Work Productivity Loss Research Articles

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.

Interventions to Reduce the Role Strain of Informal Adult Caregivers of Individuals With Neurocognitive and Mental Disorders

AbstractBackgroundThe value of the unpaid labor performed by caregivers is estimated to be at least $306 billion annually, nearly double the combined costs of home health care ($43 billion) and nursing home care ($115 billion). However, studies show caregivers are at risk of developing high levels of physical, emotional, and mental strain, which can negatively impact their role, quality of life, and increase medical costs.PurposeThe project aims to determine if giving informal caregivers non-pharmacological interventions such as self-guided bibliotherapy, stress reduction interventions, and improving health literacy will reduce the role strain of informal adult caregivers and improve their quality of life.MethodThis project employed a mix-method design focusing on the role strain and quality of life of relatives and friends assisting individuals with neurocognitive or mental health disorders. The subjects engaged in weekly self-guided activities for 8 weeks, and responded to survey questions regarding demographics, depression, anxiety, and stress levels. Personal health information (PHI) was not obtained. The subjects were required to answer qualifying questions. A $5 Amazon gift card was given to participants who completed the project.ResultsSeven people enrolled in the project, but only four participated. All participants were female. Two were African Americans, one Caucasian, and one Hispanic. All four participants completed the pre-test, demographic surveys, and intervention. However, only two completed the post-test survey. One participant completed the pre-test and post-test on the same day at the end of the project.Descriptive statistics were employed for the data analysis due to the small sample size. A non-parametric 2-independent sample test was used because of the small sample size. The test did not show any statistical significance between the variables in the pre-and post-test DASS-21 after the intervention. Subjects reported the project intervention was “helpful.” Another participant said she could not fully engage in the interventions because of family obligations. Still, she enjoyed the resources, such as the weekly NAMI family support group meetings given by the SI. The pre-test DASS-21 mean score for N=3 was 26 and standard deviation was 15.62.DiscussionThe current COVID-19 has led to an increase in mental health issues. Because of the overwhelming increase in mental health cases, many individuals with mental health problems are being turned away. The decrease in the availability of mental health providers has led to an increased need for informal caregivers. However, studies show stress from caregiving can negatively affect the health of caregivers and result in loss of work productivity. However, specialized support for caregivers is frequently limited. Brown et al. (2016) said nonpharmacological self-help interventions such as bibliotherapy, stress-reduction techniques, and health literacy training could improve caregivers’ health. Therefore, lawmakers and healthcare professionals need to come up with interventions to help caregivers.FundingNo Funding

