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Research ArticleArticle
Open Access

Work-Related Issues and Physical and Psychological Burden in Canadian Patients With Axial Spondyloarthritis: Results From the International Map of Axial Spondyloarthritis

Robert D. Inman, Marco Garrido-Cumbrera, Jonathan Chan, Martin Cohen, Artur J. de Brum-Fernandes, Wendy Gerhart, Nigil Haroon, Algis V. Jovaisas, Gerald Major, Michael G. Mallinson, Sherry Rohekar, Patrick Leclerc and Proton Rahman
The Journal of Rheumatology December 2022, jrheum.220596; DOI: https://doi.org/10.3899/jrheum.220596
Robert D. Inman
R.D. Inman, MD, Medicine and Immunology, Schroeder Arthritis Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada.
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Marco Garrido-Cumbrera
M. Garrido-Cumbrera, PhD, Health & Territory Research, Universidad de Sevilla, Seville, Spain, and Axial Spondyloarthritis International Federation, London, UK.
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Jonathan Chan
J. Chan, MD, Department of Medicine, Division of Rheumatology, University of British Columbia, and Arthritis Research Canada, Vancouver, British Columbia, Canada.
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Martin Cohen
M. Cohen, MD, West Island Rheumatology Research Associates, Montréal, Québec, Canada.
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Artur J. de Brum-Fernandes
A.J. de Brum-Fernandes, MD, PhD, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.
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Wendy Gerhart
W. Gerhart, BComm, G. Major, BA, Canadian Spondylitis Association, Phelpston, Ontario, Canada.
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Nigil Haroon
N. Haroon, MD, Spondylitis Program, Schroeder Arthritis Institute, University Health Network, and University of Toronto, Ontario, Canada.
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Algis V. Jovaisas
A.V. Jovaisas, MD, Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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Gerald Major
W. Gerhart, BComm, G. Major, BA, Canadian Spondylitis Association, Phelpston, Ontario, Canada.
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Michael G. Mallinson
M.G. Mallinson, MA, Canadian Spondylitis Association, and Axial Spondyloarthritis International Federation, Toronto, Ontario, Canada.
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Sherry Rohekar
S. Rohekar, MD, Division of Rheumatology, Western University, London, Ontario, Canada.
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Patrick Leclerc
P. Leclerc, PhD, Novartis Canada, Montréal, Québec, Canada.
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Proton Rahman
P. Rahman, MD, Department of Medicine, Memorial University, St. John's, Newfoundland, Canada.
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Abstract

Objective To identify factors associated with work-related issues in Canadian patients with axial spondyloarthritis.

Methods Data from 542 Canadian patients who participated in the International Map of Axial Spondyloarthritis online survey were analyzed. Participants who were employed, unemployed, or on short-term disability were included in this analysis. Regression analysis was used to study the association between work-related issues, disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), and psychological distress (12-item General Health Questionnaire [GHQ-12]).

Results The mean age of surveyed participants was 44.3 (SD 13.9) years, 81% were university educated, and 52.6% employed. A substantial proportion had high disease activity (BASDAI ≥ 4, 72.1%) and psychological distress (GHQ-12 ≥ 3, 53.1%); 81% had work-related issues. This study analyzed responses from a subset of participants who were either employed, unemployed, or on short-term disability (n = 339). Ninety percent of this subset reported at least 1 work-related issue in the year before questionnaire completion, with the most frequent being absenteeism (49.3%) and missing work for healthcare provider visits (42.5%). Factoring in disability benefits eliminated the association between work-related issues and disease activity for all variables except fatigue (r = 0.217; P = 0.03) and discomfort (r = 0.196; P = 0.047). Difficulty fulfilling working hours (β 2.342, 95% CI 1.413-3.272) and effect on professional advancement (β 1.426, 95% CI 0.355-2.497) were associated with psychological distress. In the presence of disability benefits, only the effect on professional advancement remained (β 2.304, 95% CI 0.082-4.527).

Conclusion Work-related issues are associated with worse patient-reported outcomes, both physical and psychological.

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The Journal of Rheumatology
Vol. 50, Issue 3
1 Mar 2023
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Work-Related Issues and Physical and Psychological Burden in Canadian Patients With Axial Spondyloarthritis: Results From the International Map of Axial Spondyloarthritis
Robert D. Inman, Marco Garrido-Cumbrera, Jonathan Chan, Martin Cohen, Artur J. de Brum-Fernandes, Wendy Gerhart, Nigil Haroon, Algis V. Jovaisas, Gerald Major, Michael G. Mallinson, Sherry Rohekar, Patrick Leclerc, Proton Rahman
The Journal of Rheumatology Dec 2022, jrheum.220596; DOI: 10.3899/jrheum.220596

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Work-Related Issues and Physical and Psychological Burden in Canadian Patients With Axial Spondyloarthritis: Results From the International Map of Axial Spondyloarthritis
Robert D. Inman, Marco Garrido-Cumbrera, Jonathan Chan, Martin Cohen, Artur J. de Brum-Fernandes, Wendy Gerhart, Nigil Haroon, Algis V. Jovaisas, Gerald Major, Michael G. Mallinson, Sherry Rohekar, Patrick Leclerc, Proton Rahman
The Journal of Rheumatology Dec 2022, jrheum.220596; DOI: 10.3899/jrheum.220596
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