干眼评估和管理研究中，干眼疾病严重程度与工作效率和活动受损的相关性。
Association of Severity of Dry Eye Disease with Work Productivity and Activity Impairment in the Dry Eye Assessment and Management Study.
机构信息
Department of Population Health Science and Policy, Icahn School of Medicine at Mt. Sinai, New York, New York.
Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
出版信息
Ophthalmology. 2021 Jun;128(6):850-856. doi: 10.1016/j.ophtha.2020.10.015. Epub 2020 Oct 15.
PURPOSE
To evaluate the association of dry eye disease (DED) severity with work productivity and activity impairment.
DESIGN
Longitudinal, observational study within a randomized clinical trial.
PARTICIPANTS
People with moderate to severe DED who enrolled in the multicenter Dry Eye Assessment and Management (DREAM) study.
METHODS
Participants completed the Work Productivity and Activity Impairment questionnaire at 0, 6, and 12 months and were assessed in parallel for symptoms and signs (conjunctival and corneal staining, tear film break-up time [TBUT], and Schirmer test) of DED. Associations of work productivity and activity impairment with symptom and signs were evaluated with linear regression models using generalized estimating equations and controlling for demographics and comorbidities.
MAIN OUTCOME MEASURES
Work productivity (employment, absenteeism, presenteeism, overall work impairment) and activity impairment.
RESULTS
Among 535 participants at baseline, 279 (52%) were employed, and mean activity impairment was 24.5%. Among those employed, the mean score was 2% for absenteeism, 18% for presenteeism, and 19.6% for overall work impairment. Higher Ocular Surface Disease Index (OSDI) symptom scores were associated with greater absenteeism, presenteeism, and activity impairment. Overall work impairment and activity impairment were greater by 4.3% and 4.8%, respectively, per 10-unit difference in OSDI score (P < 0.001). Longitudinal increases (worsening) in OSDI scores were associated with increasing impairment in work and non-work-related activity: 2.0% and 3.1% per 10 units in OSDI, respectively (P < 0.01). Worse corneal staining and TBUT were associated with higher overall work impairment and activity level (P ≤ 0.04). However, longitudinal changes in these two signs were not associated with changes in work productivity or activity impairment.
CONCLUSIONS
Worse symptoms of DED are associated with decreased work productivity and activity level, both cross-sectionally (interindividually) and longitudinally within person (intraindividually). Corneal staining and TBUT are associated with interindividual differences but not intraindividual changes in work productivity and activity impairment.
目的
评估干眼疾病（DED）严重程度与工作生产力和活动受损之间的关系。
设计
随机临床试验中的纵向观察性研究。
参与者
参加多中心干眼评估和管理（DREAM）研究的中重度 DED 患者。
方法
参与者在 0、6 和 12 个月时完成工作生产力和活动障碍问卷，并同时评估 DED 的症状和体征（结膜和角膜染色、泪膜破裂时间 [TBUT] 和泪液分泌试验）。使用广义估计方程的线性回归模型评估工作生产力和活动障碍与症状和体征之间的关联，并控制人口统计学和合并症。
主要观察指标
工作生产力（就业、缺勤、在职病假、整体工作障碍）和活动障碍。
结果
在基线时的 535 名参与者中，有 279 名（52%）就业，平均活动障碍为 24.5%。在就业者中，缺勤率平均为 2%，在职病假率为 18%，整体工作障碍率为 19.6%。更高的眼表疾病指数（OSDI）症状评分与更大的缺勤、在职病假和活动障碍相关。OSDI 评分每增加 10 个单位，整体工作障碍和活动障碍分别增加 4.3%和 4.8%（P<0.001）。OSDI 评分的纵向增加（恶化）与工作和非工作相关活动的损害增加相关：OSDI 每增加 10 个单位分别增加 2.0%和 3.1%（P<0.01）。更严重的角膜染色和 TBUT 与更高的整体工作障碍和活动水平相关（P≤0.04）。然而，这两个指标的纵向变化与工作生产力或活动障碍的变化无关。
结论
DED 的症状更严重与工作生产力和活动水平下降有关，无论是在横断面（个体间）还是个体内的纵向（个体内）。角膜染色和 TBUT 与工作生产力和活动障碍的个体间差异相关，但与个体内变化无关。
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