Sofie Persson1, Pierre Johansen2, Emelie Andersson1, Peter Lindgren1,3, Desirée Thielke2, Brian L Thorsted2, Johan Jendle4, Katarina Steen Carlsson1,5. 1. Swedish Institute for Health Economics, Lund, Sweden. 2. Novo Nordisk A/S, Søborg, Denmark. 3. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockhom, Sweden. 4. Institution of Medical Sciences, Örebro University, Örebro, Sweden. 5. Department of Clinical Sciences, Malmö, Health Economics Unit, Lund University, Lund, Sweden.
Abstract
AIMS: To analyse days absent from work related to individual microvascular, macrovascular and other complications of type 2 diabetes (T2D) and to identify key drivers of absence. MATERIALS AND METHODS: National health and socio-economic individual-level data were analysed for the years 1997 to 2016 for people with T2D, and age-, sex- and residential region-matched controls (5:1) using linkage to Swedish national administrative registers, based on personal identity numbers. Regression analyses accounting for individual-level clustering and education were estimated to obtain days absent by individual complications. Alternative analyses, for example, workforce indicator and age subgroups, were explored for robustness and comparison purposes. RESULTS: A total of 413 000 people with T2D aged <66 years, comprising 4.9 million person-years, was included. The crude proportion with any absence was higher among those with T2D compared to controls (47% vs. 26%) in the index year, and the median (IQR) number of days was higher (223 [77;359] vs. 196 [59;352]) if any absence. Regression analyses showed that complications per se were a key driver of days absent: stroke (+102 days); end-stage renal disease (+70 days); severe vision loss (+56 days); and angina pectoris, heart failure, and osteoarthritis (+53 days each). The alternative analyses showed similar levels of days absent and age subgroups differed in expected directions. CONCLUSIONS: This study provides evidence of the persisting impact on productivity from complications that supports continued efforts to reduce risk factors in T2D. Future studies on burden of disease and economic evaluations of new therapies and disease management may use this new set of complication-specific estimates to improve understanding of the value of reducing complications.
AIMS: To analyse days absent from work related to individual microvascular, macrovascular and other complications of type 2 diabetes (T2D) and to identify key drivers of absence. MATERIALS AND METHODS: National health and socio-economic individual-level data were analysed for the years 1997 to 2016 for people with T2D, and age-, sex- and residential region-matched controls (5:1) using linkage to Swedish national administrative registers, based on personal identity numbers. Regression analyses accounting for individual-level clustering and education were estimated to obtain days absent by individual complications. Alternative analyses, for example, workforce indicator and age subgroups, were explored for robustness and comparison purposes. RESULTS: A total of 413 000 people with T2D aged <66 years, comprising 4.9 million person-years, was included. The crude proportion with any absence was higher among those with T2D compared to controls (47% vs. 26%) in the index year, and the median (IQR) number of days was higher (223 [77;359] vs. 196 [59;352]) if any absence. Regression analyses showed that complications per se were a key driver of days absent: stroke (+102 days); end-stage renal disease (+70 days); severe vision loss (+56 days); and angina pectoris, heart failure, and osteoarthritis (+53 days each). The alternative analyses showed similar levels of days absent and age subgroups differed in expected directions. CONCLUSIONS: This study provides evidence of the persisting impact on productivity from complications that supports continued efforts to reduce risk factors in T2D. Future studies on burden of disease and economic evaluations of new therapies and disease management may use this new set of complication-specific estimates to improve understanding of the value of reducing complications.
Authors: Chinmay Dwibedi; Emelia Mellergård; Amaru Cuba Gyllensten; Kristoffer Nilsson; Annika S Axelsson; Malin Bäckman; Magnus Sahlgren; Stephen H Friend; Sofie Persson; Stefan Franzén; Birgitta Abrahamsson; Katarina Steen Carlsson; Anders H Rosengren Journal: NPJ Digit Med Date: 2022-05-11
Authors: Tony Blakely; Finn Sigglekow; Muhammad Irfan; Anja Mizdrak; Joseph Dieleman; Laxman Bablani; Philip Clarke; Nick Wilson Journal: PLoS Med Date: 2021-11-30 Impact factor: 11.069