Work Productivity And Activity Impairment Questionnaire Research Articles

Association of social isolation and depressive symptoms with workplace productivity loss in a multi-ethnic Asian study

The association of health-related productivity loss (HRPL) with social isolation and depressive symptoms is not well studied. We aimed to examine the association of social isolation and depressive symptoms with productivity loss. Data on employed adults aged 21 years and above were derived from the Population Health Index (PHI) study conducted by the National Healthcare Group (NHG) on community-dwelling adults, residing in the Central and Northern residential areas of Singapore. The severity of depressive symptoms and social isolation were assessed using the 9-item Patient Health Questionnaire (PHQ-9) and Lubben Social Network Scale-6 (LSNS-6) respectively. Productivity loss was assessed using the Work Productivity and Activity Impairment Questionnaire (WPAI). We used Generalised Linear Models, with family gamma, log link for the analysis. Models were adjusted for socio-demographic variables (including age, gender, ethnicity, employment status, housing type) and self-reported chronic conditions (including the presence of diabetes, hypertension, and dyslipidemia). There were 2,605 working (2,143 full-time) adults in this study. The median reported percentage of unadjusted productivity loss was 0.0%, 10.0% and 20.0% for participants with social isolation, depressive symptoms, and both, respectively. In the regression analysis, mean productivity loss scores were 2.81 times (95% Confidence Interval: 2.12, 3.72) higher in participants with depressive symptoms than those without. On the other hand, social isolation was not found to be associated with productivity loss scores (1.17, 95% Confidence Interval: 0.96, 1.42). The interaction term of depressive symptoms with social isolation was statistically significant, with an effect size of 1.89 (95% Confidence Interval: 1.04, 3.44). It appeared that productivity loss was amplified when social isolation and depressive symptoms were concomitant. Our results suggested significant associations of social isolation and depressive symptoms with productivity loss. These findings highlighted the potential impact of social isolation and depressive symptoms on work performance and drew attention to the importance of having a holistic work support system that promotes social connectedness, mental wellbeing and work productivity.

Patient-reported outcomes and healthcare resource utilization in systemic lupus erythematosus: impact of disease activity

BackgroundLimited real-world data exists on clinical outcomes in systemic lupus erythematosus (SLE) patients by SLE Disease Activity Index 2000 (SLEDAI-2 K), hereafter, SLEDAI. We aimed to examine the association between SLEDAI score and clinical, patient-reported and economic outcomes in patients with SLE.MethodsRheumatologists from the United States of America and Europe provided real-world demographic, clinical, and healthcare resource utilization (HCRU) data for SLE patients. Patients provided self-reported outcome data, capturing their general health status using the EuroQol 5-dimension 3-level questionnaire (EQ-5D-3 L), health-related quality of life using the Functional Assessment of Chronic Illness Therapy (FACIT) and work productivity using the Work Productivity and Activity Impairment questionnaire (WPAI). Low disease activity was defined as SLEDAI score ≤ 4 and ≤ 7.5 mg/day glucocorticoids; patients not meeting these criteria were considered to have “higher” active disease. Data were compared between patients with low and higher disease activity. Logistic regression estimated a propensity score for SLE based on demographic and clinical characteristics. Propensity score matched analyses compared HCRU, patient-reported outcomes, income loss and treatment satisfaction in patients with low disease activity versus higher active disease.ResultsData from 296 physicians reporting on 730 patients (46 low disease activity, 684 higher active disease), and from 377 patients’ self-reported questionnaires (24 low disease activity, 353 higher active disease) were analyzed. Flaring in the previous 12 months was 2.6-fold more common among patients with higher versus low active disease. Equation 5D-3 L utility index was 0.79 and 0.88 and FACIT-Fatigue scores were 34.78 and 39.79 in low versus higher active disease patients, respectively, indicating better health and less fatigue, among patients with low versus higher active disease. Absenteeism, presenteeism, overall work impairment, and total activity impairment were 47.0-, 2.0-, 2.6- and 1.5-fold greater in patients with higher versus low disease activity. In the previous 12 months there were 28% more healthcare consultations and 3.4-fold more patients hospitalized in patients with higher versus low disease activity.ConclusionCompared to SLE patients with higher active disease, patients with low disease activity experienced better health status, lower HCRU, less fatigue, and lower work productivity impairment, with work absenteeism being substantially lower in these patients.

The impact of myasthenia gravis severity on work and daily activities.

