Burden of Systemic Lupus Erythematosus on Employment and Work Productivity: Data From a Large Cohort in the Southeastern United States
Burden of Systemic Lupus Erythematosus on Employment and Work Productivity: Data From a Large Cohort in the Southeastern United States
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DOI：
10.1002/acr.22245
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发表时间：
2014-06-01
影响因子：
4.7
通讯作者：
Lim, S. Sam
中科院分区：
文献类型：
--
作者：
Drenkard, Cristina;Bao, Gaobin;Lim, S. Sam
objective.研究美国东南部系统性红斑狼疮（SLE）患者对工作损失、失业和工作效率损害的负担。我们检查了689例SLE患者，年龄18 - 64岁，来自格鲁吉亚组织抗狼疮（GOAL）队列。GOAL是一个纵向队列，主要来自格鲁吉亚狼疮登记处，这是一个在亚特兰大大都市建立的基于人群的登记处。我们使用Kaplan-Meier方法评估自诊断以来自我报告工作损失的患者比例。我们比较了SLE患者和来自同一地理区域的普通人群之间的失业情况，计算了人口统计学和疾病分层内的标准化失业率（SUR）。我们还计算了疾病结果导致的工作效率受损的百分比。在诊断时雇用的511名患者中，249名（49%）在平均13年的疾病持续时间内经历了工作损失。自诊断以来失去工作的患者比例，非洲裔美国人几乎是白人的两倍。然而，包括种族在内的人口统计学特征的SUR相似。重度疾病活动和重度器官损伤患者的SUR最高，分别为4.4和5.6。在那些仍然工作的人中，有严重疲劳、神经认知症状和肌肉骨骼症状的患者的工作效率受损最高。SLE给个人带来了巨大的损失，给社会带来了负担。对工作成果产生负面影响的主要因素是疲劳、疾病活动和器官损伤。需要更有效的治疗沿着工作场所的应对策略，以减少SLE对工作成果的负担。
Objective. To examine the burden of systemic lupus erythematosus (SLE) on work loss, unemployment, and work productivity impairment in an SLE cohort from the southeastern US.Methods. We examined 689 SLE patients ages 18-64 years from the Georgians Organized Against Lupus (GOAL) cohort. GOAL is a longitudinal cohort predominantly derived from the Georgia Lupus Registry, a population-based registry established in metropolitan Atlanta. We used the Kaplan-Meier method to assess the proportion of patients who self-reported work loss since diagnosis. We compared unemployment between SLE patients and the general population from the same geographic area, calculating the standardized unemployment ratio (SUR) within demographic and disease strata. We also calculated the percentage of work productivity impairment by disease outcomes.Results. Of 511 patients employed at diagnosis, 249 (49%) experienced work loss within an average disease duration of 13 years. The proportion of patients who lost their jobs since diagnosis was almost twice for African Americans than for whites. However, the SURs were similar across demographic characteristics, including race. Patients with severe disease activity and severe organ damage had the highest SUR at 4.4 and 5.6, respectively. Among those that remained employed, patients with severe fatigue, neurocognitive symptoms, and musculoskeletal symptoms had the highest impairment of work productivity.Conclusion. SLE imposes a substantial toll on individuals and burden on society. Major factors that negatively impact work outcomes are fatigue, disease activity, and organ damage. More effective treatments along with coping strategies at the workplace are needed to reduce the burden of SLE on work outcomes.