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The Journal of Clinical Psychiatry Mar 2021Estimates of prevalence and burden of treatment-resistant depression (TRD) vary widely in the literature. This study evaluated the prevalence and burden of TRD and the...
OBJECTIVE
Estimates of prevalence and burden of treatment-resistant depression (TRD) vary widely in the literature. This study evaluated the prevalence and burden of TRD and the share of TRD in the burden of medication-treated major depressive disorder (MDD) using the most commonly accepted definition of TRD and a novel bottom-up approach.
METHODS
Prevalence and health care burden of TRD were estimated by synthetizing inputs across 4 similarly designed claims studies in adults covered by Medicare, Medicaid, commercial plans, and the US Veterans Health Administration (VHA). Productivity (absenteeism and presenteeism) and unemployment burden were estimated based on inputs from a study conducted with data from the Kantar National Health and Wellness Survey (NHWS; 2017). A targeted literature search for additional inputs was performed. A cost model was developed to estimate the burden of TRD and medication-treated DSM-5-defined MDD in the United States. Study outcomes were the 12-month prevalence of TRD and the annual health care, productivity, and unemployment burden of TRD and medication-treated MDD in the United States.
RESULTS
The estimated 12-month prevalence of medication-treated MDD in the United States was 8.9 million adults, and 2.8 million (30.9%) had TRD. The total annual burden of medication-treated MDD among the US population was $92.7 billion, with $43.8 billion (47.2%) attributable to TRD. The share of TRD was 56.6% ($25.8 billion) of the health care burden, 47.7% ($8.7 billion) of the unemployment burden, and 32.2% ($9.3 billion) of the productivity burden of medication-treated MDD.
CONCLUSIONS
TRD is associated with disproportionate health care costs and unemployment, suggesting potentially large economic and societal gains with effective management.
Topics: Absenteeism; Adult; Antidepressive Agents; Cost of Illness; Depressive Disorder, Major; Depressive Disorder, Treatment-Resistant; Health Care Costs; Humans; Prevalence; United States
PubMed: 33989464
DOI: 10.4088/JCP.20m13699 -
Annals of the Rheumatic Diseases Jun 2020The past decades have seen rapid advances in the treatment of rheumatoid arthritis (RA). In particular, the introduction of biologic and targeted synthetic...
BACKGROUND
The past decades have seen rapid advances in the treatment of rheumatoid arthritis (RA). In particular, the introduction of biologic and targeted synthetic disease-modifying antirheumatic drugs have improved clinical outcomes and reconfigured traditional RA cost compositions.
OBJECTIVES
To map the existing evidence concerning cost of illness of RA, as the treatment pathway evolves in the biologic era, and examine how costs have been measured and estimated, in order to assemble and appropriately interpret available data.
METHODS
Systematic review of studies that estimated the costs of patients with RA. Multiple electronic databases were searched to identify studies published between 2000 and 2019. The reported total costs and cost components were evaluated according to the study and population characteristics. The Cochran-Armitage test was used to determine statistically significant trends in increasing or decreasing proportions over time.
RESULTS
Overall, 72 studies were included. Drug costs compromised the main component (up to 87%) of direct costs with an increasing trajectory over time, although not statistically significant. The proportion of costs for hospitalisation showed a statistically significant decrease chronologically (p=0.044). Indirect costs, primarily associated with absenteeism and work disability accounted for 39% to 86% of total costs. The reported indirect costs are highly sensitive to the approach to estimation.
CONCLUSIONS
A decreasing trend in inpatient costs chronologically suggested a cost shift in other components of direct costs. Indirect costs still contributed a considerable proportion of total costs, with work disability being the main cost component. