Disease Activity and Quality of Life Influence Work Productivity of AAV Patients, Study Finds

Work productivity of people with ANCA-associated vasculitis is influenced by their disease activity, the extent of organ damage, and their health-related quality of life, a study reports.

The findings were presented in a poster, titled “Association of Work Productivity Assessed by Absenteeism and Presenteeism with Disease Activity, Damage and Health-related Quality of Life in Patients with ANCA-associated Vasculitis,” at the recent 2019 American College of Rheumatology/Association for Rheumatology Professionals Annual Meeting, in Atlanta.

Anti-neutrophil cytoplasmic autoantibody (ANCA) vasculitis, or AAV, is an autoimmune disease that is caused by the production of autoantibodies — antibodies that wrongly target and attack healthy cells. In AAV, autoantibodies target neutrophils, a type of immune cell. This leads to damage in small blood vessels as well as inflammation and swelling in affected tissues and organs.

Despite advances in treatment, chronic inflammatory diseases such as AAV still pose a major burden to patients, including on their work productivity.

“Although the management of AAV has improved, many patients still have to take sick leave or even stop working because of their diseases (i.e., absenteeism). Even for those remaining in paid work, patients may experience problems due to AAV resulting in productivity loss while at work (i.e., presenteeism),” the researchers wrote.

In the study, the researchers, from the Tokyo Women’s Medical University School of Medicine, and their collaborators set out to investigate the work productivity of people with AAV, as well as the different factors that may influence it.

The study included data from 92 people with AAV which was gathered during their outpatient appointments at three different university hospitals between November 2017 and February 2018.

During these appointments, patients were asked to complete the Work Productivity and Activity Impairment-General Health (WPAI-GH) questionnaire to evaluate their work productivity and the 5-level EuroQoL 5-Dimensions Questionnaire (EQ-5D-5L) to evaluate their health-related quality of life (HRQoL).

Clinicians who were caring for these patients and unaware of their WPAI-GH and EQ-5D-5L scores were asked to complete the Birmingham Vasculitis Activity Score (BVAS) to rate disease activity and the Vasculitis Damage Index (VDI) to measure the degree of organ damage associated with vasculitis.

Findings revealed the mean EQ-5D-5L score was 0.755, which was significantly lower than the scores attained by people of the same age and sex who did not have AAV.

From the 92 patients who participated in the study, 25 (27%) were working at a paid job. From these, 11 admitted missing work hours due to health issues. The researchers found that a patient’s health problems led to an average net loss of 17% of their working time (absenteeism), and to 32% of their work being impaired (presenteeism).

Statistical analyses revealed that work absenteeism was moderately correlated with disease activity and HRQoL, but not with organ damage associated with vasculitis. In contrast, work presenteeism was weakly to moderately associated with all these factors.

Investigators also found that, compared to those with higher HRQoL scores, those who had lower HRQoL missed more working hours (absenteeism of 28% versus 17%) and had lower work productivity (presenteeism of 48% versus 32%).

Therefore, “work productivity assessed by absenteeism and presenteeism are associated with disease activity, damage, and HRQoL in patients with AAV,” the investigators said.