The assessment of presenteeism and activity impairment in Behçet's syndrome and recurrent aphthous stomatitis: a multicentre study.

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Karacayli U., Adesanya A., Aksoy A., Belem J. M. F. M., Cardin N. B., Sarı F. B., ...More

Rheumatology (Oxford, England), vol.61, no.4, pp.1538-1547, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 61 Issue: 4
  • Publication Date: 2022
  • Doi Number: 10.1093/rheumatology/keab581
  • Journal Name: Rheumatology (Oxford, England)
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, EMBASE, International Pharmaceutical Abstracts, MEDLINE
  • Page Numbers: pp.1538-1547
  • Keywords: Behcet's syndrome, aphthous stomatitis, presenteeism, daily activity, mediation analysis, QUALITY-OF-LIFE, ORAL ULCER ACTIVITY, WORK PRODUCTIVITY, COMPOSITE INDEX, OUTCOME MEASURE, DISEASE, HEALTH, ABSENTEEISM, SMOKING, IMPACT
  • Marmara University Affiliated: Yes

Abstract

Objective To evaluate key factors for presenteeism and activity impairment in multinational patients with Behcet's syndrome (BS) and recurrent aphthous stomatitis (RAS). Methods In this cross-sectional study, 364 BS patients from Jordan, Brazil, the United Kingdom and Turkey and 143 RAS patients from the United Kingdom and Turkey were included. The Work Productivity Activity Impairment (WPAI) scale was used for presenteeism and activity impairment. Mediation analyses were performed to evaluate both direct and indirect causal effects. Results Presenteeism score was higher in active patients with genital ulcers and eye involvement as well as patients with comorbidities and current smokers than the others in BS (P <0.05). In RAS, presenteeism score was elevated by oral ulcer activity in the direct path (P =0.0073) and long disease duration as a mediator in the indirect path (P =0.0191). Patients with active joint involvement had poor scores in absenteeism, presenteeism, overall impairment and activity impairment compared with those of inactive patients (P <0.05). Using mediation analysis, the activity impairment score was directly mediated by joint activity (P =0.0001) and indirectly mediated through oral ulcer-related pain in BS (P =0.0309). Conclusion In BS, presenteeism was associated with disease activity, presence of comorbidities and being a current smoker, whereas in RAS, presenteeism was associated with oral ulcer activity and increased length of the disease. Moreover, activity impairment was adversely affected by joint activity and oral ulcer related pain in BS. Patients need to be empowered by using appropriate treatment strategies in their working environment and daily life.