THU0381 PATIENT-REPORTED IMPACT OF AXIAL SPONDYLOARTHRITIS ON WORKING LIFE: RESULTS FROM THE EMAS SURVEY

Abstract

Background: Axial spondyloarthritis (axSpA) impacts multiple dimensions of patients' lives, including working life. Objective(s): To evaluate work-related issues, their associations and determinants among European axSpA patients. Method(s): The European Map of Axial Spondyloarthritis (EMAS), conducted from July 2017 to February 2018, was a cross-sectional on-line survey of unselected patients with self-reported axSpA from Austria, Belgium, France, Germany, Italy, Netherlands, Norway, Russia, Slovenia, Spain, Sweden, Switzerland, and the UK. Participants were recruited through an on-line panel and patient organizations. Participants were classified as active (employed, unemployed between 15-64 years) or inactive (retirees, on sick leave, students and homemakers). Those employed were asked to report work-related issues (sick-leave, difficulty fulfilling work hours, missing work for doctors' appointments, reducing working hours or taking days off) in the past 12 months. Disease activity (BAS-DAI), self-reported spinal stiffness, diagnostic delay and psychological distress (General Health Questionnaire, GHQ-12) were compared between employed patients with or without work-related issues using a Mann-Whitney and Kruskal-Wallis test. Two-stage regression analysis was conducted to determine explicative sociodemographic (using stepwise method for income, age, gender, education) and disease-related factors (enter method for BASDAI, self-reported spinal stiffness, functional limitation) over work-related issues. Result(s): 2846 axSpA patients participated in EMAS: Mean age was 44 +/-12 years, 61.3% were female and 48.1% were university educated. Mean disease duration and diagnostic delay were 17.2+/-12.4 and 7.4+/-8.4 years, respectively, and mean BASDAI was 5.5+/-2.0. 61.3% (n=1653) were considered active, of which 87.7% (n=1450) were employed. Of those employed, 67.7% reported a work-related issue, specifically 56.3% took sick leave, 44.6% had difficulties in fulfilling the working hours, 34.6% missed work due to doctor's appointments, 31.6% requested days off, and 25.7% reduced their number of working hours (Table 1). Among all patients, 74.1% faced or believed they would face difficulties finding a job due to axSpA. Experiencing work-related issues due to axSpA was significantly associated with higher disease activity, self-reported spinal stiffness, longer diagnostic delay, and higher level of psychological distress (p<0.001). First regression step showed gender and educational level as explanatory sociodemographic control factors, while educational level and BASDAI were the only statistically significant explanatory factors in the second step (p0.001) (Table 2). Abstract THU0381-Table 1. [TABLE PRESENTED] Conclusion(s): Nearly two-thirds of employed patients experienced work-related issues due to axSpA. The strongest factor associated with work-related issues was high disease activity. Understanding the determinants of work-related issues is needed to ensure that patients have adequate workplace and holistic medical support to lead productive work-lives.