MP16-02 WORK PRODUCTIVITY OF PATIENTS UNDERGOING TRIAL OF PASSAGE FOR URETERAL STONES

You have accessJournal of UrologyCME1 Apr 2023MP16-02 WORK PRODUCTIVITY OF PATIENTS UNDERGOING TRIAL OF PASSAGE FOR URETERAL STONES Ian Berger, Alexandria Spellman, Vishnukamal Golla, Michael Lipkin, Gary Faerber, Jodi Antonelli, Charles Scales, and Deborah Kaye Ian BergerIan Berger More articles by this author , Alexandria SpellmanAlexandria Spellman More articles by this author , Vishnukamal GollaVishnukamal Golla More articles by this author , Michael LipkinMichael Lipkin More articles by this author , Gary FaerberGary Faerber More articles by this author , Jodi AntonelliJodi Antonelli More articles by this author , Charles ScalesCharles Scales More articles by this author , and Deborah KayeDeborah Kaye More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003236.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteral stones affect patients of working age and disrupt daily activities. Patient reported outcomes during trial of passage are understudied which hinders counseling and expectation setting. We sought to characterize work productivity losses for patients with a ureteral stone undergoing a trial of passage. METHODS: We identified employed, English speaking patients aged 18-64 years and discharged from Duke University Health System EDs with unilateral ureteral stones on CT scan from February-October 2022. Patients were contacted by phone 4 weeks after discharge and administered the Institute for Medical Technology Assessment Productivity Cost Questionnaire which evaluates three domains of productivity loss over a four-week period: absenteeism (missed work), presenteeism (decreased productivity at work), and volunteerism (help with unpaid work or domestic tasks). Patients were designated as reporting passage of their stone if they noticed it in the toilet or identified a day with symptom resolution that did not return. RESULTS: We enrolled 64 patients who completed the survey. 71% (46/64) had distal stones and 14% (9/64) had symptoms at the time of the survey. 73% (47/64) of patients missed work after discharge (Figure 1), missing a median of 2 days (interquartile range [IQR] 1.0-4.0). 58% (37/64) had pain at work, with a median of 3 days of pain (IQR 1.5-6.5) and a median of 40% reduction in productivity (IQR 20%-50%) on symptomatic days. 38% (24/64) required help with unpaid work for a median of 2.5 days (IQR 1.0-5.8) and median of 3.5 hours per day (IQR 2.0-5.0). 58% (37/64) of patients passed their stone with a median passage time of 3.5 days (IQR 2.0-7.8). Of patients who passed their stone, 68% (25/37) missed work, with a median of 2 days missed (IQR 1-2) or 50% of work days until their stone passed (IQR 21%-83%). Of patients who reported not passing their stone, 74% (20/27) missed work for a median of 4.5 days (IQR 1-7). This was a median of 14% (IQR 3%-22%) of days until surgery or survey completion. CONCLUSIONS: The majority of patients miss work during passage of a ureteral stone. While time off work is less than published rates after ureteroscopy, it is common to miss half of work days until the stone passes. This information may aid patient counselling and help to prevent return ED visits. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e201 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ian Berger More articles by this author Alexandria Spellman More articles by this author Vishnukamal Golla More articles by this author Michael Lipkin More articles by this author Gary Faerber More articles by this author Jodi Antonelli More articles by this author Charles Scales More articles by this author Deborah Kaye More articles by this author Expand All Advertisement PDF downloadLoading ...

Economic Impacts and Quality of Life for Caregivers of Patients with Retinitis Pigmentosa: A Cross-Sectional Japanese Study.

Retinitis pigmentosa (RP) is the second leading cause of visual impairment in Japan and causes progressive vision loss in affected patients. Caregiving for patients with RP is associated with socioeconomic impacts; however, data on the magnitude and scope of these impacts are lacking. This cross-sectional study surveyed informal caregivers of patients with RP in Japan. The questionnaire assessed the socioeconomic status of participants; work impacts through the Work Productivity and Activity Impairment Questionnaire adapted for caregivers; and quality of life impacts through the Japanese version of the Caregiver Reaction Assessment (CRA) and the 5-level EQ-5D version (EQ-5D-5L). Of the 37 participating caregivers, 28 (75.7%) were employed. Among those, the average annual income was 2,722,080 yen (n = 20) and the mean loss of work productivity was 6.6%. The mean EQ-5D-5L index score was 0.882, and the mean CRA total score was 2.1. A mild to very severe impact on family life, leisure and hobbies, social life, and mental health was experienced by 83.8%, 78.4%, 75.7%, and 70.3%, respectively. These results suggest that caregivers of patients with RP may be disadvantaged in terms of employment and income and may experience wide-ranging impacts on their quality of daily life.

The impact of preloaded intraocular lens implantation system (TECNIS iTec®) in routine cataract surgery in China: a time-motion analysis

ObjectiveTo evaluate the impact on surgical efficiency and labor time cost of preloaded intraocular lens (IOL) implantation system compared with manual IOL implantation system in age-related cataract surgery in China.MethodsThis study was an observational, multicenter, prospective time-motion analysis. IOL preparation time, operation time, cleaning time, number and cost of cataract surgeries in eight participating hospitals were collected. The linear mixed model was used to explore factors associated with the difference in operation time between the preloaded IOL implantation system and the manual IOL implantation system. A time-motion model was constructed to convert the operation time cost saved by using preloaded IOL into economic benefits from hospital and social perspective, respectively.ResultsThere were 2,591 cases included in the study (preloaded IOL: 1,591 cases; manual IOL: 1,000 cases). The preloaded IOL implantation system was significant time-saving in both preparation time and operation time compared to the manual IOL implantation system (25.48s vs. 47.04s, P < 0.001 and 353.84s vs. 367.46s, P = 0.004, respectively). An average total of 35.18s can be saved by using preloaded IOL per procedure. The results of linear mixed model showed that the type of IOL was the main factor leading to the difference in preparation time between preloaded IOL and manual IOL implantation system. By switching from manual IOL to preloaded IOL, the model projected additional 392 surgeries can be performed each year and an increase in revenue of $565,282 per hospital, a 9% increase from hospital perspective. And the annual productivity loss saved by using preloaded IOL was $3,006 in eight hospitals from perspective of society.ConclusionCompared with manual IOL implantation system, the preloaded IOL implantation system reduces lens preparation time and operation time, which increases potential surgical volume and revenue, and reduces the loss of work productivity. This study provides real-world evidence to support the advantages of the preloaded IOL implantation system in improving efficiency of ophthalmic surgery in China.