People with myasthenia gravis (MG) experience impaired quality of life. However, the impact of MG symptoms on work productivity has not been well-studied. We aimed to evaluate this impact and to examine associations between disease severity and the degree of impairment. Data were drawn from the Adelphi MG Disease-Specific Programme™, a multinational (USA, France, Germany, Italy, Spain, UK) survey completed by physicians and their patients with MG in 2020. Patient-reported measures included the Work Productivity and Activity Impairment (WPAI): Specific Health Problem questionnaire. The WPAI questionnaire was completed by 330 patients. Among those currently employed, the mean percentage of work time missed (absenteeism) was 13.3% (N = 116), percentage impairment of productivity at work (presenteeism) was 26.7% (N = 121), and overall work impairment was 30.0% (N = 110). Across all patients, impairment of non-work-related activities due to health problems (ADL impairment) was 39.2% (N = 330). Regression analysis indicated that impairment differed according to MG Foundation of America (MGFA) class (p = .0147, p < .0001, p < .0001 and p < .0001 for absenteeism, presenteeism, overall work impairment and ADL impairment, respectively). Being MGFA class III/IV was a predictor of presenteeism, overall work impairment and ADL impairment in a predictor model. Patients with MG experience substantial work impairment particularly those with more severe symptoms, highlighting an important way in which patient quality of life is negatively affected. More effective treatment strategies would enable patients to lead more productive lives and could impact decisions relating to work and career.

Paradoxical Findings in Patients with Paroxysmal Nocturnal Hemoglobinuria Treated with C5 Inhibitors: Suboptimal Disease Control Perceived As Satisfactory

Introduction: The introduction of C5 inhibitors (C5i) for the treatment of patients with paroxysmal nocturnal hemoglobinuria (PNH) has resulted in lower morbidity and mortality rates. However up to 86% of patients still experience anemia and fatigue in 63% of them which may impact their quality of life (QoL). The SATURNO study aimed to assess PNH patient and physician satisfaction with C5i treatment, along with the impact of the disease and clinical outcomes. Methods: A multicenter, observational, cross-sectional study conducted in PNH patients receiving C5i treatment for at least 3 months in Spain. Key clinical and laboratory data were collected, including red blood cells (RBC) transfusions, hemolytic crisis, hemoglobin (Hb), haptoglobin (Hp), lactate dehydrogenase (LDH), absolute reticulocyte count (ARC) and bilirubin. Patient satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM) and Visual Analog Scale (VAS). Physician satisfaction was measured using the TSQM general item and VAS. Fatigue and QoL were evaluated using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), respectively. The Work Productivity and Activity Impairment questionnaire (WPAI) was also used. Results: A total of 56 patients and 13 physicians participated in the study. Median (IQR) age of patients was 54.0 (44.5; 63.5) years, 35.7% were female and median (IQR) duration of treatment with C5i was 6.6 (3.3; 11.6) years. Overall, 94.6% of patients and 90.6% of physicians reported to be satisfied, very satisfied, or extremely satisfied with the treatment. Mean (SD) VAS score for patient satisfaction was 9.0 (1.2) and for physicians 7.9 (1.7) out of 10. Mean (SD) EORTC QLQ-C30 score was 71.7 (21.7) out of 100. Mean (SD) FACIT-F score was 39.7 (10.6) out of 52 and fatigue was reported by 55.2% of patients. Clinical and laboratory parameters showed a significant proportion of patients exhibiting abnormal values. Hb and Hp were below the normal ranges in 67.9% and 65.1% of patients, respectively, whereas elevated LDH, ARC and indirect bilirubin were observed in 50.0%, 83.0% and 75.9% of them, respectively. In the last 12 months, 30.9% of patients had received at least one RBC transfusion, with a mean (SD) number of 8.6 (8.4) RBC transfusions, and 33.9% experienced at least one hemolytic crisis with a mean (SD) of 4.9 (9.4). Work productivity assessment revealed that 60.7% of patients were currently unemployed, a mean (SD) percentage of absenteeism of 5.7% (12.4) and presenteeism of 23.8% (26.0). Overall mean (SD) percentage of work productivity impairment was 25.6% (27.3). Activity impairment was reported by 36.4% (28.3) of patients. Conclusions: The SATURNO study showed that although patients and physicians reported satisfaction with C5i treatment, this might be challenged. A substantial number of PNH patients treated with C5i still experience anemia, fatigue and abnormal laboratory values, indicative of ongoing hemolysis and suboptimal control. Moreover, patients with PNH had affected work productivity and a proportion of them were experiencing activity impairment. These findings highlight the need for comprehensive management strategies to address the impact of the disease on patients with PNH receiving C5i treatment.

