Impact of self-rated osteoarthritis severity in an employed population: Cross-sectional analysis of data from the national health and wellness survey

Health and Quality of Life Outcomes

Stuart Silverman¹  Dan Pettitt²  Alesia Sadosky²  Margaret McDonald²  Shaloo Gupta³  Marco daCosta DiBonaventura³ 

[1] Cedars-Sinai Medical Center, Los Angeles, CA, USA;Pfizer Inc., 235 East 42nd Street, New York, NY 10017, USA;Kantar Health, New York, NY, USA

关键词: Quality of life;    Productivity;    Workforce;    Burden;    Osteoarthritis;   

Others  :  825809
DOI  :  10.1186/1477-7525-10-30

 received in 2011-08-25, accepted in 2012-03-15,  发布年份 2012

【 摘 要 】

Background

Although osteoarthritis (OA) often affects older persons, it has a profound effect on individuals actively employed. Despite reports of reduced productivity among workers with OA, data are limited regarding the impact of OA among workers. The objective of this study was to evaluate the impact of self-rated OA severity on quality of life, healthcare resource utilization, productivity and costs in an employed population relative to employed individuals without OA.

Methods

This cross-sectional analysis used data derived from the 2009 National Health and Wellness Survey (NHWS). Multivariable analyses characterized outcomes and costs (direct medical costs and indirect) among workers (full-time, part-time, or self-employed) ≥ 20 years of age who were diagnosed with OA and who self-rated their OA severity as mild, moderate, or severe relative to workers without OA. Evaluated outcomes included productivity, assessed using the Work Productivity and Impairment (WPAI) scale; health-related quality of life, using the SF-12v2 Health Survey; and healthcare resource utilization.

Results

4,876 workers reported being diagnosed with OA (45.0% mild, 45.9% moderate, and 9.1% severe); 34,896 workers comprised the non-OA comparator cohort. There was a greater proportion of females in the OA cohort (55.5% vs 45.6%; P < 0.0001) and more individuals in the 40-64 year and ≥ 65 year age ranges (P < 0.0001). As OA severity increased, workers reported more frequent pain, poorer quality of life, greater use of specific healthcare resources (hospitalizations) and reduced productivity. All outcomes indicated a significantly greater burden among workers with OA relative to those without OA (P < 0.0001). Estimated total annual costs per worker were $9,801 for mild OA, $14,761 for moderate OA, $22,111 for severe OA compared with $7,901 for workers without OA (P < 0.0001).

Conclusions

Workers with OA were characterized by significant disease and economic burdens relative to workers without OA that substantially increased with greater self-rated OA severity. Greater levels of OA severity were associated with reductions in quality of life and productivity, and increases in healthcare resource utilization and costs.

