REVIEW - Employment and work disability in SLE: a systematic review

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Rheumatology Advance Access published online on January 19, 2009

Rheumatology, doi:10.1093/rheumatology/ken477

Employment and work disability in systemic lupus erythematosus: a

systematic review

Kim Baker1 and Janet Pope2

1School of Medicine, Queen's University, Kingston and 2Division of

Rheumatology, University of Western Ontario, St ph's Health Care,

London, Ontario, Canada

Abstract

Objectives. Many studies have provided information on employment and

work disability (WD) rates in patients with SLE, yet are often limited

by small sample sizes, poor generalizability or fail to examine the

risks and outcomes of WD. Our objective was to systematically review

the literature on WD in SLE to identify a more generalizable point

estimate and range of WD in SLE patients.

Methods. A search was conducted using Medline, EMBase, PubMed and

Cochrane databases to identify publications related to SLE and

employment and/or WD. Characteristics of the study samples and

employment/WD data were extracted. Descriptive statistics, a test for

heterogeneity and random effects models were performed to obtain

pooled estimates of employment and WD rates for all patients.

Results. Twenty-six studies with a total of 9886 SLE patients were

found; however, not all patients were reviewed for WD. Larger studies

demonstrated the prevalence of WD at 20–40%, and pooled estimates

found that 46% (95% CI 40%, 52%) were employed with SLE and 34% (95%

CI 24%, 44%) had WD. WD was related to psychosocial and

disease-related factors including age, race, socioeconomic status

(SES), education, disease activity and duration, pain, fatigue,

anxiety and neurocognitive involvement.

Conclusions. This study provides strong evidence that costs of SLE may

be very high due to job loss at a younger age in SLE patients, and

identifies some risk factors associated with WD, which should be

targeted by interventions aimed at preventing job loss.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken477v1?papetoc

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