Work loss and activity impairment due to extended nausea and vomiting in patients with breast cancer receiving CINV prophylaxis

PurposeChemotherapy-induced nausea and vomiting (CINV)’s impact on work loss remains poorly described. We evaluated associations between the duration of CINV episodes, CINV-related work loss (CINV-WL), and CINV-related activity impairment (CINV-AI) in patients with breast cancer receiving highly emetogenic chemotherapy.MethodsWe analyzed data from a prospective CINV prophylaxis trial of netupitant/palonestron and dexamethasone for patients receiving an anthracycline and cyclophosphamide (AC) for breast cancer (NCT0340371). Over the observed CINV duration (0–5 days), we analyzed patient-reported CINV-WL and CINV-AI for the first two chemotherapy cycles. We categorized patients as having either extended (≥ 3 days) or short (1–2 days) CINV duration and quantified its impact on work using the Work Productivity and Activity Impairment Questionnaire (WPAI).ResultsOverall, we captured data for 792 cycles in 402 women, including 136 (33.8%) employed patients with 35.3% reporting CINV. Of those with CINV, patients reported CINV-WL in 26 cycles and CINV-AI in 142 cycles. Of those with CINV, 55.3% of extended CINV cycles experienced CINV-WL compared to 16.7% of short CINV cycles (p < 0.001). The relative risk of CINV-WL between extended and short CINV was 3.32 (p < 0.01) for employed patients. The mean difference in CINV-AI scores (higher = worse) between extended and short duration CINV was 5.0 vs. 3.0 (p < 0.001).ConclusionExtended (≥ 3 days) CINV was associated with more than triple the risk of CINV-WL and higher CINV-AI compared with short CINV.

The humanistic and economic burden of work-related musculoskeletal pain: a cross-sectional survey of workers in the United Kingdom.

The aim of this study was to evaluate the impact of work-related musculoskeletal (MSK) lower body pain on health-related quality of life (HRQoL) and work productivity in a large sample of workers in the United Kingdom, as well as evaluating the potential economic impact of MSK pain. Participants with self-reported work-related MSK pain were recruited from an online panel maintained by a third party (Qualtrics LLC). Participants completed three validated instruments online: the Brief Pain Inventory (BPI), the Assessment of Quality of Life Instrument (AQoL-4D), and the 6-item Work Productivity and Activity Impairment Questionnaire (WPAI). Sociodemographic details, work patterns and healthcare resource utilisation were also reported. One-way analysis of variance (ANOVA) and t-tests were used to explore differences between variables. Linear regression was applied to determine the impact of work-related MSK pain on HRQoL. All 1035 recruited participants completed the survey (57.4% female; mean age 43.4 years). Participants reported spending all (25.2%) or most (53%) of their time at work on their feet. Mean pain severity was 4.63 (standard deviation: 2.07); mean pain interference was 4.37 (2.49). There was a linear relationship between length of shift, time on feet and pain. Mean AQoL-4D scores were 0.609 (0.254). A mean of 4.12h was lost per week due to pain. Absenteeism (last 7 days) was 9.5% (20.7%), and presenteeism 33.3% (24.9%). An average 1.55 visits were made to family practitioners (total cost: £19,866) and 1 hospital visit (£37,320) due to work-related MSK pain. This study demonstrated that work-related lower body pain has a significant impact in terms of individual HRQoL and as an economic societal burden.

Disability in Migraine: Multicountry Results From the CaMEO-International Study (S41.002)

Disability in Migraine: Multicountry Results From the CaMEO-International Study (S41.002)

Caregivers of patients with malignant pleural mesothelioma: who provides care, what care do they provide and what burden do they experience?

There are limited data on the impact of caregiving for patients with malignant pleural mesothelioma (MPM) on the caregiver. We aimed to identify the demographic characteristics of these caregivers, the caregiving activities they perform and how caregiving burden impacts their work productivity and overall activity. This cross-sectional study collected data from caregivers of patients with MPM across France, Italy, Spain and the United Kingdom January-June 2019. Caregiver demographics, daily caregiving tasks and the impact of caregiving on physical health was collected via questionnaire. The Zarit Burden Interview (ZBI) was used to assess caregiver burden and the Work Productivity and Activity Impairment questionnaire (WPAI) assessed impairment at work and during daily activities. Analyses were descriptive. Overall, 291 caregivers provided data. Caregivers were mostly female (83%), living with the patient (82%) and their partner/spouse (71%). Caregivers provided over five hours of daily emotional/physical support to patients. ZBI scores indicated 74% of caregivers were at risk of developing depression. Employed caregivers had missed 12% of work in the past seven days, with considerable presenteeism (25%) and overall work impairment (33%) observed. Overall, the mean activity impairment was 40%. Caregivers provide essential care for those with MPM. We show caregiving for patients with MPM involves a range of burdensome tasks that impact caregivers' emotional health and work reflected in ZBI and WPAI scores. Innovations in the management of MPM must account for how caregivers may be impacted and can be supported to carry out this important role.

