Markers for work disability in anti-neutrophil cytoplasmic antibody-associated vasculitis

Neil Basu*, Andrew McClean, Lorraine Harper, Esther N. Amft, Neeraj Dhaun, Raashid A. Luqmani, Mark A. Little, David R. W. Jayne, Oliver Flossmann, John McLaren, Vinod Kumar, Lars P. Erwig, David M. Reid, Gary J. Macfarlane, Gareth T. Jones

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

Objectives. ANCA-associated vasculitis (AAV) commonly affects those of working age. Since survival rates have been transformed by immunotherapeutics, the measurement of other outcomes has become increasingly relevant. Work disability is an important outcome for both patient and society that has yet to be fully evaluated in AAV. We aimed to assess employment status in AAV patients and identify putative predictors of their work disability.

Methods. A cross-sectional study was undertaken. AAV cases were recruited according to consecutive clinic attendance. Subjects completed a questionnaire that determined employment status and other psychosocial measures. Clinical factors were concurrently recorded by the attending physician. From the data of those subjects of working age, a multivariable model was developed using forward stepwise logistic regression to identify the independent associations of work disability, defined by those subjects reporting unemployment secondary to ill-health. Results are expressed as odds ratios (ORs) and 95% CIs.

Results. Of the 410 participants (84.4% response rate), 149 (36.7%) were employed, 197 (48.6%) retired and 54 (13.3%) unemployed secondary to ill health. Of those of working age, 26.0% were considered work disabled. Fatigue (OR 7.1, 95% CI 1.5, 33.1), depression (OR 4.4, 95% CI 1.8, 10.8), severe disease damage [Vasculitis Damage Index (VDI) > 4 (OR 3.9, 95% CI 1.01, 14.7)] and being overweight (OR 3.4, 95% CI 1.3, 8.9) were independently associated with their unemployment.

Conclusion. A quarter of working-age AAV subjects reported unemployment as a result of ill health and are characterized by high levels of fatigue, depression, disease damage and being overweight. These potentially modifiable factors may inform future multidisciplinary interventions aimed at alleviating work disability.

Original languageEnglish
Pages (from-to)953-956
Number of pages4
JournalRheumatology
Volume53
Issue number5
Early online date31 Jan 2014
DOIs
Publication statusPublished - May 2014

Keywords

  • ANCA-associated vasculitis
  • work disability
  • fatigue
  • systemic-lupus-erythematosus
  • quality-of-life
  • Wegeners-granulomatosis
  • ankylosing-spondylitis
  • rheumatoid-arthritis
  • risk-factors
  • obesity
  • disease
  • health

Cite this

Markers for work disability in anti-neutrophil cytoplasmic antibody-associated vasculitis. / Basu, Neil; McClean, Andrew; Harper, Lorraine; Amft, Esther N.; Dhaun, Neeraj; Luqmani, Raashid A.; Little, Mark A.; Jayne, David R. W.; Flossmann, Oliver; McLaren, John; Kumar, Vinod; Erwig, Lars P.; Reid, David M.; Macfarlane, Gary J.; Jones, Gareth T.

In: Rheumatology, Vol. 53, No. 5, 05.2014, p. 953-956.

