between violence and work functioning in a sample of Italian nurses. Cross-sectional, with retrospective analysis of exposure. All nurses from a local hospital were invited to complete a questionnaire assessing violent experiences that occurred in the previous 12 months. The questionnaire also measured job strain (with the Demand-Control-Support questionnaire), organizational justice (with Colquitt's Questionnaire), and work impairment (with the Nurses Work Functioning Questionnaire). The associations were examined with logistic regression analyses. Of the 302 nurses who were invited, 275 (91.1%) agreed to participate. The total work impairment score was significantly higher among the nurses exposed to violence compared with the nonexposed nurses (42.2 ± 27.8 vs. 31.9 ± 31.6, respectively; p < .001). Exposed nurses also reported significantly higher levels of job strain (0.96 ± 0.25 vs. 0.8 ± 0.21; p = .003) and lower levels of perceived organizational justice (56.6 ± 12.6 vs. 62.5 ± 14.8; p = .001) than nonexposed nurses. Nurses who had experienced violence had a significantly higher risk for impairment of work functioning than their colleagues (crude odds ratio [OR] = 2.33; 95% confidence interval [CI 95%] = 1.42-3.83). The association between violence and impairment remained significant after adjusting for demographic variables, occupational stress, and perceived organizational justice (OR = 1.83; 95% CI 95%= 1.06-3.17). Workplace violence is associated with impaired work function in nurses. Job strain and perceived organizational injustice are associated with impairment. Violence prevention programs in healthcare activities should include training for violent behavior identification and de-escalation techniques, structural and administrative measures for violence control (such as alarms, surveillance, staff increase), and measures to reduce occupational stress, which can include wellness courses, spirituality, organizational improvements, and staffing methodologies.

Factors Related to Presenteeism in Young and Middle-aged Nurses

Presenteeism is considered to be not only a work-related stressor but also a factor involved in the development of workaholism and error proneness, which is often described as careless. Additionally, increasing health issues arising from aging suggest the possibility that presenteeism in middle-aged nurses is different than that in young ones. Therefore, the present study aimed to identify and tease apart factors involved in presenteeism among young and middle-aged nurses. An anonymous self-administered questionnaire survey was conducted among 2,006 nurses working at 10 hospitals. In total, 761 nurses aged <40 years and 536 nurses aged ≥40 years were enrolled in this study. Work Impairment Scores (WIS) on the Japanese version of the Stanford Presenteeism Scale were measured for presenteeism. Job stressors, workaholism, and error proneness were measured for related factors. Multiple regression analysis was conducted after determining the WIS as the dependent variable and related factors as independent variables. Overall, 70.8% of the young nurses reported health problems compared to 82.5% of the middle-aged nurses. However, WIS in young nurses was significantly higher than that in middle-aged ones (p < 0.001). WIS in young nurses showed a significant relationship with the degree of stressors, "difficulty of work" (β = 0.28, p < 0.001) and tendency to "work excessively" (β = 0.18, p < 0.001), which is a subscale of workaholism, error proneness of "action slips" (β = 0.14, p < 0.01) and "cognitive narrowing" (β = 0.11, p < 0.05). Conversely, WIS in middle-aged nurses showed a significant relationship with "cognitive narrowing" (β = 0.29, p < 0.001) and to "work excessively" (β = 0.17, p < 0.001), the degree of stressors on "difficulty of work" (β = 0.12, p < 0.05) and "lack of communication" (β = 0.13, p < 0.01). It was clarified that the increased health problems of middle-aged nurses does not necessarily lower their working capacity. Also, compared to young nurses, the degree of failing tendency, rather than the degree of job stressors, was more related to presenteeism for middle-aged nurses. It can be considered that middle-aged nurses simply realize that their working ability is hindered because of incidents resulting from attention narrowing. As fatigue and state of tension tend to cause narrowing of attention, it may be necessary to reduce such risks and adjust work environments so mistakes can be avoided.

