Productivity Loss Due to Presenteeism Among Patients with Arthritis: Estimates from 4 Instruments
ABSTRACT To estimate and compare lost work hours attributable to presenteeism, defined as reduced productivity while working, in individuals with osteoarthritis (OA) or rheumatoid arthritis (RA), according to 4 instruments.
In our prospective study, 250 workers with OA (n = 130) or RA (n = 120) were recruited from community and clinical sites. Lost hours due to presenteeism at baseline were estimated using the Health and Labor Questionnaire (HLQ), the Work Limitations Questionnaire (WLQ), the World Health Organization's Health and Work Performance Questionnaire (HPQ), and the Work Productivity and Activity Impairment Questionnaire (WPAI). Only those respondents working over the past 2 weeks were included. Repeated-measures ANOVA was used to compare the lost-time estimates, according to each instrument.
Of the 212 respondents included in the analyses, the frequency of missing and "0" values among the instruments was different (17% and 61% for HLQ, 8% and 5% for WLQ, 1% and 16% for HPQ, 0% and 27% for WPAI, respectively). The average numbers of lost hours (SD) per 2 weeks due to presenteeism using HLQ, WLQ, HPQ, and WPAI were 1.6 (3.9), 4.0 (3.9), 13.5 (12.5), and 14.2 (16.7). The corresponding costs for the 2-week period were CAN$30.03, $83.05, $284.07, and $285.10. The differences in the lost-hour estimates according to instruments were significant (p < 0.001).
Among individuals with arthritis, estimates of productivity losses while working vary widely according to the instruments chosen. Further research on instrument design and implications for a standardized approach to estimate lost time due to presenteeism is needed.
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ABSTRACT: Impairments in work productivity and daily activities contribute to the burden of rheumatoid arthritis (RA). It is thus essential to use an instrument assessing both work and daily activity impairments when studying the full impact of RA on individuals. The Work Productivity and Activity Impairment (WPAI) questionnaire is such an instrument. This study aims to linguistically validate the RA-specific WPAI (WPAI:RA) instrument in 20 new languages and to assess its content validity for individuals with RA. The linguistic validation of the questionnaire followed a standard methodology that included comprehension test interviews (n = 5 individuals with RA per language) to assess the relevance, understanding and acceptability of the WPAI:RA. Content validity of the instrument was simultaneously investigated. Comprehension testing showed that the WPAI:RA questionnaire was well understood similarly across countries; minor changes were made to ensure fidelity to the original concepts and for ease of comprehension. The majority of interviewees (66/93) considered its content comprehensive and appropriate to measure their ability to work and perform daily activities. The WPAI:RA questionnaire is now linguistically validated in 20 new languages [Czech (Czech Republic), Dutch (Belgium), English (Canada and UK), French (Belgium, Canada and France), German (Germany), Hungarian (Hungary), Italian (Italy), Polish (Poland), Portuguese (Brazil), Romanian (Romania), Russian (Russia and Ukraine), Spanish (Argentina, Mexico, Spain and US) and Ukrainian (Ukraine)]. The WPAI:RA questionnaire shows good content validity. It can thus be used in multi-country clinical trials to assess RA-related impact on the patients' ability to work and perform daily activities.The patient 03/2014; DOI:10.1007/s40271-014-0053-4 · 1.96 Impact Factor
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ABSTRACT: Health economic evaluations (i.e. cost-effectiveness appraisal of an intervention) are useful aids for decision makers responsible for the allocation of scarce healthcare resources. The relevance of including health-related productivity costs (or benefits) in these evaluations is increasingly recognized and, as such, reliable and valid instruments to quantify productivity costs are needed. Over the years, a number of work productivity instruments have emerged in the literature, along with a growing body of psychometric evidence. The overall aim of this paper is to provide a review of available instruments with potential for estimating health-related productivity costs. This included the Health and Labor Questionnaire, Health and Work Performance Questionnaire, Health-Related Productivity Questionnaire Diary, Productivity and Disease Questionnaire, Quantity and Quality method, Stanford Presenteeism Scale 13, Valuation of Lost Productivity, Work and Health Interview, Work Limitations Questionnaire, Work Productivity and Activity Impairment Questionnaire, and Work Productivity Short Inventory. Critical discussions on the instruments' overall strengths and limitations, applicability for health economic evaluations, as well as the methodological quality of existing psychometric evidence were provided. Lastly, a set of reflective questions were proposed for users to consider when selecting an instrument for health economic evaluations.PharmacoEconomics 08/2014; 33(1). DOI:10.1007/s40273-014-0209-z · 3.34 Impact Factor
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ABSTRACT: Productivity loss is often an overlooked aspect of the burden of chronic health conditions. While modern guidelines emphasize achieving clinical control in asthma management, few studies have reported on the relation between asthma control and productivity loss. We calculated the productivity loss that can be avoided by achieving and maintaining clinical control in adult employed asthma patients. We prospectively recruited a population-based random sample of adults with asthma in British Columbia, Canada. We measured productivity loss due to absenteeism and presenteeism using validated instruments, and ascertained asthma control according to the Global Initiative for Asthma classification. We estimated the average gain in productivity for each individual if the individual's asthma was controlled in the past week, by fitting two-part regression models associating asthma control and productivity loss, controlling for potential confounding variables. The final sample included 300 adult employed individuals (mean age 47.9 years (S.D. 12.0), 67.3% female). 49 (16.3%) reported absenteeism, while 137 (45.7%) reported presenteeism. Productivity loss due to presenteeism, but not absenteeism, was associated with asthma control. A person with uncontrolled asthma would avoid CAD$184.8 in productivity loss by achieving clinical control during a week, $167.5 (90.6%) of which would be due to presenteeism. The corresponding value was CAD$34.2 for partially controlled asthma and was not statistically significant. Our results indicate that substantial gain in productivity can be obtained by achieving asthma control. Presenteeism is more responsive than absenteeism to asthma control, thus comprising a more important source of preventable burden.Chest 12/2013; 145(4). DOI:10.1378/chest.13-1619 · 7.13 Impact Factor