ISR Autumn Meeting 2018

3rd Place Poster Award

Dr Sinead Maguire

TBA (18A145)

High Unemployment Rates in Irish patients with Ankylosing Spondylitis

Author(s)

S Maguire, G Fitzgerald, C Sheehy, F O’Shea

Department(s)/Institutions

on behalf of the ASRI Steering Committee University Hospital Waterford & St James’s Hospital

Introduction

Previous registry studies have noted increased rates of unemployment in patients with ankylosing spondylitis (AS)(1-2). With improved treatment options and earlier detection of AS, it was anticipated that this would no longer be true.

Aims/Background

The Ankylosing Spondylitis Registry of Ireland (ASRI) is a source of epidemiological data on AS patients in Ireland. The aim of this study was to examine unemployment rates in this population and possible links with disease activity, function and quality of life.

Method

An analysis of the current patient population of the ASRI was performed using IBM SPSS Statistics version 25. Comparison of the mean ASQoL, HAQ, BASDAI, BASFI and BASMI scores were carried out between the employed versus the unemployed. An independent two tailed t test and a Mann Whitney U test was then carried out to determine significance. Further analysis was then done on age and disease duration.

Results

At the time of analysis 734 patients were enrolled. The mean age was 45.02, with 77% males and 23% female, mean duration of disease 18 years (means: ASQoL 6.57, HAQ 0.54, BASDAI 4.02, BASFI 3.63, BASFI 3.58). Unemployment rate in the ASRI population was 23%, which is noticeably higher than the national unemployment of 6%(3). Those patients were also noted to have higher ASQoL (9.74 versus 5.62), HAQ (0.85 versus 0.45), BASDAI (5.31 versus 3.65), and BASFI scores (5.19 versus 3.19)(figure 1). The difference between these means was statistically significant (p<0.05) across all 4 measures. However, BASMI scores were significantly lower in the unemployed (3.75 versus 3.04). No statistically significant difference was detected between genders. The distribution of age and disease duration was determined to be equal between the groups.

Conclusions

There is a higher prevalence of unemployment in the AS population as compared to the general population of Ireland. Unemployed AS patients tend to have decreased quality of life, poorer level of function, and higher levels of disease activity. Further research is needed to determine causation between level of disease activity and employment.


Figure