Relationships between presenteeism and work-related musculoskeletal disorders among physical therapists in the Republic of Korea

This study investigated the relationship between presenteeism and work-related musculoskeletal disorders (WMSDs) among physical therapists (PTs) in the Republic of Korea. Questionnaires were given to 600 PTs in the Republic of Korea. General and occupational characteristics and the prevalence of presenteeism and absenteeism were self-reported on the questionnaire. Stepwise regression analyses were used to evaluate the effects of presenteeism and other variables on general and occupational characteristics. Of the 490 PTs who responded, 399 (81.4%) reported at least one WMSD. There was a low incidence rate of absenteeism, but work impairment scores indicate there was a high incidence of presenteeism. In the stepwise regression analyses, the incidence of WMSDs was highest in cases of presenteeism. The results of this study demonstrate that there is a high incidence rate of WMSDs in Republic of Korean PTs, that WMSDs are related to presenteeism and that PTs demonstrate high presenteeism and low absenteeism.

Obesity surgery and Ramadan: a prospective analysis of nutritional intake, hunger and satiety and adaptive behaviours during fasting.

Fasting for religious or lifestyle reasons poses a challenge to people who have undergone bariatric surgery. A total fast (abstaining from all forms of nourishment including liquids) during long summer days puts these patients at risk of dehydration and poor calorie and nutrient intake. We undertook telephone surveys of 24-h food recall, hunger and satiety scores, medication use, adverse symptoms and depression scores on a fasting day in Ramadan and a non-fasting day subsequently. We studied 207 participants (166 women) who had undergone sleeve gastrectomy. The mean (standard error) age was 35.2 (0.7) years. Men and women consumed 20.4 % (P = 0.018) and 16.9 % (P < 0.001) fewer calories and 44.8 % (P < 0.001) and 32.4 % (P < 0.001) less protein during fasting, respectively. There was no significant difference in the intake of fluids or incidence of adverse gastrointestinal, hypoglycaemic and sympathoadrenal symptoms. Of participants on pharmacotherapy, 89.5 % took their prescribed medications; 86.3 % made no changes to the doses, but 80.4 % changed the timing of the medications. Both women and men reported feeling less hungry and a preference for savoury foods during Ramadan. There was no difference in depression and work impairment scores. Fasting was well tolerated in persons who had undergone sleeve gastrectomy. It may be advisable to raise awareness about dietary protein intake and managing medications appropriately during fasting.

Su1030 Genetic Variation in Vitamin D Pathway DHCR7 Gene Predicts Poor Response to Pegylated Interferon-Alfa Based Therapy in Asian Chronic Hepatitis C Genotype 1-Infected Patients

were descriptively evaluated for observed self-reportedQOL (SF-36v2) andwork productivity and activity impairment (WPAI) assessments. Assessments were scored such that lower SF36v2 Mental Component Summary (MCS) and Physical Component Summary (PCS) scores corresponded to lower QOL while higher WPAI scores represented higher levels of impairment and work time missed. Results: Among the 71,157 NHWS total respondents, 0.9% reported an HCV diagnosis, 1.3% CHF, 2.8% MI, 5.0% COPD, 10.9% Diabetes, 14.9% Depression, and 17.3%OA. Among these 7 cohorts, the HCV cohort was the second youngest with a mean age of 54 years and had the second highest proportion of male respondents (69.8%). The HCV cohort was observed to have the second lowest average MCS scores (44.6) among the seven cohorts while having mean PCS scores (43.7) that were numerically third highest (Table 1.). Full-time employment was reported by 25.0% of the HCV group, 17.2% COPD, 28.9% Depression, 14.7% MI, 20.2% OA, 11.4% HF, and 24.4% Diabetes. Numerically, the HCV cohort had the second highest reported overall work impairment scores (29.5%) among the seven conditions and was ranked between cohorts for mean total activity impairment scores (39.8%). Conclusions: Results provide further insight into QOL and productivity as reported by a population of US survey respondents with HCV. Although one-fourth of survey respondents with HCV reported full-time employment, these same individuals reported productivity losses in the forms of absenteeism and presenteeism. Further evaluation of the impact of comorbidity burden and HCV treatment on these patient outcomes is warranted. Table 1. Cohort Mean Scores

