Department of Medicine and.
Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Ann Am Thorac Soc. 2020 Sep;17(9):1077-1084. doi: 10.1513/AnnalsATS.201911-822OC.
Interstitial lung disease (ILD) develops in a large percentage of patients with connective tissue disease (CTD) and is associated with increased morbidity and mortality. Patients with CTD-associated ILD (CTD-ILD) often present at a young age, suggesting that ILD likely impacts workplace productivity. We aimed to determine the employment rate and workplace productivity loss, along with its associated factors and estimated costs, in patients with fibrotic CTD-ILD. Patients with fibrotic CTD-ILD from the six centers of the Canadian Registry for Pulmonary Fibrosis were eligible. Health-related productivity loss was assessed using the Work Productivity and Activity Impairment questionnaire. Proposed factors associated with low workplace productivity were forced into a multivariable regression model. Average productivity loss in hours/week was used to calculate the costs of productivity loss based on hourly wages obtained from national census data matched for age and sex. Workplace productivity loss outcomes were compared between patients with CTD-ILD and patients with a non-CTD fibrotic ILD. Of 375 eligible patients with fibrotic CTD-ILD, 113 (30%) were employed. Productivity loss was reported by 59% of employed patients, with a mean loss of 9.4 ± 1.2 hours/week, including 3.9 ± 0.9 hours/week from absenteeism and 5.5 ± 0.7 hours/week from presenteeism. Employment among patients 25-54 years of age with fibrotic CTD-ILD was 27% lower than that in the matched general Canadian population (56% vs. 83%; < 0.001). Employment among patients ≥55 years of age with CTD-ILD was 17% lower than that in the matched population (19% vs. 36%; < 0.001). Workplace productivity loss was not associated with respiratory symptoms or lung physiology. Annual costs of productivity loss were calculated at 13,593 Canadian dollars per employee with fibrotic CTD-ILD. Workplace productivity loss was similar in patients with fibrotic CTD-ILD and those with non-CTD fibrotic ILD. Patients with fibrotic CTD-ILD frequently report workplace productivity loss, which is unexplained by respiratory symptoms or lung physiology and is associated with significant costs.
间质性肺病 (ILD) 在很大比例的结缔组织病 (CTD) 患者中发展，并与发病率和死亡率的增加相关。患有 CTD 相关间质性肺病 (CTD-ILD) 的患者通常在年轻时就出现，这表明 ILD 可能会影响工作场所的生产力。我们旨在确定纤维化 CTD-ILD 患者的就业率和工作场所生产力损失，以及相关因素和估计成本。纤维化 CTD-ILD 患者来自加拿大肺纤维化登记处的六个中心。使用工作生产力和活动障碍问卷评估与健康相关的生产力损失。与低工作场所生产力相关的拟议因素被纳入多变量回归模型。每周平均生产力损失小时数用于根据从全国人口普查数据中获得的与年龄和性别匹配的每小时工资计算生产力损失成本。将 CTD-ILD 患者与非 CTD 纤维化 ILD 患者的工作场所生产力损失结果进行比较。在 375 名符合条件的纤维化 CTD-ILD 患者中，有 113 名 (30%) 有工作。59%的在职患者报告存在生产力损失，平均每周损失 9.4 ± 1.2 小时，包括旷工 3.9 ± 0.9 小时和在职工作 5.5 ± 0.7 小时。25-54 岁纤维化 CTD-ILD 患者的就业率比加拿大一般人群低 27% (56% vs. 83%； < 0.001)。≥55 岁 CTD-ILD 患者的就业率比匹配人群低 17% (19% vs. 36%； < 0.001)。工作场所生产力损失与呼吸症状或肺生理学无关。每年因纤维化 CTD-ILD 导致的生产力损失成本为每位员工 13593 加元。纤维化 CTD-ILD 患者和非 CTD 纤维化 ILD 患者的工作场所生产力损失相似。纤维化 CTD-ILD 患者经常报告工作场所生产力损失，这与呼吸症状或肺生理学无关，并带来重大成本。