Research output: Contribution to journalArticle

Basu, N, McClean, A, Harper, L, Amft, EN, Dhaun, N, Luqmani, RA, Little, MA, Jayne, DRW, Flossmann, O, McLaren, J, Kumar, V, Erwig, LP, Reid, DM, Macfarlane, GJ & Jones, GT 2014, 'Markers for work disability in anti-neutrophil cytoplasmic antibody-associated vasculitis', Rheumatology, vol. 53, no. 5, pp. 953-956. https://doi.org/10.1093/rheumatology/ket483
Basu, Neil ; McClean, Andrew ; Harper, Lorraine ; Amft, Esther N. ; Dhaun, Neeraj ; Luqmani, Raashid A. ; Little, Mark A. ; Jayne, David R. W. ; Flossmann, Oliver ; McLaren, John ; Kumar, Vinod ; Erwig, Lars P. ; Reid, David M. ; Macfarlane, Gary J. ; Jones, Gareth T. / Markers for work disability in anti-neutrophil cytoplasmic antibody-associated vasculitis. In: Rheumatology. 2014 ; Vol. 53, No. 5. pp. 953-956.
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title = "Markers for work disability in anti-neutrophil cytoplasmic antibody-associated vasculitis",
abstract = "Objectives. ANCA-associated vasculitis (AAV) commonly affects those of working age. Since survival rates have been transformed by immunotherapeutics, the measurement of other outcomes has become increasingly relevant. Work disability is an important outcome for both patient and society that has yet to be fully evaluated in AAV. We aimed to assess employment status in AAV patients and identify putative predictors of their work disability.Methods. A cross-sectional study was undertaken. AAV cases were recruited according to consecutive clinic attendance. Subjects completed a questionnaire that determined employment status and other psychosocial measures. Clinical factors were concurrently recorded by the attending physician. From the data of those subjects of working age, a multivariable model was developed using forward stepwise logistic regression to identify the independent associations of work disability, defined by those subjects reporting unemployment secondary to ill-health. Results are expressed as odds ratios (ORs) and 95{\%} CIs.Results. Of the 410 participants (84.4{\%} response rate), 149 (36.7{\%}) were employed, 197 (48.6{\%}) retired and 54 (13.3{\%}) unemployed secondary to ill health. Of those of working age, 26.0{\%} were considered work disabled. Fatigue (OR 7.1, 95{\%} CI 1.5, 33.1), depression (OR 4.4, 95{\%} CI 1.8, 10.8), severe disease damage [Vasculitis Damage Index (VDI) > 4 (OR 3.9, 95{\%} CI 1.01, 14.7)] and being overweight (OR 3.4, 95{\%} CI 1.3, 8.9) were independently associated with their unemployment.Conclusion. A quarter of working-age AAV subjects reported unemployment as a result of ill health and are characterized by high levels of fatigue, depression, disease damage and being overweight. These potentially modifiable factors may inform future multidisciplinary interventions aimed at alleviating work disability.",
keywords = "ANCA-associated vasculitis, work disability, fatigue, systemic-lupus-erythematosus, quality-of-life, Wegeners-granulomatosis, ankylosing-spondylitis, rheumatoid-arthritis, risk-factors, obesity, disease, health",
author = "Neil Basu and Andrew McClean and Lorraine Harper and Amft, {Esther N.} and Neeraj Dhaun and Luqmani, {Raashid A.} and Little, {Mark A.} and Jayne, {David R. W.} and Oliver Flossmann and John McLaren and Vinod Kumar and Erwig, {Lars P.} and Reid, {David M.} and Macfarlane, {Gary J.} and Jones, {Gareth T.}",
note = "Acknowledgements We are grateful to Jennie King, Jennifer O’Donoghue and Denise Brown for supporting patient recruitment and Nabi Moaven-Hashemi, Jennifer Banister, Marcus Beasley and Leyla Swafe, who assisted with the mailing and data entry for the study. Funding: This work was supported by the Chief Scientist’s Office (reference CAF/08/08)",
year = "2014",
month = "5",
doi = "10.1093/rheumatology/ket483",
language = "English",
volume = "53",
pages = "953--956",
journal = "Rheumatology",
issn = "1462-0324",
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number = "5",

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TY - JOUR

T1 - Markers for work disability in anti-neutrophil cytoplasmic antibody-associated vasculitis

AU - Basu, Neil

AU - McClean, Andrew

AU - Harper, Lorraine

AU - Amft, Esther N.

AU - Dhaun, Neeraj

AU - Luqmani, Raashid A.

AU - Little, Mark A.

AU - Jayne, David R. W.

AU - Flossmann, Oliver

AU - McLaren, John

AU - Kumar, Vinod

AU - Erwig, Lars P.

AU - Reid, David M.

AU - Macfarlane, Gary J.

AU - Jones, Gareth T.

