Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.
Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia.
Clin Exp Allergy. 2018 Jun;48(6):650-662. doi: 10.1111/cea.13153. Epub 2018 May 17.
Severe asthma affects quality of life; however, its impact on workplace productivity is poorly understood.
To compare workplace productivity-absenteeism and presenteeism-and impairment in daily activities in severe and non-severe asthma over time and identify characteristics associated with presenteeism in severe asthma.
The Severe Asthma Web-based Database is an ongoing observational registry from Australia, New Zealand and Singapore. At April 2017, 434 patients with severe asthma and 102 with non-severe asthma were enrolled (18-88 years; 59% female). Participants provided comprehensive clinical and questionnaire data at baseline and were followed-up every 6 months for 24 months. Absenteeism (percentage of time not at work), presenteeism (self-reported impairment at work) and impairment in daily activities outside work due to health problems in the last week were calculated.
At baseline, 61.4% of participants with severe asthma and 66.2% with non-severe asthma under 65 years were employed. At younger ages (30-50 years), fewer severe asthma participants were employed (69% vs 100%). Presenteeism and impairment in daily activity were more frequently reported in severe asthma and in participants with poorer asthma control, poorer lung function and more past-year exacerbations (P < .01). Over time, deteriorating asthma control was associated with increasing presenteeism. Although absenteeism was not different between severe and non-severe asthma, worse asthma control was associated with absenteeism (P < .001). In participants with severe asthma, presenteeism was reported more frequently in those with poorer asthma control, poorer asthma-related quality of life and symptoms of depression or anxiety (P < .01).
Severe asthma was associated with impairment at work and outside the workplace. Improving asthma control and mental health may be important targets for optimizing workplace productivity in severe asthma. Presenteeism and absenteeism may represent key metrics for assessing intervention efficacy in people with severe asthma of working age.
重度哮喘会降低生活质量；然而，其对工作场所生产力的影响还不甚了解。
比较重度和非重度哮喘患者的工作场所生产力（缺勤和出勤）和日常活动障碍随时间的变化，并确定与重度哮喘患者出勤相关的特征。
重度哮喘网络数据库是一个正在进行的澳大利亚、新西兰和新加坡的观察性登记处。截至 2017 年 4 月，纳入 434 例重度哮喘患者和 102 例非重度哮喘患者（18-88 岁；59%女性）。患者在基线时提供全面的临床和问卷调查数据，并在 24 个月内每 6 个月随访一次。计算缺勤率（未工作时间的百分比）、出勤时的工作障碍（工作时自我报告的障碍）和过去一周因健康问题导致的工作外日常活动障碍。
在基线时，61.4%的重度哮喘患者和 66.2%的非重度哮喘患者年龄小于 65 岁。在较年轻的年龄（30-50 岁），重度哮喘患者的就业率较低（69%比 100%）。在重度哮喘患者和哮喘控制较差、肺功能较差和过去一年加重次数较多的患者中，报告的出勤时工作障碍和日常活动障碍更为常见（P<.01）。随着时间的推移，哮喘控制的恶化与出勤时工作障碍的增加相关。尽管重度哮喘和非重度哮喘的缺勤率无差异，但较差的哮喘控制与缺勤相关（P<.001）。在重度哮喘患者中，哮喘控制较差、哮喘相关生活质量较差以及存在抑郁或焦虑症状的患者报告出勤时工作障碍更为常见（P<.01）。
重度哮喘与工作场所和工作外的障碍相关。改善哮喘控制和心理健康可能是优化重度哮喘患者工作场所生产力的重要目标。出勤时工作障碍和缺勤可能是评估重度哮喘患者工作年龄人群干预效果的关键指标。
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