Employment status and socio-economic burden in systemic sclerosis: a cross-sectional survey

Rheumatology (Oxford). 2010 May;49(5):982-9. doi: 10.1093/rheumatology/kep400. Epub 2010 Feb 16.

Abstract

Objective: To assess employment status and socio-economic burden in SSc patients.

Methods: Eighty-seven SSc patients (72 females), fulfilling the ACR or the Leroy and Medsger criteria, or both, were evaluated for employment status, socio-economic burden and handicap. Statistical analysis involved Mann-Whitney U-test and Fisher's exact test and backward stepwise regression analysis.

Results: In total, 60.9% of the SSc patients were on full-time sick leave and 35.6% were receiving a disability pension. On univariate analysis, myalgia was the only clinical manifestation more frequently encountered in sick-leave patients than others (73.6 vs 47.1%; P = 0.012). Karnofsky performance status (KPS) was lower in SSc patients who were on sick leave or were receiving a disability pension than others [78.5 (10.6) vs 85.8 (9.0); P = 0.004 and 78.1 (8.7) vs 83.1 (11.2); P = 0.016, respectively]. In addition, greater global, hand and mouth handicaps and depression were observed in patients on sick leave [HAQ 0.9 (0.7) vs 0.6 (0.5); P = 0.021; Cochin Hand Function Scale 21.7 (18.9) vs 10.7 (12.1); P = 0.003; mouth handicap scale 20.2 (10.8) vs 14.6 (10.0); P = 0.014; and depression dimension of the hospital anxiety and depression scale 7.1 (3.9) vs 4.8 (3.4); P = 0.003]. On multivariate analysis, factors associated with sick leave were KPS [odds ratio (OR) 0.92; 95%CI 0.88, 0.98] and myalgias (OR 3.19; 95% CI 1.19, 8.58), and the factor associated with receiving a disability pension was decreased income (OR 8.19; 95% CI 2.67, 25.12).

Conclusions: SSc patients commonly have to take full-time sick leave from work. Despite such patients receiving disability pensions, the socio-economic burden is considerable.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Disability Evaluation
  • Employment / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Regression Analysis
  • Scleroderma, Systemic / economics*
  • Scleroderma, Systemic / physiopathology
  • Scleroderma, Systemic / psychology
  • Severity of Illness Index
  • Sick Leave / economics
  • Sick Leave / statistics & numerical data*
  • Sickness Impact Profile
  • Socioeconomic Factors*