The burden of nonalcoholic steatohepatitis (NASH) in the United States

BackgroundThere is limited data on the comparative economic and humanistic burden of non-alcoholic steatohepatitis (NASH) in the United States. The objective was to examine the burden of disease comparing NASH to a representative sample of the general population and separately to a type 2 diabetes mellitus (T2DM) cohort by assessing health-related quality of life (HRQoL) measures, healthcare resource use (HRU) and work productivity and activity impairment (WPAI).MethodsData came from the 2016 National Health and Wellness Survey, a nationally representative patient-reported outcomes survey conducted in the United States. Respondents with physician-diagnosed NASH, physician-diagnosed T2DM, and respondents from the general population were compared. Humanistic burden was examined with mental (MCS) and physical (PCS) component summary scores from the Short-Form (SF)-36v2, concomitant diagnosis of anxiety, depression, and sleep difficulties. Economic burden was analysed based on healthcare professional (HCP) and emergency room (ER) visits, hospitalizations in the past six months; absenteeism, presenteeism, overall work impairment, and activity impairment scores on WPAI questionnaire. Bivariate and multivariable analysis were conducted for each outcome and matched comparative group.ResultsAfter adjusting for baseline demographics and characteristics, NASH (N = 136) compared to the matched general population cohort (N = 544), reported significantly lower (worse) mental (MCS 43.19 vs. 46.22, p = 0.010) and physical (PCS 42.04 vs. 47.10, p < 0.001) status, higher % with anxiety (37.5% vs 25.5%, p = 0.006) and depression (43.4% vs 30.1%, p = 0.004), more HCP visits (8.43 vs. 5.17), ER visits (0.73 vs. 0.38), and hospitalizations (0.43 vs. 0.2) all p’s < 0.05, and higher WPAI scores (e.g. overall work impairment 39.64% vs. 26.19%, p = 0.011). NASH cohort did not differ from matched T2DM cohort (N = 272) on mental or work-related WPAI scores, but had significantly worse physical status (PCS 40.52 vs. 44.58, p = 0.001), higher % with anxiety (39.9% vs 27.8%, p = 0.043), more HCP visits (8.63 vs. 5.68, p = 0.003) and greater activity impairment (47.14% vs. 36.07%, p = 0.010).ConclusionThis real-world study suggests that burden of disease is higher for all outcomes assessed among NASH compared to matched general controls. When comparing to T2DM, NASH cohort has comparable mental and work-related impairment but worse physical status, daily activities impairment and more HRU.

Validation and meaningful within-patient change in work productivity and activity impairment questionnaire (WPAI) for episodic or chronic migraine

BackgroundNo available studies demonstrate validity and meaningful change thresholds of Work Productivity and Activity Impairment (WPAI) questionnaire in patients with migraine. In this post-hoc analysis, we assessed reliability, validity, responsiveness, and meaningful within-patient change from baseline to Month 3 for Work Productivity and Activity Impairment (WPAI) domain scores in patients with episodic migraine (EM) or chronic migraine (CM).MethodThe Phase 3, multicenter, randomized, double-blind, placebo-controlled CONQUER study (NCT03559257, N = 462) enrolled patients with EM or CM who failed two to four categories of prior preventive medication in past ten years. The analyses were performed for WPAI domain scores (absenteeism, presenteeism, overall work productivity, and non-work-related activity impairment). Migraine Specific Quality of Life Questionnaire version 2.1 (MSQv2.1) domain scores (Role Function-Restrictive [RFR] and Role Function-Preventive [RFP]), and monthly migraine headache days were used as anchors. Responder criteria were changes from baseline to Month 3 for each of these anchors and were defined as: increase in MSQ-RFR by ≥ 25.71 points and MSQ-RFP by ≥ 20.00 points and a 50% reduction in monthly migraine headache days. Assessments were performed for overall population, and patients with EM or CM. The meaningful change threshold was determined based on Youden index, Phi coefficient and sensitivity.ResultsOf 462 randomized patients, 444 who completed WPAI questionnaire were included in post-hoc analysis. Test–retest reliability over 3 months in a stable subgroup revealed moderate correlations for non-work-related Activity Impairment (ICC = 0.446) presenteeism (ICC = 0.438) and a fair correlation for overall work productivity loss (ICC = 0.360). At baseline, all correlations between WPAI domain scores and continuous anchor variables exceeded recommended threshold of ≥ 0.30, except for WPAI domain scores with number of monthly migraine headache days. Patients achieving pre-specified responsiveness thresholds for monthly migraine headache days, and MSQ-RFP, MSQ-RFR from baseline to Month 3 (responders) showed significant improvements in WPAI domain scores compared with non-responders (P < 0.001). The meaningful change thresholds of -20 (% unit) were identified for WPAI domain scores.ConclusionIn conclusion, WPAI has sufficient validity, reliability, responsiveness, and appropriate interpretation standards to assess the impact of EM or CM on presenteeism and overall work productivity loss and non-work-related activity impairment.Trial registrationNCT number of CONQUER study, NCT03559257.

Quality of Life and Economic Impacts of Retinitis Pigmentosa on Japanese Patients: A Non-interventional Cross-sectional Study.

