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Abstract
Objective To study transitions in work participation in patients with systemic lupus erythematosus (SLE) over a six year period. In addition, possible associations with having (and maintaining) paid work, and receiving work disability pension were studied, focusing on demographic, disease-related and work characteristics.
Methods Patients are participants of the Amsterdam SLE cohort. For this study, data from all patients with 5 yearly follow-up visits were used for the analyses. Logistic Generalized Estimating Equations were performed to identify associations between demographic, disease-related and work characteristics and having paid work. Logistic regression analyses were performed to study associations with maintaining paid work after 6 years and with work disability.
Results In total, 261 patients were included in the SLE cohort. A total of 220 SLE patients had at least 5 follow-up visits and were included in this study (table 1). Fifty-two percent had paid work at baseline, which decreased to 46% after six years (figure 1). Of the patients without paid work at baseline, 16% started working during follow-up of whom 29% maintained work. Maintaining work for ≥5 years during follow-up occurred in 29 percent. The majority (63%) of patients without work at baseline reported to have stopped working due to SLE-related symptoms. Having paid work was associated with younger age, higher level of education, shorter disease duration, lower organ damage index and supervisor support at work. Maintaining work for ≥5 years during follow-up was associated with regular working hours, skill discretion, decision authority and decision latitude. Work disability at baseline was associated with a longer disease duration.
Conclusion Having work is associated with various characteristics, but maintaining work is mainly associated with work characteristics. Work disability is only associated with longer disease duration. So, depending on the work situation of the patient as well as future whishes related to work participation, different types of interventions are needed to support work participation of patients with SLE.
Funding A research grant from the NVLE Foundation was used to perform this study.
Transitions in employment status of patients with SLE. Figure showing transitions in employment status during follow-up of the study. At baseline, 114 patients are having paid work and 106 patients are not having paid work. The figure shows the transitions patients are making between having paid work and having no paid work
Baseline demographic, disease related and work characteristics
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