Work disability rate high among lupus patients

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May 18, 2004

Work disability rate high among lupus patients

New York, NY - Work prognosis for systemic lupus erythematosus (SLE)

patients is pooreven compared with other chronic diseases such as rheumatoid

arthritis (RA), according to a new study presented last week here at the 7th

International Congress on Systemic Lupus Erythematosus and Related

Conditions [1].

Dr Yelin (University of California, San Francisco) and colleagues

interviewed 919 SLE patients and found that nearly half could no longer work

because of their diseasethe work disability rate was 47% among those who

were working when they were first diagnosed with SLE. And, unlike with RA,

most SLE patients left the work force due to disease severity as opposed to

the nature of their jobs. Moreover, the study showed, work disability tends

to occur earlier among SLE patients, potentially robbing them of the last 2

to 3 decades of their career.

" The work prognosis is quite poor for SLE relative to other diseases, " Yelin

commented. " The [disease] onset is early in a career before the accumulation

of seniority and assets . . . [and] unfortunately in this case, since it is

primarily the severity of the disease that dictates work status, there are

no interventions. "

Extensive hour-long interviews

SLE patients were recruited to the study via community-based providers,

tertiary care centers, and community-based sources such as public-service

announcements. The majority (91%) were female, with a mean age of 24.6 years

and an average disease duration of 12.7 years. In this cohort, 23% of

patients had renal involvement, 8% had lung involvement, 35% had thrombotic

involvement, and 18% had a history of seizures.

Extensive one-hour telephone interviews (conducted in 2003) gauged medical

history, current disease severity, history of complications, healthcare

utilization, demographics, and employment at time of diagnosis and at the

time of the interview.

Factors that affected work disability in SLE include advancing age, disease

duration, and low levels of education, history of SLE-related seizures, and

poor physical- or mental-health status.

Overall, employment rate declined 25% between diagnosis and interview

yearfrom 71% to 46%. During the year of their diagnosis, 651 patients were

gainfully employed and 263 were not, the study showed. Of those working at

the time of their diagnosis, 422 were still working during the year that

they were interviewed and 492 were not. In addition, the amount of time

spent working declined from diagnosis until the time of the interview.

Specifically, there was a 40.3% reduction in hours worked per week, a 29.2%

reduction in weeks worked per year, and a 38% reduction in hours worked per

year.

By contrast, among the 263 patients who were not working at the time of

their SLE diagnosis, 184 were still not working when the interviews were

conducted, but 79 were now employed.

Notably, gender, marital status, race, and education beyond high school did

not affect work disability in SLE, nor did the presence of renal, lung, or

thrombotic complications and/or physical or cognitive demands of the job,

the study found.

" Participation in the labor market is certainly the key to maintaining

financial stability, and when you withdraw from work, you lose the chance to

make new friends . . . so it affects more than the ability to maintain

financial stability, " Yelin commented. " Every illness has a work-disability

footprint, [and] in SLE, work disability occurs earlier in life, so patients

often lose their ability to accrue long-term, financial stability. "

Mann

Source

1. Yelin E, Trupin L, Katz P, et al. Presentation: Work disability and SLE:

Incidence and correlates. New York, NY: 7th International Congress on

Systemic Lupus Erythematosus and Related Conditions: Session on long-term

outcome: heart and vessels; May 9-13, 2004:Abstract 23A.