【 授权许可】

   
2012 DiBonaventura et al; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Centers for Disease Control and Prevention (CDC): Prevalence and most common causes of disability among adults--United States, 2005. MMWR Morb Mortal Wkly Rep 2009, 58:421-426.
• [2]Woolf AD, Pfleger B: Burden of major musculoskeletal conditions. Bull World Health Organ 2003, 81:646-656.
• [3]Dominick KL, Ahern FM, Gold CH, Heller DA: Health-related quality of life and health service use among older adults with osteoarthritis. Arthritis Rheum 2004, 51:326-331.
• [4]Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC: The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 2005, 44:1531-1537.
• [5]Rabenda V, Manette C, Lemmens R, Mariani AM, Struvay N, Reginster JY: Direct and indirect costs attributable to osteoarthritis in active subjects. J Rheumatol 2006, 33:1152-1158.
• [6]Cook C, Pietrobon R, Hegedus E: Osteoarthritis and the impact on quality of life health indicators. Rheumatol Int 2007, 27:315-321.
• [7]Kotlarz H, Gunnarsson CL, Fang H, Rizzo JA: Insurer and out-of-pocket costs of osteoarthritis in the US: evidence from national survey data. Arthritis Rheum 2009, 60:3546-3553.
• [8]Kotlarz H, Gunnarsson CL, Fang H, Rizzo JA: Osteoarthritis and absenteeism costs: evidence from US National Survey Data. J Occup Environ Med 2010, 52:263-268.
• [9]White LA, Birnbaum HG, Kaltenboeck A, Tang J, Mallett D, Robinson RL: Employees with fibromyalgia: medical comorbidity, healthcare costs, and work loss. J Occup Environ Med 2008, 50:13-24.
• [10]Kleinman N, Harnett J, Melkonian A, Lynch W, Kaplan-Machlis B, Silverman S: Burden of Fibromyalgia and Comparisons With Osteoarthritis in the Workforce. J Occup Environ Med 2009, 51:1384-1393.
• [11]daCosta DiBonaventura M, Gupta S, McDonald M, Sadosky A: Evaluating the health and economic impact of osteoarthritis pain in the workforce: results from the National Health and Wellness Survey. BMC Musculoskelet Disord 2011, 12:83. BioMed Central Full Text
• [12]McDonald M, DiBonaventura MD, Ullman SJP: Musculoskeletal pain in the workforce: the effects of back, arthritis and fibromyalgia pain on quality of life and work productivity. J Occup Environ Med 2011, 53:765-770.
• [13]Li X, Gignac MA, Anis AH: The indirect costs of arthritis resulting from unemployment, reduced performance, and occupational changes while at work. Med Care 2006, 44:304-310.
• [14]Gignac MA, Cao X, Lacaille D, Anis AH, Badley EM: Arthritis-related work transitions: a prospective analysis of reported productivity losses, work changes, and leaving the labor force. Arthritis Rheum 2008, 59:1805-1813.
• [15]Zhang W, Gignac MA, Beaton D, Tang K, Anis AH: Productivity loss due to presenteeism among patients with arthritis: estimates from 4 instruments. J Rheumatol 2010, 37:1805-1814.
• [16]Zhang W, Koehoorn M, Anis AH: Work productivity among employed Canadians with arthritis. J Occup Environ Med 2010, 52:872-877.
• [17]Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R: Lost productive time and cost due to common pain conditions in the US workforce. JAMA 2003, 290:2443-2454.
• [18]Hutchings A, Calloway M, Choy E, Hooper M, Hunter DJ, Jordan JM, Zhang Y, Baser O, Long S, Palmer L: The Longitudinal Examination of Arthritis Pain (LEAP) study: relationships between weekly fluctuations in patient-rated joint pain and other health outcomes. J Rheumatol 2007, 34:2291-2300.
• [19]Sadosky A, Bushmakin A, Cappelleri JC, Lionberger DR: Relationship between patient-reported disease severity in osteoarthritis and self-reported pain, function, and work productivity. Arthritis Res Ther 2010, 12:R162. BioMed Central Full Text
• [20]Sadosky A, Cappelleri J, Bushmakin A, Lionberger D: Health status and disease severity in osteoarthritis. [abstract]. J Pain 2010, 11(Suppl):S1.
• [21]Bushmakin AG, Cappelleri JC, Taylor-Stokes G, Sayers J, Sadosky A, Carroll D, Gosden T, Emery P: Relationship between patient-reported disease severity and other clinical outcomes in osteoarthritis: a European perspective. J Med Econ 2011, 14:381-389.
