P592 Absenteeism and presenteeism amongst Crohn’s disease patients: results from a real-world cohort in Israel
D. Schwartz*1, D. Greenberg2, E. Chernin2, H. Vardi2, M. Friger2, O. Sarid2, V. Slonim-Nevo2, S. Odes2
1Soroka UMC, Gastroenterology, Beer Sheva, Israel, 2Ben Gurion University, Beer Sheva, Israel
Crohn’s disease (CD) is a chronic debilitating inflammatory disease affecting patients’ ability to perform daily activities, as well as work productivity. We assessed work productivity in a sample of adult CD patients in Israel.
Patients enrolled in an ongoing socioeconomic study of CD in the Israeli adult patient population completed self-administered questionnaires including the Work Productivity and Activity Impairment (WPAI) questionnaire to assess work absenteeism and presenteeism. Patients were assessed for their current clinical and treatment status, including the Harvey–Bradshaw Index (HBI) of disease severity and use of medications.
The cohort comprised of 597 patients, of which 366 (61.3%) were employed. The mean age of patients (± SD) was 37.9 ± 11.2 (range 18–71) years; 57.4% were female; mean disease duration was 12.2 ± 8.1 (range 0–49) years; 55% had disease remission, and 24% had mild, 18% moderate, and 3% severe disease. The proportion of employed CD patients was lower compared with the proportion in the general population for both women (54.9% vs 70.9%) and men (72.3% vs 80.3%). Further, 29.1% of patients reported missing from work in the last week because of their disease (20.9% in men vs 33.8% in women p = 0.023). The mean missing hours from work (absenteeism) per week was 3.1 ± 6.9 (range 0 to 40) hours. Absenteeism was higher with increase in disease severity (1.3 ± 3.4 hours amongst patients in disease remission; 2.9 ± 5.5 in mild disease; 8.0 ± 11.7 in moderate disease; and 10.7 ± 10.3 in severe disease; p < 0.001). Absenteeism was higher amongst patients treated with steroids (8.1 ± 11.0 vs 2.2 ± 5.4; p < 0.001) and was negatively correlated with length of disease (-0.135; p = 0.032). Patients were asked to indicate on a 0-to-10 scale the effect of their disease on their productivity (presenteeism) while working (0 = no impact; 10 = completely prevented them for working). The mean score was higher with increase in disease severity (1.3 ± 2.2 amongst patients in disease remission; 2.5 ± 3.3 in mild disease; 4.7 ± 2.9 in moderate disease; and 5.7 ± 2.0 in severe disease; p < 0.001), higher in patients treated with steroids (3.7 ± 2.9 vs 2.1 ± 2.6; p < 0.001), those treated with biological drugs (2.8 ± 2.9 vs 2.1 ± 2.5; p < 0.001), and in patients with extraintestinal manifestation (3.0 ± 2.8 vs 1.8 ± 2.5; p < 0.001).
Work productivity is significantly impaired in CD patients and is associated with both disease severity and treatment patterns. A long-term assessment of the effect of new pharmaceutical treatments on patients’ productivity is warranted.