Retinitis pigmentosa (RP) is an inherited progressive disease, characterized by a loss of photoreceptors, and is the second leading cause of visual impairment in Japan. RP is currently incurable and can result in complete blindness, with affected patients typically experiencing a gradual loss of light sensitivity, visual field, and visual acuity. Identification of any unmet medical needs of patients with this condition requires an understanding of the impacts of RP; in this study, we surveyed Japanese patients with RP to investigate the quality of life and economic impacts of visual impairment. This non-interventional, cross-sectional study surveyed Japanese patients with RP. Economic impact was measured using an original questionnaire that assessed out-of-pocket cost (e.g., vision aids and medical services), salary gap with the general public, and the cost of depression and anxiety. Worker productivity was assessed using the Work Productivity and Activity Impairment Questionnaire (WPAI). Quality of life was evaluated using the Health Utilities Index Mark 3 (HUI3), the National Eye Institute Visual Function Questionnaire-25 (VFQ-25), and the 5-level EQ-5D version (EQ-5D-5L). The primary outcome was direct and indirect costs of visual impairment or blindness during the lifetime of patients with RP. Among 122 surveyed patients with RP, the estimated annual cost per patient was 218,520 yen (2176 USD), and the estimated lifetime cost per patient was 18,523,909 yen (184,501 USD). Additional robustness testing increased the estimated annual cost and lifetime cost per patient to 783,176 yen (7801 USD) and 66,389,827 yen (661,253 USD), respectively. In working patients, work productivity loss was 26.2% per person and impairment of daily activities was 31.6% per person. The mean VFQ-25, HUI3, and EQ-5D-5L scores were 42.0, 0.393, and 0.833, respectively. RP imposed a heavy economic burden and negative quality of life impacts in Japanese patients.

Singapore KneE osTeoarthritis CoHort (SKETCH): protocol for a multi-centre prospective cohort study

BackgroundKnee osteoarthritis (OA) is a leading cause of global disability. The understanding of the role of psychosocial factors in knee OA outcomes is still evolving particularly in an Asian context. The primary aim of this study is to explore psychosocial factors that prognosticate short and long-term clinical outcomes, productivity, and healthcare utilization in patients with knee OA. Secondary aims are to explore the mediation and directional relationships and the role it plays in predicting the discordance between self-reported measures (SRM), physical-performance measures (PPMs) and objective clinical parameters.MethodsA multi-centre prospective cohort study of community ambulant knee OA patients seeking treatment in the tertiary healthcare institutions in Singapore will be conducted. Patients with secondary arthritis, significant cognitive impairment, severe medical comorbidities or previous knee arthroplasty will be excluded. Primary clinical outcome measure is the Knee injury and OA Outcome Score-12 (KOOS-12). Baseline characteristics include sociodemographic status, arthritis status including symptom duration and radiographic severity, comorbidities and functional status through Charlson Comorbidities Index (CCI), Barthel Index (BI) and Parker Mobility Score (PMS). Psychosocial variables include social support, kinesiophobia, negative affect, self-efficacy, injustice, chronic illness shame and the built environment. Clinical outcomes include quality of life, physical performance, global assessment, satisfaction and physical activity levels. Productivity and healthcare utilization will be assessed by a modified OA Cost and Consequences Questionnaire (OCC-Q) and the Work Productivity and Activity Impairment Questionnaire (WPAI). Variables will be collected at baseline, 4, 12 months and yearly thereafter. Regression, mediation and structural equation modelling will be used for analysis.DiscussionResults will allow contextualization, identification, and phenotyping of the critical (and potentially modifiable) psychosocial parameters that predict positive clinical outcomes in the OA population to guide optimization and refinement of healthcare and community. This will facilitate: 1. identification of high-risk knee OA subpopulations that will likely experience poor outcomes and 2. formulation of targeted multidisciplinary comprehensive approaches to address these psychosocial factors to optimize non-surgical treatment care, maximize functional outcomes and create more value-based care model for knee OA.Ethics and disseminationThe study has been registered under clinicaltrials.gov registry (Identifier: NCT04942236).

Cost of Illness, Quality of Life, and Work Productivity in Axial Spondyloarthritis Patients Receiving Biological Treatments in Greece.

To estimate the cost of illness, quality of life and work productivity in patients with Axial Spondyloarthritis (Axial SpA) under biological treatment in Greece. We conducted a prospective study of 12-month duration, of patients with Axial SpA from a tertiary hospital in Greece. Adult patients fulfilling the Assessment of SpondyloArthritis international Society (ASAS) criteria were enrolled at the beginning of biological treatment due to active disease [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) >4] and failure of first line treatment. All participants completed questionnaires about quality of life, financial costs and work productivity at the same time with the disease activity assessment. 74 patients of whom 57 (77%) with a paid job, were included in the study. The total annual cost for Axial SpA patients is € 9,012.40 while the average cost of acquisition and administration of the drugs is € 8,364. The mean BASDAI in the 52 weeks of follow-up, was decreased from 5.74 to 3.2 and the mean Health Assessment Questionnaire (HAQ) also from 1.13 to 0.75. Work productivity of these patients as measured with the Work Productivity and Activity Impairment Questionnaire (WPAI), was significantly impaired at the baseline and improved after the initiation of biological treatment. The cost of illness in patients receiving biological treatments in Greece is high. However, these treatments except from the well-established positive effect on disease activity, can improve remarkably the work productivity and quality of life of Axial SpA patients.