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.

How to Improve Non-Invasive Diagnosis of Endometriosis with Advanced Statistical Methods.

Background and Objectives: Endometriosis is one of the most common gynecological disorders in women of reproductive age. Causing pelvic pain and infertility, it is considered one of the most serious health problems, being responsible for work absences or productivity loss. Its diagnosis is often delayed because of the need for an invasive laparoscopic approach. Despite years of studies, no single marker for endometriosis has been discovered. The aim of this research was to find an algorithm based on symptoms and laboratory tests that could diagnose endometriosis in a non-invasive way. Materials and Methods: The research group consisted of 101 women hospitalized for diagnostic laparoscopy, among which 71 had confirmed endometriosis. Data on reproductive history were collected in detail. CA125 (cancer antigen-125) level and VEGF1(vascular endothelial growth factor 1) were tested in blood samples. Among the used statistical methods, the LASSO regression-a new important statistical tool eliminating the least useful features-was the only method to have significant results. Results: Out of 19 features based on results of LASSO, 7 variables were chosen: body mass index, age of menarche, cycle length, painful periods, information about using contraception, CA125, and VEGF1. After multivariate logistic regression with a backward strategy, the three most significant features were evaluated. The strongest impact on endometriosis prediction had information about painful periods, CA125 over 15 u/mL, and the lowest BMI, with a sensitivity of 0.8800 and a specificity of 0.8000, respectively. Conclusions: Advanced statistical methods are crucial when creating non-invasive tests for endometriosis. An algorithm based on three easy features, including painful menses, BMI level, and CA125 concentration could have an important place in the non-invasive diagnosis of endometriosis. If confirmed in a prospective study, implementing such an algorithm in populations with a high risk of endometriosis will allow us to cover patients suspected of endometriosis with proper treatment.

Use of oral GnRH antagonists combined therapy in the management of symptomatic uterine fibroids.

Uterine fibroids have an impact on women's lives due to their high prevalence, physical symptoms, their consequences on patients' emotional and psychological well-being and loss of work productivity. The choice of therapeutical approaches varies depending on several factors, and therefore should be applied individually. Currently, there is an unmet need for good, reliable, uterine-sparing options. The oral GnRH antagonists (Elagolix, Relugolix, Linzagolix) represent a new alternative for the medical management of hormone-dependent gynaecological diseases such as uterine fibroids or endometriosis. They rapidly bind to the GnRH receptor, block endogenous GnRH activity and directly suppress LH and FSH production, avoiding unwanted flare-up effects. Some GnRH antagonists are marketed in combination with hormone replacement therapy add-back to counteract hypo-oestrogenic side effects. According to the registration trials, once-daily GhRH antagonist combination therapy results in a significant reduction in menstrual bleeding, as compared with placebo, and preserves bone mineral density, for up to 104 weeks. Further studies in the long term are needed to evaluate the whole impact of medical treatment of uterine fibroids on the management of this common women's disease.

P646 Relative association of bowel urgency clinically meaningful improvement and bowel urgency remission versus stool frequency remission and rectal bleeding remission with improvement in Work Productivity and Activity Impairment Scores in patients with moderately-to-severely active Ulcerative Colitis: An analysis from LUCENT-1 and LUCENT-2 Phase 3 clinical trials.