Presenteeism in college students: reliability and validity of the Presenteeism Scale for Students

Presenteeism is the impaired work performance due to health problems. We aimed to develop a Presenteeism Scale for Students (PSS), and to reveal the existence of presenteeism among students. Students (n = 5,701) in 4 national universities in Japan were recruited via the school-based health examination. Moreover, 122 students participated in a 2-week interval test-retest to examine the reliability and criterion-related validity of the PSS. Of the students, 59.2% indicated some health problems. Allergy was most prevalent health problems, affecting 35.7% of the whole students. Students with emotional problems had higher degree of presenteeism than those with the other problems. The Cronbach's α of the work impairment score of the PSS was 0.90. The Spearman's coefficient for the test-retest score was 0.80 (P < 0.001). Regarding criterion-related validity, Spearman's coefficient between the work impairment score of the PSS and summary score of the SF-36 was -0.60 (P < 0.001). These findings suggest that the PSS can be expected to be useful for assessment of students with presenteeism. Furthermore, we found that the majority of students have some health problems, and proposed that the issue of presenteeism on campus should be addressed.

関東地区の事業場における慢性疾患による仕事の生産性への影響

Chronic disease has a significant impact on workers' productivity. The aim of this study was to determine the prevalence of chronic health conditions, the work impairment score, and the total lost working hours absent at companies in Japan. Eligible participants were all 544 workers of 4 manufacturing companies in the Kanto area. The Stanford Presenteeism Scale that was developed by Merck & Co., Inc and Stanford University was translated into Japanese and was given to the workers at a periodic health examination between April and June 2006. A total of 433 workers completed the questionnaire, and 48.9% of the participants reported having one or more chronic health conditions which affected their work performance. Allergy (13.3%) was the highest primary chronic health condition followed by back/neck disorders (9.7%). The work impairment score was higher for individuals with depression and migraine/chronic headache. The total lost working hours due to the primary chronic health conditions were 1.4% of the total working hours among the participants. The total lost working hours was highest for those with allergy followed by back/neck disorders and depression. These results should make it possible to develop an occupational health program that can reduce the effects of chronic health conditions on work performance.

Impact of adalimumab treatment on patient‐reported outcomes: Results from a Phase III clinical trial in patients with moderate to severe plaque psoriasis

Objective: The effect of adalimumab on patient‐reported outcomes (PROs) was evaluated in patients with moderate to severe psoriasis during the initial 16‐week, double‐blind period of a 52‐week, Phase III, multicenter trial. Methods: Patients were randomized to placebo or adalimumab 80 mg at Week 0 and 40 mg every other week from Week 1 to Week 15. PROs were evaluated throughout the study and included the Dermatology Life Quality Index (DLQI), the Short Form 36 Health Survey (SF‐36), the Work Productivity and Activity Impairment Questionnaire‐Specific Health Problem (WPAI‐SHP), and several patient‐rated symptom scales. Results: The adalimumab‐treated group reported significantly greater improvements in DLQI total score (p<0.001), SF‐36 Physical Component Summary score (p<0.001), and Mental Component Summary score (p<0.001) compared with the placebo‐treated group over 16 weeks. Significant differences, favoring adalimumab, were also seen for the DLQI subscale scores (p < 0.001); SF‐36 scale scores (p<0.001); WPAI‐SHP work impairment (p<0.001), activity limitation (p<0.001), and overall work impairment scores (p<0.001); patient's global assessment of disease severity (p<0.001), psoriasis pain (p<0.001), and psoriasis‐related pruritus (p = 0.002). Conclusion: Adalimumab was efficacious in improving dermatology‐specific and general health‐related quality of life, work and activity limitations, and psoriasis‐related symptoms in patients with moderate to severe psoriasis over a 16‐week period.