Ankilozan spondilitte iş engelliliği ve iş verimliliği kaybı ile ilişkili faktörler

Objective: To assess the rate of employment and factors associated with work productivity loss in Ankylosing spondylitis (AS).&#x0D; Material and Method: This study was designed as a cross-sectional study that included 70 patients with AS. Fatigue, morning stiffness, and pain were assessed on a visual analogue scale (VAS). Disease activity, physical function, quality of life, anxiety and depression were assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL), and Hospital Anxiety and Depression Scale (HAD), respectively. We used the Work Productivity and Activity Impairment Questionnaire (WPAI) to determine the impact of AS on work productivity. The clinical and demographic characteristics of working and not working patients were compared. Factors associated with absenteeism and presenteeism were assessed using univariable logistic and linear regression analysis, respectively.&#x0D; Results: Mean age of 70 patients (24 women, 46 men) with AS was 42.96 ± 7.83 years. The percentages of working patients was 65.7%. The percentages of presenteeism and absenteeism were 60.21% and 37%, respectively. The clinical and demographic characteristics of working and not working patients were not different (p&gt;0.05). Absenteeism was associated with low educational level (odds ratio [OR]=7.636; 95% confidence interval [CI]=1.782-32.723; p=0.006), morning stiffness (OR=1.545; 95% CI=1.118-2.134; p=0.008), BASDAI (OR=1.645; 95% CI=1.088-2.489; p=0.018), and ASQoL (OR=1.392; 95% CI=1.094-1.772; p=0.007). In the linear regression model, BASDAI (β=8.394; 95% CI=5.570-11.217; p

Improvements in Cognitive Processing Speed, Disability, and Patient-Reported Outcomes in Patients with Early Relapsing-Remitting Multiple Sclerosis Treated with Natalizumab: Results of a 4-year, Real-World, Open-Label Study.

STRIVE was a prospective, 4-year, multicenter, observational, open-label, single-arm study of natalizumab treatment in anti-JC virus antibody-negative patients with early relapsing-remitting multiple sclerosis (RRMS). Study objectives examined the effects of natalizumab on cognitive processing speed, confirmed disability improvement (CDI), and patient-reported outcomes (PROs). Clinical and PRO secondary endpoints were assessed annually over 4 years in STRIVE. The Symbol Digit Modalities Test (SDMT) was used as a measure of cognitive processing speed. PROs were assessed using the Multiple Sclerosis Impact Score (MSIS-29) and the Work Productivity and Activity Impairment Questionnaire (WPAI). At all four annual assessments, the proportion of patients in the intent-to-treat (ITT) population (N = 222) who exhibited clinically meaningful improvement in their SDMT score from baseline (i.e., change ≥4 points) ranged from 41.9 to 54.0%. The cumulative probability of CDI at 4 years in patients in the ITT population with a baseline Expanded Disability Status Scale score ≥2 (N = 133) was 43.9%. Statistically significant reductions in the mean change from screening in the MSIS-29 physical and psychological scores, indicating improved quality of life, were observed over all 4 years (P ≤0.0012 for all). A statistically significant decrease from screening in the impact of MS on regular activities, signifying an improvement in this WPAI measure, was also observed over all 4 years of the study. These results further extend our knowledge of the effectiveness, specifically regarding improvements in cognitive processing speed, disability and PROs, of long-term natalizumab treatment in early RRMS patients. GOV: NCT01485003 (5 December 2011).

