DOP026. Work related problems and impaired productivity in patients with inflammatory bowel diseases (IBD)
A. Zand, W.K. Van Deen, C.H. Ha, E. Kane, J.M. Choi, B.E. Roth, A. Centeno, E. Esrailian, D.W. Hommes, UCLA Center for Inflammatory Bowel Diseases, Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, United States
Indirect costs in IBD are major contributors to health expenditures. It has been estimated that 63% of US medical costs is due to presenteeism, defined as decreased productivity at work. In IBD, the effects of absenteeism (missed hours from work due to disease) on indirect medical costs have been estimated, but the effects of presenteeism have not been studied. In addition, patients can be in ‘job-lock’, which means they are not able to change their job because of employer provided health-insurance and fear of loss of employee benefits. In order to understand these work productivity components, we performed a study analyzing absenteeism, presenteeism, work limitations and job lock in IBD.
Questionnaires were completed by patients of the UCLA Center for Inflammatory Bowel Diseases. The Work Productivity and Activity Impairment (WPAI) questionnaire was used, which measures absenteeism, presenteeism and loss of leisure in the past 7 days. Furthermore, we developed a work limitations questionnaire that inquired specifically about work related problems including job lock. In addition, assessments of clinical disease activity, and quality of life (QoL, using the short IBDQ) were performed.
In total, 365 patients completed the WPAI questionnaire, 146 of 365 also completed the work limitations questionnaire. 36% of 365 patients were not employed. In the employed cohort (n = 231) we found a prevalence of 21% absenteeism, 62% presenteeism, and 66% loss of leisure. Employed patients had an average QoL of 50 (SD 12) while unemployed had an average QoL of 44 (SD 15). Looking at work limitations among others we found that 69% of employed IBD patients could not or have not made adjustments to avoid taking sick days off due to their disease, 40% of employed IBD patients miss work due to doctor appointments, 47% of employed IBD patients are affected by fatigue in their performance at work and 50% of employed IBD-patients experience stress or pressure when taking sick time off from work. In regards to job-lock, 58% of employed IBD patients (n = 146) had employer-provided health insurance of which 20% experienced job-lock.
A high prevalence of absenteeism and presenteeism in employed IBD patients continues to be a problem, patients are absent from work because of doctor appointments and are stressed or pressured if they have to take sick days off due to their disease. Job-lock occurred in 20% of employed IBD patients with employer-provided health insurance. These high percentages indicate that IBD patients continue to have difficulties finding and maintaining employment.
- Posted in: DOP Session 3 - Epidemiology in practice