title: Work disability, lost productivity and associated risk factors in patients diagnosed with systemic lupus erythematosus.
abstract: OBJECTIVE
  To assess prevalence and correlates of work presenteeism, absenteeism and work disability (WD) in patients with systemic lupus erythematous (SLE) and matched controls.
  
  
  METHODS
  Patients with SLE from six medical centres were recruited to complete a questionnaire consisting of several prevalidated survey instruments. The subject's rheumatologist completed medical history. Subjects recruited two non-SLE 'best friend' controls with matching demographics to complete a control survey. Analyses employed Student's t tests, χ(2) tests and logistic regression models.
  
  
  RESULTS
  344 subjects with SLE and 322 controls submitted completed questionnaires. Mean pain, fatigue, Brief Cognitive Symptoms Index (BCSI) scores and depressive symptoms were worse in patients with SLE with WD (all p<0.01). WD was associated with African-American race, older age (51-65 years) and less than 4-year college education (all p<0.01). High presenteeism was associated with low pain and fatigue levels, higher BCSI scores and negatively correlated with depressive symptoms (all p<0.05). Increased pain and fatigue were associated with elevated absenteeism (p<0.05). Subjects with physically and cognitively demanding work reported worse presenteeism compared with controls with similar jobs (77% vs 85%, p<0.05 and 75% vs 85%, p<0.001), respectively. Patients with most cognitively demanding jobs reported greater weekly absenteeism (mean, 5.9 h) compared with controls (mean, 6.9 overtime hours, p<0.05).
  
  
  CONCLUSIONS
  The questionnaire demonstrated increased WD in SLE. Highly physical and highly cognitive jobs are challenging to patients with SLE and had increased absenteeism compared with controls. Depressive symptoms were correlated with better presenteeism without major socio-demographic determinants. Employability may be enhanced by improving treatment of depressive symptoms in patients with SLE.
authors: Department of Medicine/Rheumatology , University of Chicago , Chicago, Illinois , USA.
authors: Tammy O
authors: TO
authors: Utset
authors: Department of Medicine/Rheumatology , University of California San Diego , La Jolla, California , USA.
authors: Amrutha
authors: A
authors: Baskaran
authors: Department of Medicine/Rheumatology , University of Minnesota , Minneapolis, Minnesota , USA.
authors: Barbara M
authors: BM
authors: Segal
authors: Department of Medicine/Rheumatology , University of California San Francisco , San Francisco, California , USA.
authors: Laura
authors: L
authors: Trupin
authors: Department of Medicine/Rheumatology , Genentech , South San Francisco, California , USA.
authors: Sarika
authors: S
authors: Ogale
authors: Harris Interactive , Rochester, New York , USA.
authors: Ellen
authors: E
authors: Herberich
authors: Department of Medicine/Rheumatology , University of California San Diego , La Jolla, California , USA.
authors: Kenneth
authors: K
authors: Kalunian
keywords: Epidemiology; Qualitative research; Systemic Lupus Erythematosus
references: Medicine (Baltimore). 2003 Sep;82(5):299-308
references: 14530779
references: J Rheumatol. 1992 Nov;19(11):1820-1
references: 1362779
references: Arthritis Rheum. 2007 Feb 15;57(1):56-63
references: 17266065
references: Med Care. 1996 Jan;34(1):73-84
references: 8551813
references: Arthritis Care Res (Hoboken). 2014 Jun;66(6):878-87
references: 24339382
references: J Rheumatol. 2008 Jun;35(6):1046-52
references: 18464309
references: J Occup Environ Med. 2003 Feb;45(2):156-74
references: 12625231
references: Lupus. 2009 Dec;18(14):1281-8
references: 19854811
references: Lupus. 2013 Sep;22(10):1077-86
references: 23920376
references: Arthritis Care Res (Hoboken). 2010 Dec;62(12):1812-3; author reply 1813
references: 20662043
references: J Rheumatol. 2009 Nov;36(11):2470-5
references: 19273454
references: Ann Rheum Dis. 2006 May;65(5):601-6
references: 16166104
references: Med Care. 1996 Mar;34(3):220-33
references: 8628042
references: Scand J Rheumatol. 2010;39(1):58-62
references: 20132072
references: Arthritis Rheum. 2007 Dec 15;57(8):1453-60
references: 18050187
references: Paediatr Perinat Epidemiol. 2011 Sep;25(5):402-12
references: 21819422
references: Clin Exp Rheumatol. 1985 Oct-Dec;3(4):303-10
references: 3878760
references: J Rheumatol. 2006 Mar;33(3):531-8
references: 16511923
references: Arthritis Rheum. 2002 Apr 15;47(2):196-201
references: 11954014
references: Arthritis Rheum. 1993 Nov;36(11):1548-59
references: 8240431
references: Arthritis Rheum. 2009 May 15;61(5):680-7
references: 19405004
references: Rheumatology (Oxford). 2013 Dec;52(12):2292-301
references: 24049101
references: J Occup Environ Med. 2003 Dec;45(12):1303-11
references: 14665817
references: Rheumatology (Oxford). 1999 Nov;38(11):1130-7
references: 10556268
references: Best Pract Res Clin Rheumatol. 2012 Oct;26(5):695-704
references: 23218432
references: Arch Intern Med. 1999 Aug 9-23;159(15):1701-4
references: 10448771
references: Rheumatology (Oxford). 2009 Mar;48(3):281-4
references: 19153144
references: Arthritis Rheum. 1997 Sep;40(9):1725
references: 9324032
references: Arthritis Care Res (Hoboken). 2010 Jun;62(6):873-80
references: 20191478
references: Rheumatology (Oxford). 2001 Jan;40(1):37-47
references: 11157140
references: Am J Epidemiol. 1992 May 1;135(9):1029-41
references: 1595689
references: Health Qual Life Outcomes. 2003 Dec 16;1:79
references: 14678568
references: J Rheumatol. 1986 Jun;13(3):570-6
references: 3735279
references: J Rheumatol. 2008 Jun;35(6):1053-7
references: 18381792
references: Arthritis Rheum. 2009 Feb 15;61(2):247-58
references: 19177546
references: Am J Prev Med. 1994 Mar-Apr;10(2):77-84
references: 8037935
references: Clin J Pain. 2004 Sep-Oct;20(5):309-18
references: 15322437
references: Arthritis Rheum. 2003 Apr 15;49(2):156-63
references: 12687505
references: Arthritis Rheum. 1997 Dec;40(12):2199-206
references: 9416857