MP30-06 FINANCIAL IMPACT OF UROLOGIC CONDITIONS IN MEN AND WOMEN IN BELIZE

You have accessJournal of UrologyCME1 May 2022MP30-06 FINANCIAL IMPACT OF UROLOGIC CONDITIONS IN MEN AND WOMEN IN BELIZE Clinton Yeaman, Devang Sharma, Raj Desai, Rajesh Balkrishnan, and David Rapp Clinton YeamanClinton Yeaman More articles by this author , Devang SharmaDevang Sharma More articles by this author , Raj DesaiRaj Desai More articles by this author , Rajesh BalkrishnanRajesh Balkrishnan More articles by this author , and David RappDavid Rapp More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002573.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urologic disease (UD) is highly prevalent in low- and middle-income countries (LMIC). Concurrently, the inability to maintain employment or provide care for family are significant factors that contribute to extreme poverty in these countries. The impact of urologic disease on economic productivity and caretaking responsibilities in developing countries is poorly understood. METHODS: We conducted a prospective survey-based study of patients treated during two separate global health trips from 2019-2021 with the charity Global Surgical Expedition. Patients completed a 17-item survey with focus on urologic disease, work and caretaking responsibilities, and financial data. Items from the Work Productivity and Activity Impairment Questionnaire (WPAI) were used to assess financial impact. RESULTS: A total of 114 patients completed surveys, with 61 having financial data sufficient for analysis. Most common presenting urologic diagnosis category included Female (pelvic organ prolapse, urinary incontinence)- 41.4%, BPH/strictures- 28.4%, urolithiasis- 19.8%, oncology- 7.7%, and other- 2.6%. Diagnoses were not mutually exclusive. Overall, 87.7% and 36.8% reported a negative impact of urologic disorders on job and caretaking responsibilities, respectively. 9 patients (7.7%) were unemployed secondary to their UD. Mean percent work time missed and percent impairment while working due to UD was 21.8% and 42.0%, respectively. Overall activity impairment due to UD was 30.4%. Mean weekly income of respondents was BZ $461 BZD (approximately $230.50 USD). Accordingly, the percent overall work impairment resulted in $59.10 BZD per capita in lost potential income per week. This represents a loss of 12.8% of total income attributable to UD. 88.6% of patients reported that cure of UD would increase ability to work and/or care for family. CONCLUSIONS: In Belize, UD results in significant impairment and time missed as related to work and caretaking responsibilities. This impairment is associated with a significant level of lost income. Focused efforts are necessary to provide urologic surgeries in developing countries as not only do they impact quality of life but also deleteriously impact financial health of patients and families. Source of Funding: University of Virginia Center for Global Inquiry and Innovation © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e480 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Clinton Yeaman More articles by this author Devang Sharma More articles by this author Raj Desai More articles by this author Rajesh Balkrishnan More articles by this author David Rapp More articles by this author Expand All Advertisement PDF DownloadLoading ...

Improvement in Work Productivity After Group Voice Therapy in Professional Voice Users

A disordered voice may significantly impair the ability of workers to perform optimally on the job, especially those classified as professional voice users (PVU). Voice therapy is a common treatment option for voice disorders, but there are few studies demonstrating its effect on work productivity. The objective of this study was to evaluate the change in work productivity in PVU after group voice therapy. Prospective cohort study SETTING: Academic Voice Center METHODS: PVUs whose primary treatment for their voice disorder was voice therapy were recruited. Participants completed a 7-week group voice therapy course from January 2018 to December 2020. Participants completed the validated Work Productivity and Activity Impairment questionnaire (WPAI) which measured presenteeism (on the job work productivity impairment) and absenteeism (time missed from work), general self-efficacy scale (GSES), and Voice handicap index -10 (VHI-10) before and after group voice therapy. Changes in scores before and after therapy were compared using a Wilcoxon Signed-Rank test. Twenty-seven PVU were recruited; 25 had complete data (100% female, mean age 45.4 years, 68% teachers). Presenteeism (SD) decreased from 72.0% (23.3) to 36.8% (24.8), which represented a significant improvement of 35.2% (27.8) [95% CI 21.7-38.7; P < 0.001]. Activity impairment decreased from 48.4% (32.0) to 25.6% (23.8), which represented a significant improvement of 22.8% (26.5) [95% CI 20.7-37.0; P < 0.00]. There was no change in absenteeism (P = 0.27). Patients had high mean GSES of 34.4 (3.7) and abnormal mean VHI-10 of 18.2 (7.2). Changes in VHI-10 and GSES were not significant. PVU had an improvement in work productivity that was largely represented by decreased presenteeism after completing group voice therapy.

C-reactive protein is associated with impaired working capacity in Chinese patients with ankylosing spondylitis in paid employment: the real-world evidence from Smart-phone SpondyloArthritis Management System

To investigate the relationship between serum C-reactive protein (CRP) levels and work impairment in patients with ankylosing spondylitis (AS) based on real-world evidence. Outpatients with confirmed AS at Chinese PLA General Hospital were recruited consecutively by Smart-phone SpondyloArthritis Management System (SpAMS) from April 2016 to April 2018. The relationship between CRP and work productivity and activity impairment questionnaire (WPAI) were evaluated. Five hundred and fifty-one outpatients with AS in paid employment were recruited. The presenteeism, overall work impairment, and activity impairment rates increased by 1.4% (1.1%, 1.8%), 1.1% (0.5%, 1.6%), and 1.7% (1.3%, 2.1%), respectively, for every 10 mg/L increase in the CRP level (all P value<0.01). However, the CRP level was not associated with absenteeism after adjusting for covariates [0.5%(-0.4%, 1.0%),P>0.05]. There is a significant association between increased serum CRP levels at baseline and the previous 7-day work impairment in patients with AS. Higher CRP levels contribute to worse presenteeism, overall work impairment, and activity impairment rates, which suggests the necessity of monitoring CRP on treatment, and also indicates that anti-inflammatory therapy may be effective for improving work productivity.

