Work-related Issues, Physical and Psychological Burden in Canadian Axial Spondyloarthritis Patients. Results From the International Map of Axial Spondyloarthritis.

OBJECTIVE
To identify factors associated with work-related issues in Canadian patients with axial spondyloarthritis (axSpA).


METHODS
Data from 542 Canadian patients who participated in the International Map of Axial Spondyloarthritis (IMAS) online survey were analysed. 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
Mean ± SD age of surveyed participants was 44.3 ± 13.9 years, 81.0% were university educated, and 52.6% employed. A substantial proportion had high disease activity (BASDAI, 72.1%) and psychological distress (GHQ-12, 53.1%); 81.1% had workrelated issues. This study analysed 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 one 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=0.028) and discomfort (r=0.196; p=0.047). Difficulty fulfilling working hours (B=2.342; 95% CI, 1.413 to 3.272) and impact on professional advancement (B=1.426; 95% CI, 0.355 to 2.497) were associated with psychological distress. In the presence of disability benefits, only the impact on professional advancement remained (B=2.304; 95% CI, 0.082 to 4.527).


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