Abstract Background Bowel urgency is increasingly recognized as a common and impactful symptom in patients with Ulcerative Colitis (UC).1 However, there are limited data exploring the relationship of bowel urgency with work productivity. We examined the relative association of bowel urgency clinically meaningful improvement (CMI) and bowel urgency remission with Work Productivity and Activity Impairment (WPAI) scores in the presence of rectal bleeding (RB) remission and stool frequency (SF) remission as potential confounding variables using data from LUCENT-1 (NCT03518086) and LUCENT-2 (NCT03524092) phase 3 trials. Methods Bowel urgency severity was assessed using the Urgency Numeric Rating Scale (UNRS; 0=no urgency to 10=worst possible urgency). Bowel urgency CMI is a ≥3-point decrease and bowel urgency remission is a UNRS score of 0 or 1.2 WPAI scores (absenteeism, presenteeism, and work productivity loss in employed patients, and activity impairment in all patients) were measured using a 6-item questionnaire; higher scores indicate greater impairment and less productivity. Mediation analyses were performed to separately examine the relative association between the direct effect of bowel urgency CMI and bowel urgency remission (predictor) and WPAI scores while adjusting for the potential confounding effects of RB remission and SF remission (mediator). Analyses were treatment agnostic and combined patients from mirikizumab and placebo groups from LUCENT-1 (N=1162) and LUCENT-2 (N=544) trials. Results At week (W)12 and W52, the direct effect of bowel urgency remission accounted for 43%–49% and 27%–57% of the improvement in all WPAI domain scores except absenteeism, respectively. The association values greater than 100% at W12 and W52 (153% and 148%, respectively) reflect the critical importance of SF remission in the improvement of absenteeism score (Table 1). Bowel urgency CMI resulted in the largest proportion of improvement in WPAI domain scores (except absenteeism) at W12 (71%–74%) and W52 (66%–78%). Bowel urgency CMI accounted for 68% and 239% of the improvement in absenteeism scores at W12 and W52, respectively. At W52, 750% of the effect was mediated by RB remission (Table 2). Conclusion Improvement in work productivity and regular activities were primarily ascribed to bowel urgency remission or bowel urgency CMI relative to RB remission and SF remission in patients with moderately-to-severely active UC. These findings suggest that bowel urgency is a critical and independent symptom that considerably impacts patients’ productivity. Reference: 1Dubinsky MC, et al. Crohn's &amp; Colitis 360. Volume 4, Issue 3, July 2022;7(4):3. 2Dubinsky MC, et al. J Patient Rep Outcomes. 2022;6(1):114.

350 Examining the relationships among abrocitinib treatment, itch, skin pain and work and activity impairments in patients with atopic dermatitis: a mediation modelling analysis

Abstract Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense itch, skin pain and impaired quality of life. Skin pain is a common and bothersome symptom of AD and increases in prevalence and intensity with worsening disease severity. Abrocitinib is an oral, once-daily, selective Janus kinase-1 inhibitor approved for the treatment of moderate-to-severe AD. Abrocitinib treatment resulted in improvements in skin clearance as well as rapid itch reduction in patients with moderate-to-severe AD across multiple phase 3 studies. Work productivity loss and activity impairment were assessed in the phase 3 JADE MONO-2 (NCT03575871) trial, with greater improvements being associated with abrocitinib treatment compared with placebo. The mechanism(s) through which abrocitinib reduces work productivity loss and activity impairment are unclear. To describe the interrelationships among abrocitinib treatment, itch, skin pain, and work productivity and activity impairment using a mediation modelling analysis in patients with AD. Data from adult patients treated with abrocitinib monotherapy (200 or 100 mg) or placebo in JADE MONO-2 were included in this analysis. As separate outcomes, work productivity loss and activity impairment (outcome variables) were measured by the Work Productivity and Activity Impairment Questionnaire: Atopic Dermatitis version 2.0 (WPAI-AD 2.0). Itch and skin pain (mediator variables) were evaluated using the Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD) item #1 (How itchy was your skin over the past 24 h?) and item #2 (How painful was your skin over the past 24 h?), respectively. Mediation modelling was conducted independently for work productivity loss and activity impairment. All available data at week 12 were used in the modelling. Effects with P &amp;lt; 0.05 were considered statistically significant. The direct effects of abrocitinib were estimated to be 7.3% (P = 0.779) and 17.5% (P = 0.258) on work productivity loss and activity impairment, respectively. The indirect effects of abrocitinib treatment on work productivity loss and, separately, on activity impairment mediated via itch were estimated to be 50.6% (P = 0.017) and 20.9% (P = 0.062), respectively, and via skin, pain were estimated to be 42.1% and 61.5%, respectively, (P &amp;lt; 0.05 for both). The indirect effect of abrocitinib treatment on work productivity loss is mediated approximately equally through the reduction in itch severity and skin pain. The effect of abrocitinib treatment on activity impairment is mostly mediated indirectly through the reduction of skin pain, along with a smaller indirect contribution from the reduction in itch. These findings support further research into the extent that patients consider itch and skin pain as separate concepts in terms of their impact on work productivity.