Analysis of Cost Associated with Treatment of Road Traffic Injuries among Victims at the Kenyatta National Hospital Nairobi City Kenya

Previous studies have pointed out that road traffic injuries (RTIs) as a leading cause to fatalities of over one million victims globally per year which bears negative impact on health, economy and development of the society as a whole. Furthermore, young men and women at their most economic age group have been identified as the most vulnerable group to road traffic injuries (RTIs) resulting to mortality and very severe morbidity due disability. However, there is little or no published evidence on healthcare resource allocations and utilization after RTIs, especially in developing countries that include those in Africa. Objective: The main objective of this study was to analyze the total hospital cost related to RTI (Road traffic injury) victims admitted for a period of 3 months. The study demonstrated effects of direct and indirect medical cost , productivity loss and hospital length of stay on total cost of road traffic injuries of RTI victims at KNH. Methods: This was a cross sectional study design done at the Kenyatta Hospital Nairobi, surgical wards and Accident &amp; Emergency. A sample (n=124) consisted of new victims admitted to the Hospital due to RTI from January 25th 2019 to 24th April 2019., this was two thirds of the sample size at 74% respondent rate who gave consent and all ethical approvals granted. The data collection of direct and indirect medical cost was by data extraction tool, testing of the tools was done at the surgical ward. Productivity loss of the victims was calculated by use of Work Productivity and Activity Impairment Questionnaire (WPAIQ). SPSS version 22 was applied and descriptive statistics to show frequencies and Percentages for categorical variables (victim’s unique individualized characteristics). Multi Linear Regression Model Test was used test the relationship between the independent and dependent variables. Results: The study results indicated that direct cost factors (laboratory cost, A&amp;E Charges and Diagnostic Cost) (X1: β1 =.199, P&lt;. 047), (X3: β3 =.469, P&lt; .037), and (X4: β4 =.029, P&lt; .048) had a significant influence on the overall cost of treatment of RTI victims seeking treatment at the KNH, there was no significant relationship between Bed Charges (X2: β2 =.117, P&gt;.689) and the cost of treatment of RTI victims seeking treatment at the KNH. The findings of the study also indicated that Y= 7.949+.001X1+0. 458X2+0. .239 X3+ 0. .305X4+e where a .199 change in direct cost, .117 changes in indirect cost, .469 change in total productivity cost and .029 changes in duration of stay in hospital influenced a unit change on the cost of treatment of RTI victims seeking treatment at the KNH. Most distribution of injuries was lower limbs at 51.6% Conclusion &amp; Recommendation: The study concludes that Road traffic accident is an economic burden to individual, family and country at large. The study recommends, need for an awareness on importance of National Hospital insurance fund (NHIF) as a universal health coverage fund for people at an affordable cost, there is need to reduce the indirect cost of treatment associated indirect cost of treatment, support to from one person or two further increasing productivity time associated with the injury. Further motion study on cost analysis will give a detailed insight on these area of study.

Work productivity and activity impairment in patients with primary Sjögren's syndrome.

In this observational, analytical, cross-sectional study we aimed to describe the impact of primary Sjögren's syndrome (pSS) on work productivity and activities of daily living (ADL) to assess the association between ADL impairment and clinical manifestations and to compare ADL impairment according to patients' socioeconomic condition. Patients diagnosed with pSS attending 11 centres from Argentina were included. To evaluate work productivity and ADL impairment, a work productivity and activity impairment questionnaire (WPAI) was used. A multiple linear regression model was performed, considering deterioration on ADL due to health as a dependent variable, adjusted for potential confounders. 252 patients were included, 98.4% were women, with a mean age of 52.6 years (±14.8). The average percentage of time lost due to health was 15.7 hours (±30.1 95% CI: 9.6-21.9); the decrease in work productivity was 27.2 (±30.2 95% CI: 21.3-33.1), the total disability was 33.7 (±35.8 95% CI: 26.4-4) and ADL deterioration was 34.2 (±30.9. 95% CI: 30.4-38). In the multivariate analysis, xerostomia, arthritis and depression showed significant and independent association. The mean of ADL impairment was 38.2 (±30.7) in patients attending public centres versus 28 (± 30.6) in private centres, which was a statistically significant difference. We found a compromise in all WPAI domains. Arthritis, xerostomia and depression were associated significantly and independently with ADL impairment. Deterioration in ADL was greater in patients treated in public centres. Considering these aspects will allow a better understanding of patients who suffer from this disease.