Driving Difficulties in Patients With Axial Spondyloarthritis: Results From the Scotland Registry for Ankylosing Spondylitis

Abstract

Objective: To describe the driving difficulties experienced by individuals with axial spondyloarthritis (SpA), and to characterize associated clinical and sociodemographic features and impact on work. Methods: The Scotland Registry for Ankylosing Spondylitis (SIRAS) is a cohort study of patients with a clinical diagnosis of axial SpA. Baseline information was collected on clinical and patient-reported measures and work participation measures (using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem [WPAI:SHP]). Patient-rated difficulties with 9 driving tasks were used in a factor analysis, and relationships between driving difficulty and work participation were investigated. Results: In total, 718 patients provided data for analysis, of which 642 (89%) had some difficulty with at least 1 driving task, and 72 (10%) had some difficulty with all 9 tasks. Three domains of driving difficulty were identified: dynamic driving scenarios, crossing traffic, and the physical act of driving. Chronic widespread pain, knee and back pain, fatigue, high disease activity, and anxiety/depression were significantly associated with reporting driving difficulties across all 3 domains, particularly the physical act of driving. After adjusting for sociodemographic, disease activity, physical and mental health, driving difficulties in each domain were associated with a 2–3 times increased likelihood of restricted work productivity and with an increased risk of sickness absence in the past 7 days. Conclusion: Driving difficulties are common in individuals with axial SpA and impact on work, even after adjusting for clinical status. Improving understanding and awareness of driving disability will help direct advice and resources to enable individuals to remain independent and economically active.