Burden of Systemic Lupus Erythematosus on Work Productivity and Daily Living Activity: A Cross-Sectional Study Among Malaysian Multi-Ethnic Cohort

Özet

Objectives: This study aims to assess the self-reported work productivity and activity daily living (ADL) impairment among Malaysian patients withsystemic lupus erythematosus (SLE) and to examine their associated factors.Patients and methods: This cross-sectional study included 167 SLE patients (21 males, 146 females; mean age 38.2±9.8 years;range, 20 to 60 years) recruited from the outpatient Rheumatology and Nephrology clinics. Face-to-face interviews were conducted to recordpatients’ socio-demographics (age, sex, ethnicity, marital status, and occupation) and SLE disease characteristics (system involvement, ageonset, and presence of organ damage). Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index-2000(SLEDAI-2K). Short form 36 (SF-36) was used to determine health-related quality of life (HRQoL) while Work Productivity and Activity Impairment(WPAI) questionnaire was used to assess the four domains of absenteeism, presenteeism, overall work productivity, and non-work relatedADL impairment. Univariate analyses and multivariable regression analysis examined the association of demographic variables, SLE diseasecharacteristics, and activity with reduced HRQoL and WPAI scores.Results: The majority of the patients were Malays (59.3%), followed by Chinese (34.7%) and Indian (3.6%) patients. More than two-thirds of thepatients reported some degree of impairment in their work productivity and ADL due to the disease. The absenteeism rate was 10.4% in the past oneweek and their indirect costs were 2,875.17 Malaysian ringgits (US $701.22) in the past seven days. Significant predictors of higher work productivityand ADL impairment scores were higher disease activity, more frequent SLE flares, lupus nephritis, and hematological involvement of SLE. Patientswith higher work productivity and ADL impairment scores were also strongly associated with poor QoL. No ethnic disparities of work productivityand ADL impairment were found.Conclusion: Systemic lupus erythematosus significantly affected the overall productivity in work and non-work related activity in our Malaysianmulti-ethnic cohort and both impairments were significantly associated with poor QoL.