N1 - Acknowledgements We are grateful to Jennie King, Jennifer O’Donoghue and Denise Brown for supporting patient recruitment and Nabi Moaven-Hashemi, Jennifer Banister, Marcus Beasley and Leyla Swafe, who assisted with the mailing and data entry for the study. Funding: This work was supported by the Chief Scientist’s Office (reference CAF/08/08)

PY - 2014/5

Y1 - 2014/5

N2 - Objectives. ANCA-associated vasculitis (AAV) commonly affects those of working age. Since survival rates have been transformed by immunotherapeutics, the measurement of other outcomes has become increasingly relevant. Work disability is an important outcome for both patient and society that has yet to be fully evaluated in AAV. We aimed to assess employment status in AAV patients and identify putative predictors of their work disability.Methods. A cross-sectional study was undertaken. AAV cases were recruited according to consecutive clinic attendance. Subjects completed a questionnaire that determined employment status and other psychosocial measures. Clinical factors were concurrently recorded by the attending physician. From the data of those subjects of working age, a multivariable model was developed using forward stepwise logistic regression to identify the independent associations of work disability, defined by those subjects reporting unemployment secondary to ill-health. Results are expressed as odds ratios (ORs) and 95% CIs.Results. Of the 410 participants (84.4% response rate), 149 (36.7%) were employed, 197 (48.6%) retired and 54 (13.3%) unemployed secondary to ill health. Of those of working age, 26.0% were considered work disabled. Fatigue (OR 7.1, 95% CI 1.5, 33.1), depression (OR 4.4, 95% CI 1.8, 10.8), severe disease damage [Vasculitis Damage Index (VDI) > 4 (OR 3.9, 95% CI 1.01, 14.7)] and being overweight (OR 3.4, 95% CI 1.3, 8.9) were independently associated with their unemployment.Conclusion. A quarter of working-age AAV subjects reported unemployment as a result of ill health and are characterized by high levels of fatigue, depression, disease damage and being overweight. These potentially modifiable factors may inform future multidisciplinary interventions aimed at alleviating work disability.

AB - Objectives. ANCA-associated vasculitis (AAV) commonly affects those of working age. Since survival rates have been transformed by immunotherapeutics, the measurement of other outcomes has become increasingly relevant. Work disability is an important outcome for both patient and society that has yet to be fully evaluated in AAV. We aimed to assess employment status in AAV patients and identify putative predictors of their work disability.Methods. A cross-sectional study was undertaken. AAV cases were recruited according to consecutive clinic attendance. Subjects completed a questionnaire that determined employment status and other psychosocial measures. Clinical factors were concurrently recorded by the attending physician. From the data of those subjects of working age, a multivariable model was developed using forward stepwise logistic regression to identify the independent associations of work disability, defined by those subjects reporting unemployment secondary to ill-health. Results are expressed as odds ratios (ORs) and 95% CIs.Results. Of the 410 participants (84.4% response rate), 149 (36.7%) were employed, 197 (48.6%) retired and 54 (13.3%) unemployed secondary to ill health. Of those of working age, 26.0% were considered work disabled. Fatigue (OR 7.1, 95% CI 1.5, 33.1), depression (OR 4.4, 95% CI 1.8, 10.8), severe disease damage [Vasculitis Damage Index (VDI) > 4 (OR 3.9, 95% CI 1.01, 14.7)] and being overweight (OR 3.4, 95% CI 1.3, 8.9) were independently associated with their unemployment.Conclusion. A quarter of working-age AAV subjects reported unemployment as a result of ill health and are characterized by high levels of fatigue, depression, disease damage and being overweight. These potentially modifiable factors may inform future multidisciplinary interventions aimed at alleviating work disability.

KW - ANCA-associated vasculitis

KW - work disability

KW - fatigue

KW - systemic-lupus-erythematosus

KW - quality-of-life

KW - Wegeners-granulomatosis

KW - ankylosing-spondylitis

KW - rheumatoid-arthritis

KW - risk-factors

KW - obesity

KW - disease

KW - health

U2 - 10.1093/rheumatology/ket483

DO - 10.1093/rheumatology/ket483

M3 - Article

VL - 53

SP - 953

EP - 956

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 5

ER -