title: Problems in work participation and resource use should not be underestimated in patients with early spondyloarthritis.
abstract: OBJECTIVE
  To explore the effect of early spondyloarthritis (SpA) on worker participation and to investigate variables associated with work outcomes as well as the effect on resource use.
  
  
  METHODS
  Patients included in an early SpA cohort completed a questionnaire comprising items on employment status, sick leave, presenteeism, and resource use. Logistic regressions were used to investigate the associations between work status and clinical characteristics, and linear regressions were used to investigate the association between at-work productivity loss and clinical characteristics. Resource use across patient groups with different employment status was investigated with linear regression analyses.
  
  
  RESULTS
  One hundred forty patients participated in our study. Of the patients, 69% were male, the mean age was 41 years, and the disease duration was 4.8 years. Twenty-six patients (19%) were not employed because of SpA. Among 114 employed patients, sick leave was reported in 28% in the previous year. Forty-one percent of the patients reported reduced productivity at work. Multivariable regression analyses showed that high Bath Ankylosing Spondylitis Metrology Index and Ankylosing Spondylitis Quality of Life score were associated with not being employed and with reduced productivity at work. Annual costs of productivity loss attributable to sick leave and presenteeism amounted to €2000 per patient. Patients who reported sick leave show a higher (health-related) resource use.
  
  
  CONCLUSIONS
  After only 5 years of diagnosis, a considerable proportion of patients with SpA is not employed, and those working have substantial sick leave and productivity loss. Among patients reporting sick leave, resource use is higher. Alertness to work participation even in patients with a short disease duration is urgently needed.
authors.affiliation: From the Department of Rheumatology, Vrije Universiteit University Medical Center; Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Caphri Research Institute, Maastricht, Netherlands.M.A.C. van der Weijden, MD, MSc; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Reade Institute; A. Boonen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology Maastricht University Medical Center, and Caphri Research Institute. mac.vanderweijden@vumc.nl.
authors.forename: Maria A C
authors.initials: MA
authors.lastname: van der Weijden
authors.affiliation: From the Department of Rheumatology, Vrije Universiteit University Medical Center; Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Caphri Research Institute, Maastricht, Netherlands.M.A.C. van der Weijden, MD, MSc; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Reade Institute; A. Boonen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology Maastricht University Medical Center, and Caphri Research Institute.
authors.forename: Annelies
authors.initials: A
authors.lastname: Boonen
authors.affiliation: From the Department of Rheumatology, Vrije Universiteit University Medical Center; Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Caphri Research Institute, Maastricht, Netherlands.M.A.C. van der Weijden, MD, MSc; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Reade Institute; A. Boonen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology Maastricht University Medical Center, and Caphri Research Institute.
authors.forename: Irene E
authors.initials: IE
authors.lastname: van der Horst-Bruinsma
mesh_terms: D000041:Absenteeism; D000328:Adult; D015331:Cohort Studies; D003625:Data Collection; D004185:Disability Evaluation; D004526:Efficiency / Q000502:physiology; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data*; D025241:Spondylarthritis / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D016526:Workload / Q000706:statistics & numerical data*
keywords: EMPLOYMENT; PRESENTEEISM; RESOURCE USE; SPONDYLOARTHRITIS; WORK PARTICIPATION