• [22]Bolge SC, Doan JF, Kannan H, Baran RW: Association of insomnia with quality of life, work productivity, and activity impairment. Qual Life Res 2009, 18:415-422.
• [23]DiBonaventura MD, Wagner JS, Yuan Y, L'Italien G, Langley P, Ray Kim W: Humanistic and economic impacts of hepatitis C infection in the United States. J Med Econ 2010, 13:709-718.
• [24]Reilly MCZ, Dukes EMAS: The validity and reproducibility of a work productivity and activity impairment instrument. PharmacoEconomics 1993, 4:353-365.
• [25]Ware JE Jr, Kosinski M, Turner-Bowker D, Gandek B: User's Manual for the SF-12v2™ Health Survey with a Supplement Documenting SF-12® Health Survey. Lincoln, RI: QualityMetric Incorporated; 2002.
• [26]Brazier J, Roberts J, Deverill M: The estimation of a preference-based measure of health from the SF-36. J Health Econ 2002, 21:271-292.
• [27]Machlin S: Expenses for a hospital emergency room visit, 2003. MEPS Statistical Brief No. 111 (2006). [http://meps.ahrq.gov/mepsweb/data_files/publications/st111/stat111.pdf] webcite
• [28]Machlin S, Carper K: Expenses for Office-Based Physician Visits by Specialty, 2004. MEPS Statistical Brief No. 166 (2007). [http://meps.ahrq.gov/mepsweb/data_files/publications/st166/stat166.pdf] webcite
• [29]Machlin S, Carper K: Expenses for Hospital Inpatient Stays, 2004. MEPS Statistical Brief No. 164. [http://meps.ahrq.gov/mepsweb/data_files/publications/st164/stat164.pdf] webcite
• [30]Lofland JH, Pizzi L, Frick KD: A review of health-related workplace productivity loss instruments. PharmacoEconomics 2004, 22:165-184.
• [31]United States Department of Labor, United States Bureau of Labor Statistics: Highlights of women's earnings in 2008. Report 1017. [http://www.bls.gov/cps/cpswom2008.pdf] webcite
• [32]Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987, 40:373-383.
• [33]Cohen J: Statistical Power Analysis for the Behavioral Sciences. 2nd edition. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
• [34]Glynn RJ, Buring JE: Ways of measuring rates of recurrent events. BMJ 1996, 312:364-367.
• [35]Walters SJ, Brazier JE: What is the relationship between the minimally important difference and health state utility values? The case of the SF-6D. Health Qual Life Outcomes 2003, 1:4. BioMed Central Full Text
• [36]Hays RD, Morales LS: The RAND-36 measure of health-related quality of life. Ann Med 2001, 33:350-357.
• [37]White AG, Birnbaum HG, Janagap CC, Buteau L, Schein J: Direct and indirect costs of pain therapy for osteoarthritis in an insured population in the United States. J Occup Environ Med 2008, 50:998-1005.
• [38]Ricci JA, Stewart WF, Chee E, Leotta C, Foley K, Hochberg MC: Pain exacerbation as a major source of lost productive time in US workers with arthritis. Arthritis Rheum 2005, 53:673-681.
• [39]Benyon K, Hill S, Zadurian N, Mallen C: Coping strategies and self-efficacy as predictors of outcome in osteoarthritis: a systematic review. Musculoskeletal Care 2010, 8:224-236.
• [40]Trouillet R, Gana K, Lourel M, Fort I: Predictive value of age for coping: the role of self-efficacy, social support satisfaction and perceived stress. Aging Ment Health 2009, 13:357-366.
• [41]Maetzel A, Li LC, Pencharz J, Tomlinson G, Bombardier C: The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study. Ann Rheum Dis 2004, 63:395-401.
• [42]Xie F: The need for standardization: a literature review of indirect costs of rheumatoid arthritis and osteoarthritis. Arthritis Rheum 2008, 59:1027-1033.
• [43]Allen KD, Chen JC, Callahan LF, Golightly YM, Helmick CG, Renner JB, Jordan JM: Associations of occupational tasks with knee and hip osteoarthritis: the Johnston County Osteoarthritis Project. J Rheumatol 2010, 37:842-850.
• [44]McWilliams DF, Leeb BF, Muthuri SG, Doherty M, Zhang W: Occupational risk factors for osteoarthritis of the knee: a meta-analysis. Osteoarthr Cartil 2011, 19:829-839.
• [45]Sayre EC, Li LC, Kopec JA, Esdaile JM, Bar S, Cibere J: The effect of disease site (knee, hip, hand, foot, lower back or neck) on employment reduction due to osteoarthritis. PLoS One 2010, 5:e10470.