Work productivity (absenteeism and presenteeism) in persons with common mental disorders: An observational study from South India.

The greatest contributor to the economic impact of common mental disorders (CMDs) is said to be the loss of work productivity. There is a paucity of studies from India that looks at the impact of CMDs on the productivity of work, which costs both patient and society significantly. To assess and compare work productivity by evaluating both absolute and relative presenteeism and absenteeism, in persons with CMDs. This was a cross-sectional observational study on 220 subjects (110, 58, and 52 patients with depressive disorder, anxiety disorders, and somatoform disorders, respectively), recruited through purposive sampling. We evaluated work productivity using the World Health Organization Health and Work Performance Questionnaire. Absolute absenteeism was significantly different before and after treatment for CMDs as a group but not for individual disorders. Relative absenteeism, absolute presenteeism, and relative presenteeism were all significantly different before and after treatment among both CMDs as a group and also among individual disorders. Both presenteeism and absenteeism (absolute as well as relative) did not differ significantly across the diagnostic groups. Work productivity has been linearly associated with illness severity and disability. CMDs are associated with a significant loss of work productivity. Presenteeism is costlier than absenteeism in affecting work productivity. Loss of work productivity appears to be transdiagnostic across all CMDs. Also, the severity of loss of work productivity is associated linearly with the severity of illness and disability.

Humanistic burden of problem joints for children and adults with haemophilia.

The "problem joint" (PJ) concept was developed to address patient-centric needs for a more holistic assessment of joint morbidity for people with haemophilia (PwH). To quantify the humanistic burden of PJs in PwH to further support validation of the PJ outcome measure. Multivariable regression models evaluated the relationship between PJs and health-related quality of life (HRQoL, EQ-5D-5L) and overall work productivity loss (WPL) using data from the 'Cost of HaEmophilia: a Socioeconomic Survey' population studies (adults: CHESS II, CHESS US+; children/adolescents: CHESS-Paeds). Covariates included were haemophilia severity, age, comorbidities and education. The CHESS II sample included 292 and 134 PwH for HRQoL and WPL analyses, mean age 38.6 years (39% ≥1 PJ, 61% none). CHESS US+ included 345 and 239 PwH for HRQoL and WPL, mean age 35 years (43% ≥1 PJ, 57% none). CHESS-Paeds included 198 PwH aged 4-17 (HRQoL only), mean age 11.5 years (19% ≥1 PJ, 81% none). In CHESS II and CHESS US+, presence of PJs was associated with worse HRQoL (Both p<.001). Few CHESS-Paeds participants had PJs, with no significant correlation with HRQoL. In CHESS II, upper body PJs were significantly correlated to WPL (p<.05). In CHESS US+, having ≥1 PJ or upper and lower body PJs were significantly correlated to WPL (vs. none; both p<.05). This study has shown a meaningful burden of PJs on PwH, which should be considered in clinical and health policy assessments of joint health.

Patient-reported disease impact of systemic lupus erythematosus with active joint symptoms: Results from the systemic lupus erythematosus-update survey.

