Mohmmed Algamdi1, Mohsen Sadatsafavi2, Jolene H Fisher3, Julie Morisset4, Kerri A Johannson5, Charlene D Fell5, Martin Kolb6, Hélène Manganas4, Gerard Cox6, Andrea S Gershon7, Andrew J Halayko8, Nathan Hambly6, Nasreen Khalil9, Shane Shapera3, Teresa To10, Pearce G Wilcox9, Sabina Guler11, Christopher J Ryerson12. 1. Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada; Department of Pulmonary and Critical Care Medicine, King Fahad Medical City, Riyadh, Saudi Arabia. 2. Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada. 3. Department of Medicine, University of Toronto, Toronto, ON, Canada. 4. Département de Médecine, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada. 5. Department of Medicine, University of Calgary, Calgary, AB, Canada. 6. Department of Medicine, Firestone Institute for Respiratory Health, McMaster University, Hamilton, ON, Canada. 7. Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, Toronto, ON, Canada. 8. Departments of Internal Medicine and Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada. 9. Department of Medicine, University of British Columbia, Vancouver, BC, Canada. 10. Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada. 11. Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada. 12. Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada. Electronic address: chris.ryerson@hli.ubc.ca.
Abstract
BACKGROUND: Fibrotic interstitial lung diseases (ILDs) are highly morbid chronic disorders that frequently occur in working age individuals. The goal of this study was to determine workplace productivity loss, its determinants, and its estimated costs in patients with fibrotic ILD. METHODS: Patients with idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonitis, idiopathic nonspecific interstitial pneumonia, or unclassifiable ILD were identified from the six-center Canadian Registry for Pulmonary Fibrosis (CARE-PF). The Work Productivity and Activity Impairment questionnaire was used to determine health-related productivity loss. Independent predictors of low workplace productivity were identified by using multivariate regression. Patient data were compared with Canadian population census data. The average productivity loss (hours per week) and the individual's hourly wage were used to estimate the costs of productivity loss. RESULTS: Of 650 eligible patients, 148 (23%) were employed. Productivity loss was reported by 55% of employed patients with an average productivity loss of 7.8 ± 0.9 h per week (2.3 ± 0.6 h per week related to absenteeism and 5.5 ± 0.6 h per week related to presenteeism). Employment among patients with ILD aged 25 to 54 years was 23% lower than the age- and sex-matched general Canadian population (60% vs 83%; P < .001). Employment among patients with ILD aged ≥ 55 years was 18% lower than in the age- and sex-matched population (20% vs 38%; P < .001). Dyspnea and cough were independent predictors of workplace productivity loss. Estimated annual costs of productivity loss were 11,610 Canadian dollars per employee with ILD. CONCLUSIONS: Workplace productivity loss is common in fibrotic ILD, strongly correlated with symptom severity, and associated with significant cost.
BACKGROUND:Fibrotic interstitial lung diseases (ILDs) are highly morbid chronic disorders that frequently occur in working age individuals. The goal of this study was to determine workplace productivity loss, its determinants, and its estimated costs in patients with fibrotic ILD. METHODS:Patients with idiopathic pulmonary fibrosis, chronic hypersensitivitypneumonitis, idiopathic nonspecific interstitial pneumonia, or unclassifiable ILD were identified from the six-center Canadian Registry for Pulmonary Fibrosis (CARE-PF). The Work Productivity and Activity Impairment questionnaire was used to determine health-related productivity loss. Independent predictors of low workplace productivity were identified by using multivariate regression. Patient data were compared with Canadian population census data. The average productivity loss (hours per week) and the individual's hourly wage were used to estimate the costs of productivity loss. RESULTS: Of 650 eligible patients, 148 (23%) were employed. Productivity loss was reported by 55% of employed patients with an average productivity loss of 7.8 ± 0.9 h per week (2.3 ± 0.6 h per week related to absenteeism and 5.5 ± 0.6 h per week related to presenteeism). Employment among patients with ILD aged 25 to 54 years was 23% lower than the age- and sex-matched general Canadian population (60% vs 83%; P < .001). Employment among patients with ILD aged ≥ 55 years was 18% lower than in the age- and sex-matched population (20% vs 38%; P < .001). Dyspnea and cough were independent predictors of workplace productivity loss. Estimated annual costs of productivity loss were 11,610 Canadian dollars per employee with ILD. CONCLUSIONS: Workplace productivity loss is common in fibrotic ILD, strongly correlated with symptom severity, and associated with significant cost.