The substantial burden of systemic lupus erythematosus on the productivity and careers of patients: a European patient-driven online survey.
OBJECTIVE
The objective of this study was to explore the burden of SLE and its effect on patients' lives.


METHODS
The Lupus European Online (LEO) survey included patient-designed questions on demographics, SLE diagnosis, and the impact of SLE on careers. Three SLE-specific patient-reported outcome (PRO) questionnaires were also completed: the Lupus Quality of Life (LupusQoL), the Fatigue Severity Scale (FSS), and the Work Productivity and Activity Impairment (WPAI)-Lupus v2.0. The survey was available online in five languages from May through August 2010. All self-identified SLE participants were eligible to respond. Survey results were analysed using descriptive statistics. Multivariate linear regression explored factors contributing to impaired productivity.


RESULTS
Of the 2070 European SLE patients completing the survey, 93.1% were women, 86.7% were aged <50 years and 71.8% had a college or university education. More than two-thirds of respondents (69.5%) reported that SLE affected their careers; 27.7% changed careers within a year of diagnosis. All LupusQoL domains (score range 0-100) were impaired, with fatigue (median domain score 43.8) being the most affected and intimate relationships (median domain score 75.0) the least. Most patients (82.5%) reported fatigue (FSS score ≥4). Productivity was impaired across all WPAI domains, both at work and in general activities. Fatigue, an inability to plan and reduced physical health were significantly associated with impaired productivity. Patients whose careers were affected by SLE had worse health-related quality of life, more fatigue and worse productivity than patients whose careers were not affected.


CONCLUSIONS
LEO survey respondents reported that SLE negatively affects their daily lives, productivity and career choices.
Rheumatology Research Group, School of Immunity and Infection, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. p.c.gordon@bham.ac.uk.
Caroline
C
Gordon
David
D
Isenberg
Kirsten
K
Lerstrøm
Yvonne
Y
Norton
Enkeleida
E
Nikaï
Daphnee S
DS
Pushparajah
Matthias
M
Schneider
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002321:Career Choice; D017281:Cost of Illness; D004526:Efficiency; D004651:Employment; D005060:Europe; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012111:Residence Characteristics; D055815:Young Adult
HRQoL; PRO; SLE; fatigue; productivity