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Research ArticleSpondyloarthritis

Understanding the Disease Burden of Unemployed Patients With Axial Spondyloarthritis: Results From the Spanish Atlas 2017

Marco Garrido-Cumbrera, Eduardo Collantes-Estevez, Victoria Navarro-Compán, Pedro Zarco-Montejo, Carlos Sastre, José Correa-Fernández, Sergio Sanz-Gómez, Pedro Plazuelo-Ramos and Jordi Gratacos
The Journal of Rheumatology April 2022, 49 (4) 373-379; DOI: https://doi.org/10.3899/jrheum.210655
Marco Garrido-Cumbrera
1M. Garrido-Cumbrera, Professor, PhD, J. Correa-Fernández, MSc, S. Sanz-Gómez, MSc, Health & Territory Research, Centro Internacional, Universidad de Sevilla, Seville;
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  • ORCID record for Marco Garrido-Cumbrera
  • For correspondence: mcumbrera@us.es
Eduardo Collantes-Estevez
2E. Collantes-Estevez, MD, Reina Sofia University Hospital, Rheumatology Service, Córdoba, University of Córdoba, Córdoba, and Maimonides Institute for Research in Biomedicine of Córdoba (IMIBIC), Córdoba;
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Victoria Navarro-Compán
3V. Navarro-Compán, MD, University Hospital La Paz – Rheumatology, Madrid;
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  • ORCID record for Victoria Navarro-Compán
Pedro Zarco-Montejo
4P. Zarco-Montejo, MD, Hospital Fundación Halcorcón – Rheumatology, Madrid;
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Carlos Sastre
5C. Sastre, MSc, Novartis Farmacéutica SA, Barcelona;
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José Correa-Fernández
1M. Garrido-Cumbrera, Professor, PhD, J. Correa-Fernández, MSc, S. Sanz-Gómez, MSc, Health & Territory Research, Centro Internacional, Universidad de Sevilla, Seville;
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Sergio Sanz-Gómez
1M. Garrido-Cumbrera, Professor, PhD, J. Correa-Fernández, MSc, S. Sanz-Gómez, MSc, Health & Territory Research, Centro Internacional, Universidad de Sevilla, Seville;
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Pedro Plazuelo-Ramos
6P. Plazuelo-Ramos, Spanish Coordinator of Spondyloarthritis Associations (CEADE), Madrid;
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Jordi Gratacos
7J. Gratacós, MD, PhD, Rheumatology Service, University Hospital Parc Taulí Sabadell, Department Medicine, UAB, Barcelona, Spain.
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Abstract

Objective To evaluate differences in sociodemographic factors and patient-reported outcomes (PROs) between unemployed and employed patients with axial spondyloarthritis (axSpA), and to explore work-related issues (WRIs).

Methods Data from an online survey of 680 unselected patients of the Atlas of Axial Spondyloarthritis in Spain 2017 were analyzed. Active workforce participants were divided into employed and unemployed groups according to International Labour Organization definitions. Sociodemographic characteristics, PROs (Bath Ankylosing Spondylitis Disease Activity Index [0–10], Spinal Stiffness Index [3–12], Functional Limitation Index [0–54], and psychological distress through the 12-item General Health Questionnaire [0–12]) were assessed. Logistic regression analysis was used to evaluate the association with unemployment status.

Results Four hundred fifteen (63.6%) patients with axSpA were categorized in the active population, of which 325 (78.3%) were employed and 90 (21.7%) unemployed. Of the unemployed patients, 62.8% (n = 54) declared that their joblessness was due to axSpA. Of the employed patients, 170 (54.3%) reported WRIs in the year prior to the survey, the most frequent being difficulty fulfilling working hours (44.1%), missing work for doctor appointments (42.9%), and taking sick leave (37.1%). Being unemployed was associated with lower educational level (OR = 2.92), disease activity (OR = 1.37), spinal stiffness (OR = 1.21), functional limitation (OR = 1.05), worse mental health (OR = 1.15), anxiety (OR = 2.02), and depression (OR = 2.69) in the univariable models; and with lower educational level (OR = 2.76) and worse mental health (OR = 1.15) in the multivariable analysis.

Conclusion Results show significant differences between employed and unemployed patients with axSpA. Employed patients with axSpA endure many problems at work related to their condition, whereas unemployed patients present worse disease outcomes associated with greater psychological distress.

Key Indexing Terms:
  • ankylosing spondylitis
  • axial spondyloarthritis
  • patient-reported outcomes
  • unemployment
  • work outcomes
  • Accepted for publication November 26, 2021.
  • Copyright © 2022 by the Journal of Rheumatology
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Understanding the Disease Burden of Unemployed Patients With Axial Spondyloarthritis: Results From the Spanish Atlas 2017
Marco Garrido-Cumbrera, Eduardo Collantes-Estevez, Victoria Navarro-Compán, Pedro Zarco-Montejo, Carlos Sastre, José Correa-Fernández, Sergio Sanz-Gómez, Pedro Plazuelo-Ramos, Jordi Gratacos
The Journal of Rheumatology Apr 2022, 49 (4) 373-379; DOI: 10.3899/jrheum.210655

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Understanding the Disease Burden of Unemployed Patients With Axial Spondyloarthritis: Results From the Spanish Atlas 2017
Marco Garrido-Cumbrera, Eduardo Collantes-Estevez, Victoria Navarro-Compán, Pedro Zarco-Montejo, Carlos Sastre, José Correa-Fernández, Sergio Sanz-Gómez, Pedro Plazuelo-Ramos, Jordi Gratacos
The Journal of Rheumatology Apr 2022, 49 (4) 373-379; DOI: 10.3899/jrheum.210655
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Keywords

ANKYLOSING SPONDYLITIS
AXIAL SPONDYLOARTHRITIS
PATIENT-REPORTED OUTCOMES
unemployment
work outcomes

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Keywords

  • ankylosing spondylitis
  • axial spondyloarthritis
  • patient-reported outcomes
  • unemployment
  • work outcomes

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