BACKGROUND
Inflammatory bowel diseases (IBD) cause work impairments for working-age patients. Limited data are available concerning impacts of disease burden on quality of working life for patients with IBD in China. This information is important for reducing indirect costs of IBD which are mainly driven by work productivity (WP) loss.
OBJECTIVE
This study aimed to evaluate the situation of working life of patients with IBD in China and identify impairing factors predictive for work satisfaction decline and WP loss.
METHODS
This was a web-based cross-sectional cohort study performed through the WeChat public platform of China Crohn’s & Colitis Foundation. Patients with IBD completed an 82-item online questionnaire consisted of five sections, including [ⅰ] sociodemographic survey; [ⅱ] disease-related survey including the patient-reported Harvey Bradshaw Index (p-HBI) and the patient-reported Simple Clinical Colitis Activity Index (p-SCCAI) questionnaire to assess disease activity; [ⅲ] work-related survey; [ⅳ] the Work Productivity and Activity Impairment (WPAI) questionnaire to assess absenteeism, presenteeism and overall WP loss; and [ⅴ] a 22-item IBD quality-of-life questionnaire (IBDQOL-22) to assess health-related quality of life (HRQOL). Uni- and multivariable regression analyses were performed to identify predictors of work satisfaction decline and WP loss.
RESULTS
A total of 1610 IBD patients were included (67% Crohn’s disease, 71% actively employed). 468 (41%) of 1141 actively employed patients reported IBD-related limitation in working ability and 357 (76%) of 469 previously employed patients stopped work because of IBD. Fatigue and biological therapy were reported to impact working life most. In 1141 actively employed patients, work satisfaction decline, absenteeism, presenteeism, and overall WP loss were reported by 474 (42%), 423 (37%), 947 (83%), and 965 (85%) patients, respectively. Multivariate analysis revealed that aging over 30 years old (P < .001), working over 40 hours per week (P = .009), anxiety/depression (P < .001) and disease activity (P = .002) were predictive for work satisfaction decline. Low education level (P < .001), anxiety/depression (P < .001), irritability mood (P = .009) and high disease burden presented by relapse frequency ≥ 3 flare-ups per year (P = .026), hospitalizations > 3 times per year (P = .013) and disease activity (P < .001) were predictive for severe WP loss. Moreover, poor HRQOL was associated with WP loss.
CONCLUSIONS
High disease burden significantly impairs quality of working life in Chinese IBD patients. Age, education, working hours and mental health synergistically correlate with work satisfaction decline or WP loss.