Many people with systemic lupus erythematosus (SLE) experience joint pain, swelling, and stiffness. These joint symptoms are associated with problems in physical functioning and work disability. We used survey data from adults with SLE to explore the burden and impact of joint symptoms. SLE-UPDATE was a 2019 cross-sectional US survey of adults with SLE. We compared respondents with "currently active" joint symptoms' and those "without currently active" joint symptoms. The active joint cohort comprised survey respondents who self-reported current "stiffness in joints" or "pain/swelling in joints" and who had moderate to severe joint pain (Worst Joint Pain Numeric Rating Scale [NRS] score ≥ 4). Respondents not fulfilling these criteria were included in the non-active joint cohort. Outcomes included frequency and severity of pain, patient-reported outcomes (LupusPRO™ and Work Productivity and Activity Impairment: Lupus [WPAI-Lupus]), satisfaction with current treatments, and importance of different treatment goals. More respondents in the active joint cohort (N = 285) than in the non-active joint cohort (N = 215) reported pain most or all the time over the preceding 7days (77.5% vs. 32.1%, p < .0001), fibromyalgia (45% vs. 12%, p < .0001), and higher (worse) mean scores on the Worst Pain NRS (6.5 vs. 4.8, p < .0001) and Worst Joint Pain NRS (6.7 vs. 4.5, p < .0001). Mean Lupus PRO health-related quality of life (HRQoL) total score was lower (worse) in the active joint cohort (48.9 vs. 64.1, p < .0001). WPAI-Lupus scores indicated greater work productivity losses and activity impairment in the active joint cohort. More respondents in the active joint cohort than in the non-active joint cohort were neutral or not satisfied with current treatments and rated reducing pain as a "very important" treatment goal (26.7% vs. 18.1%). Respondents with SLE and active joint manifestations in addition to having more pain report lower HRQoL and were less satisfied with their current treatments. Comorbid fibromyalgia may play a role in joint symptoms in patient with SLE joint manifestations. There is an unmet need for new therapeutic options to reduce joint symptom burden among patients with SLE.

MUSCULOSKELETAL DISORDERS OF HAND IN HEALTHCARE WORKERS: A CROSS-SECTIONAL STUDY

Musculoskeletal disorders (MSDs) of the hand negatively affect the hand's functionality and lead to long periods of sick leave. MSDs of hand are associated with work absences and productivity loss more than other Musculoskeletal disorders (MSDs). The study aimed to assess the discomfort of hands in healthcare workers (HWs) and the relationship between demographics and discomfort. 217 HWs selected randomly in the Trakya University Hospital from Dec. 2019 to Feb. 2020 participated in this cross-sectional study. The study was carried out through a questionnaire for sociodemographic characteristics and Cornell Hand Discomfort Questionnaires for MSDs. SPSS v.24.0 software was used to analyze the data. The most common discomfort scores were in the right-hand wrist (1.79), right-hand thumb joint, right-hand thumb (1.65), left-hand wrist (0.86), and left-hand (index, middle, half ring) (0.87), and left-hand thumb (0.80) areas respectively. Right-hand discomfort scores were relatively higher than left-hand. While an association was detected between the level of education, years of work, and MSDs of hand, there was no relation with gender, marital status, or profession. The findings from the study indicate MSDs of hand among HWs. Further research is recommended to detect the prevalence and prevention of MSDs of hand on HWs.

Mindful work and mindful technology: Redressing digital distraction in knowledge work

Knowledge work today is characterized by frequent interruptions. Digital distraction plays an increasingly important role in this work context as workers' behavior and emotional state online spills into work practices, causing stress and productivity loss. This article discusses solutions to digital distraction by advancing the concepts of mindful work and mindful technology. In doing so, it first critiques the design of prevalent productivity tools (i.e., “block-and-avoid tools”) that avoid the problem rather than remediating it. We argue that mindfulness is particularly applicable to handling digital distraction and propose a two-part framework for mindful work and mindful design through which workers can learn to work with technology — and their emotions — in more constructive ways. Lastly, we expand on our mindful work framework by proposing the concept of an intelligent personal assistant.

The Association of Alopecia Areata-Related Emotional Symptoms with Work Productivity and Daily Activity Among Patients with Alopecia Areata.

