Thu0637 academic Achievement, Employment Status, Work Productivity and Activity Impairment in Adults With Juvenile Idiopathic Arthritis (Jia): Determinants and Consequences

Abstract

Background:Changes occurring in childhood due to JIA leads to activity and work impairment during their transition to adulthood. The factors impairing work and overall activity among adults with JIA need to be explored to formulate policy decisions and rehabilitation measures.Objectives:· To assess the level of academic achievement, employment, work productivity and activity impairment among adults suffering from JIA· To identify factors determining activity impairment among adults with JIAMethods:Consecutive adults classified as JIA (1) were included. Consenting patients filled a questionnaire comprising of demographic details, occupational/educational status, Indian health associated questionnaire (iHAQ), Work Productivity and Activity Impairment score (WPAI) (2)in the language of their choice. Clinical evaluation for disease activity and damage was done and remission was assessed by Wallace criteria. Remission was defined as ever remission: >3 months and sustained remission: > 6 months of disease control. Appropriate statistical tests to assess association and correlation of various factors with WPAI were used.Results:Demography (n=51) is depicted in table 1. Never attaining remission resulted in significantly higher college dropouts (8 vs 17, p<0.05), functional impairment (mean iHAQ 1.08 vs 0.5, p<0.05) and articular damage (mean JADI A 3 vs 8, p<0.01). Disease duration, JADI A and iHAQ correlated well (r2 >.400, p<0.05) with measures of WPAI (table 2). Assessment of patient variables like gender, occupation, disease activity and remission status (figure 1) showed that women, especially the homemakers and individuals with moderate to high disease activity had significant activity impairment (P<0.05).Conclusion:Early effective treatment directly impacts employment levels and activity in adults with JIA. Homemakers in middle- and low-income countries have the most impairment in activity as they cannot alter their work. Replacement costs for homemakers would be an added financial burden to the family and is seldom captured by studies. Our study highlights the need to look further into the indirect and intangible costs involving women that will help policy makers formulate effective economic policies for individuals with JIA.References:[1] Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004Feb;31(2):390–2.[2] Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics. 1993Nov;4(5):353–65.Table 1 Demographic, educational, occupational, health profile and WPAI measures of adults with JIA S.No Parameter (N=51)MedianIQR 1 2 3 Age Disease duration (years) Duration of treatment (years) 22958105 4 WPAI Measures (in percentage)Overall Activity ImpairmentOverall Work Impairment (N=14)Presentism (N=12)Absenteeism (N=14)4064.064033.035061.6672.0551.14 Frequency (n) ...