J Rheum Dis.  2018 Apr;25(2):122-130. 10.4078/jrd.2018.25.2.122.

Productivity Loss of Rheumatoid Arthritis Patients according to the Their Stages of the Disease Activity Score

• Bae SC
• Cha JH
• Choe JY
• Choi SJ
• Cho SK
• Chung WT
• Joung CI
• Jung YO
• Kang YM
• Kim DW
• Kim J
• Kim YJ
• Lee CK
• Lee HS
• Lee J
• Lee SH
• Lee SH
• Lee SS
• Lee YA
• Nah SS
• Shim SC
• Song GG
• Suh CH
• Won S
• Yoo WH
• Yoon BY

• KMID: 2408930
• DOI: http://doi.org/10.4078/jrd.2018.25.2.122

Abstract

OBJECTIVE
Productivity loss was compared by 3-stage of disease activity and associations between higher disease activity and high productivity loss were identified.
METHODS
Data were extracted from Rheumatoid Arthritis (RA) Patient-reported Outcomes Research, which enrolled 2,000 RA patients (>20-year) on disease-modifying-antirheumatic-drugs (DMARDs) (≥6-month) from December 2012 to June 2013. This included 1,457 RA patients with the disease activity score (DAS-28-ESR) in their medical charts. Productivity loss in time and indirect cost was estimated using The World Health Organization Health and Work Performance Questionnaire (HPQ). Baseline characteristics and productivity loss outcomes were compared according to DAS-28-ESR groups.
RESULTS
84.4% were females, 54.2% had low DAS-28-ESR ( < 3.2), and 38.2% and 7.6% had moderate (3.2∼5.1) and high DAS-28-ESR (>5.1). Patients with moderate to high DAS-28-ESR had higher lost productivity time (LPT) and monthly costs of LPT than those with low DAS-28-ESR (time in hours: 110.0±58.4 vs. 132.4±57.2 vs. 71.5±52.0, p < 0.0001; monthly costs of LPT in 1,000 Korean won: 1,097±607 vs. 1,302±554 vs. 741±531, p < 0.0001). Multiple regression analyses revealed significant associations with high LPT in high (adjusted odds ratio [OR]=3.87, 95% confidence interval [CI]: 2.18∼6.87) and moderate DAS-28-ESR (adjusted OR=1.88, 95% CI: 1.41∼2.52) compared to low DAS-28-ESR. In addition, positive associations with high monthly costs of LPT were observed in high (adjusted OR=3.45, 95% CI: 1.98∼5.99) and moderate DAS-28-ESR (adjusted OR=1.93, 95% CI: 1.43∼2.54) compared to low DAS-28-ESR.
CONCLUSION
Timely therapeutic strategies should be taken into consideration given that the RA patients with moderate to high DAS-28-ESR showed strong associations with high productivity loss for effective management of RA.

Keyword

Rheumatoid arthritis; Productivity loss; Disease activity score; Patient reported outcome measures

MeSH Terms

Arthritis, Rheumatoid*
Efficiency*
Female
Humans
Odds Ratio
Outcome Assessment (Health Care)
Work Performance
World Health Organization

Figure

• 

  Figure 1. Lost productivity time in hours by DAS-28-ESR in the past one month. DAS-28-ESR: disease activity score-28-ery-throcyte sedimentation rate. *p-value by analysis of variance.

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  Figure 2. Productivity loss in indirect cost by DAS-28-ESR per month. DAS-28-ESR: disease activity score-28-erythrocyte sedimentation rate. *p-value by analysis of variance.

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