Interaction effect of psychological distress and asthma control on productivity loss?

Abstract

Little is known about the potential synergistic effect of comorbid psychological distress (PD) and uncontrolled asthma (UA) on productivity loss. We estimated the productivity loss associated with the combination of these two potentially preventable conditions in employed adults with asthma.A population-based random sample of 300 adults with asthma in British Columbia, Canada, was prospectively recruited between Dec 2010 and Aug 2012. PD and productivity loss due to absenteeism and presenteeism was measured using validated instruments, and asthma control was ascertained using 2010 Global Initiative for Asthma management strategy. We used two-part regression models to study the contribution of UA and PD to productivity loss.Compared with reference group (controlled asthma (CA)+noPD), those with UA+noPD had CAD$286 (95%CI $276-297) weekly productivity loss, and those with CA+PD had CAD$465 ($445-485). Those with UA+PD had CAD$449 (437-462) in productivity loss. There was no significant interaction effect of PD with asthma control levels on productivity loss ( p=0.22).In patients without PD, uncontrolled asthma was associated with a higher productivity loss than controlled asthma, but this was not the case in patients with PD. This finding can be explained by the fact that the contribution of PD to productivity loss is so large that there is no room for synergy with asthma control. Future studies should assess the impact of interventions that modify PD in patients with asthma. @ERSpublications With psychological distress, the further additive effect of asthma control on productivity loss is minimal

The impact of comorbidities on productivity loss in asthma patients

“…In that study, work disability was defined as long-term sickness absence (≥90 days) and receiving a disability pension. Results of current study are inline with our previous study that demonstrated the presence of comorbid psychological conditions in asthma patients will increase productivity loss significantly [28]. …”

Working while unwell: Workplace impairment in people with severe asthma

“…The findings for depression and anxiety are novel, yet are not unexpected, given studies in non‐asthma populations . Effects of depression and anxiety on productivity may be even more profound than asthma control, highlighting the importance of improving mental health in severe asthma. We identified few other predictors of presenteeism among a range of demographic, asthma and health status characteristics.…”

“…The findings for depression and anxiety are novel, yet are not unexpected, given studies in nonasthma populations 42,43. Effects of depression and anxiety on productivity may be even more profound than asthma control,44 Associations between asthma severity characteristics, health status characteristics and immunological indicators at baseline. Abbreviations: CI, confidence interval; FEV 1 %, forced expiratory volume in 1 s % predicted (10 unit change); HADS, Hospital Anxiety and Depression Scale: OR, odds ratio highlighting the importance of improving mental health in severe asthma.…”

The Global Impact of Asthma in Adult Populations

“…Ojeda et al estimated that adults had 1.5 missed days per month due to asthma symptoms and 4.9 days per month of reduced productivity [52]. Uncontrolled asthma causes more lost productivity compared to patients with well-controlled symptoms, with a loss of approximately CAD$286 (US$219) per week [50,54]. In Spain, approximately 285 Euros (US$315) were attributed to lost workdays per patient each month [50,52].…”