Patients with alopecia areata (AA) experience psychological and psychosocial symptoms including depression, anxiety, anger, social withdrawal, embarrassment, and low self-esteem. While multiple studies have measured the detrimental emotional impact of AA on patient quality of life, evidence of its effect on work productivity loss (WPL) and daily activities is limited. This study aimed to assess the extent of AA-related emotional symptom (ES) burden on work productivity and activity impairment. A cross-sectional survey of dermatologists and their adult patients with AA was conducted in the USA in 2019. Dermatologists provided assessments of patients' clinical characteristics, while patients completed sociodemographic questionnaires along with two validated patient-reported outcome measures of the Work Productivity and Activity Impairment (WPAI) and the AA Patient Priority Outcomes (AAPPO) ES subscale. The WPAI assessed AA-related WPL (employed respondents) and activity impairment (all respondents), and the AAPPO-ES assessed AA-related frequency of feeling self-conscious, embarrassed, sad, or frustrated. Multiple linear regression models were fitted to both WPAI scores with the AAPPO ES as an independent variable. A total of 242 patients with a mean (SD) age of 39.2 (13.3) years, treated by 59 dermatologists, were evaluated. Mean (SD) ES score was 2.0 (1.1). Mean (SD) work productivity loss [n = 170] and activity impairment [n = 242] were 12.2% (17.4%) and 13.3% (18.3%), respectively. After adjusting for covariates, WPL increased by 4.1% [95% confidence interval (CI) 1.6-6.7%; p = 0.002] and activity impairment increased by 3.1% (95% CI 0.7-5.4%; p = 0.010) for every 1-point increase in ES. For an average patient, a 1-SD decrease (about 1 point) on the ES scale substantially reduced WPL and activity impairment (by at least 25%). Patients with AA reported significant increases in WPL and activity impairment associated with worsening AA-related ES. These findings underscore the substantial emotional and psychosocial burden among patients with AA and a need for improved treatment options.

Effects of eptinezumab on self-reported work productivity in adults with migraine and prior preventive treatment failure in the randomized, double-blind, placebo-controlled DELIVER study

BackgroundThe multinational phase 3b DELIVER trial was designed to evaluate the efficacy and safety of eptinezumab for migraine prevention in patients with prior preventive treatment failures across 17 countries. In the placebo-controlled portion, eptinezumab relative to placebo demonstrated greater reductions in migraine and headache frequency, migraine and headache severity, and acute medication use. The objective of this report is to describe the effects of eptinezumab on self-reported work productivity in the placebo-controlled portion of DELIVER.MethodsAdults 18–75 years of age with migraine and documented evidence of 2 to 4 prior preventive treatment failures in the past 10 years were randomized to receive eptinezumab 100 mg, 300 mg, or placebo intravenously (IV) every 12 weeks. The Work Productivity and Activity Impairment questionnaire specific to migraine (WPAI:M), which comprises 6 items (4 of which are completed by currently employed patients only), was administered every 4 weeks. Changes from baseline in subscores (absenteeism, presenteeism, work productivity loss, and activity impairment) were calculated based on item responses. A mixed model for repeated measures was used to analyze changes from baseline in WPAI:M subscores.ResultsA total of 890 adults (mean age, 43.8 years) were included in the full analysis set (eptinezumab 100 mg, n = 299; eptinezumab 300 mg, n = 293; placebo, n = 298). Mean WPAI:M subscores at baseline indicated a negative impact of migraine attacks on work productivity and ability to complete normal daily activities. Eptinezumab improved WPAI:M subscores more than placebo at all assessment points throughout the study. Mean changes from baseline in self-reported work productivity loss were −19.5, −24.0, and −9.7 at Week 12; and −22.6, −20.2, and −7.2 at Week 24 (all P < 0.001 vs placebo) for eptinezumab 100 mg, eptinezumab 300 mg, and placebo, respectively. Mean changes from baseline in activity impairment were −21.3, −23.8, and −11.2 at Week 12; and −24.7, −22.6, and −10.1 at Week 24 (all P < 0.0001 vs placebo). Similarly, mean improvements in absenteeism and presenteeism were greater in the eptinezumab groups than in the groups receiving placebo at all timepoints (P < 0.05).ConclusionIn adults with migraine and prior preventive treatment failure, eptinezumab 100 mg and 300 mg IV every 12 weeks improved absenteeism, presenteeism, work productivity loss, and activity impairment more than placebo.Trial registrationClinicalTrials.gov (Identifier: NCT04418765); EudraCT (Identifier: 2019–004497-25) (https://www.clinicaltrialsregister.eu/ctr-search/trial/2019-004497-25/PL).Graphical Eptinezumab improves self-reported work productivity in patients with migraine and prior preventive treatment failures.

