Determinants of Work Disability in Patients with Systemic Sclerosis: A Longitudinal Study of the GENISOS Cohort

Abstract

Objectives To determine the prevalence, correlates, and predictors of work disability (WD) in the Genetics versus ENvironment In Scleroderma Outcome Study (GENISOS). We hypothesized that WD in systemic sclerosis (SSc) is a function of demographic, clinical, and psychosocial factors. Methods Patients enrolled in the GENISOS cohort were subdivided in 3 groups: work disabled, working, and retired or homemakers. The latter group (n=29) was excluded from further analysis. We used logistic regression analysis with a forward hierarchical variable selection strategy to investigate the independent correlates of WD at enrollment. Cox regression proportional Hazard’s model with a similar variable selection strategy was utilized to determine the predictors of WD in those working at enrollment. Results Overall, 284 patients with mean age of 48.7 years and disease duration of 2.5 (±1.6) years were enrolled into the GENISOS cohort, consisting of 83.5% female, 46.8% Caucasian, 28.9% Hispanic, and 20.4% African American. Patients were longitudinally followed for 3.9 (±3.6) years in 1438 study visits. At enrollment, 124 patients (43.7%) were work disabled whereas 131 (46.1%) were working. Lower education (p<0.001), higher Medsger Lung Severity Index (p=0.012), higher Fatigue Severity Score (FSS) (p=0.008), and less social support (p<0.001) correlated independently with WD. Of those working at baseline, 35 (26.7%) eventually developed WD. Non-Caucasian ethnicity (p=0.038), lower DLCO %predicted value (p=0.038), and higher FSS (p=0.009) at enrollment independently predicted WD on follow-up visits. Conclusion Demographic, clinical, and psychosocial factors correlate with WD cross-sectionally and predict WD longitudinally in the patients with SSc.

Labor force participation among Asian immigrant women: Findings from the 2007 American Community Survey

“…The dependent variable was a categorical measure of labor force participation indicating whether a person was a full‐time employee, a part‐time employee, or not in the labor force. By using the number of hours worked per week a study participant reported, full‐time employment was defined as 40 or more hours worked per week (Benda, Toombs, & Corwyn, ; Sharif et al., ).…”

Selected methods of rehabilitation in systemic sclerosis

“…Increasingly, attention has been drawn to the problem of work incapacity in patients with SSc. Sharif et al have demonstrated incapacity for work in 43.7% of patients already at an early stage of systemic sclerosis [12]. Consequently, it is essential to provide patients with comprehensive and individually adjusted therapy.…”

“…Sharif i wsp. wykazali niezdolność do pracy u 43,7% pacjentów już we wczesnym okresie SSc [12]. Dlatego konieczne jest prowadzenie kompleksowej i indywidualnie dobranej terapii.…”

The Primary Care Physician in the Early Diagnosis of Systemic Sclerosis: The Cornerstone of Recognition and Hope

“…It is a major contributor of disability in SSc, paralleling that of patients with cancer undergoing chemotherapy 58,59 .…”