The cost burden of Alzheimer’s Disease on care partners

AbstractBackgroundAlzheimer’s Disease (AD) has significant impact on care partners. We conducted a systematic literature review to assess the economic impact of AD with special attention to care partners and disease progression.MethodA protocol was developed before searches in PubMed, Embase and PsycINFO were run November 2021 via the Silvi.ai‐platform. Conduct of the systematic literature review followed standard guidelines. Eligible studies were in English and provided data from earliest Jan 2011 – Nov 2021.ResultOf 1043 identified hits, 25 studies were relevant for data extraction. AD costs were defined heterogeneously between studies, however most studies included AD drugs, out‐ and inpatient visits as well as non‐AD drugs (anti‐psychotics, supplements etc).7 of the 25 studies specifically explored the cost burden of AD for care partners; hours needed to support the partner, loss of work productivity, and implications for future employability.Monthly cost of caretaking was similar across studies and countries and varied between €643 ‐ €1050 for mild AD in Germany and Spain, €804‐ €1329 for moderate AD in France and Germany, to €1515 ‐ €2376 for severe AD in UK and Germany, respectively. The major cost driver was severity of the clinical status of the patient.Only few studies reported on work impairment of care partners. A study comparing matched care partners vs. non‐care partner demonstrated significantly higher activity impairment (25.4% vs. 21.8%), greater absenteeism (5.4% vs.3.1%), presenteeism‐related impairment (22.7% vs. 18.4%), and overall work impairment (25.8% vs. 20.4%). Same pattern, showing an increase in work impairment with AD severity was seen across countries (US, Japan and EU5).ConclusionMost identified studies focused on the cost burden on society or patients. In 7 studies reporting cost impact on care partners, the cost burden was very similar across countries and health care systems. Cost impact on care partners increased from early to severe AD. In particular, work impairment increased significantly with AD severity. However, more research is needed to identify the true cost burden for care partners.

EE508 Work Productivity Loss Among Women With Menopausal Symptoms: A Systematic Literature Review

EE508 Work Productivity Loss Among Women With Menopausal Symptoms: A Systematic Literature Review

The impact of migraine and probable migraine on productivity loss in Korea: A cross-sectional online survey.

Migraine is an enormous burden on society, but relevant studies are limited. The population of interest of this study was migraine or probable migraine (PM) in Korea. In this population, we aimed to assess the productivity loss through the level of severity defined by monthly migraine days (MMD) and analgesic frequency and to estimate costs and associated factors of productivity loss. We conducted an online survey of adults with migraine symptoms. We defined migraine and PM using the modified International Classification of Headache Disorders, second edition. Severity level was defined by subgroups of MMD (0-3, 4-14, and ≥15 days) and analgesic frequency (0, 1, 2, 3, and ≥4 per week). Productivity loss was assessed using the Work Productivity and Activity Impairment questionnaire and consisted of absenteeism, presenteeism, overall work productivity loss, and activity impairment. The costs of productivity loss due to absenteeism and presenteeism were calculated in 2020 USD. We used negative binomial regression to identify the factors associated with the costs of productivity loss. We identified 362 respondents with migraine or PM. Mean age was 41.7 years, 75.7% were female (N = 274), and 73.2% (N = 265) were employed. On average, productivity losses due to absenteeism and presenteeism were 8.1% and 39.7%, respectively. As MMD increased, there was a trend toward increased activity impairment, presenteeism, and overall work productivity loss. The mean overall productivity loss cost was USD 44.61 per person per day. Duration of migraine attacks was significantly associated with higher absenteeism costs. The results of this study indicate that the higher the MMD, the greater the productivity loss in patients with migraine or PM in Korea. We also found that patients with low-frequency migraine and PM experienced substantial productivity loss. This study provides comprehensive evidence of the burden of migraine in Korea using a representative sample.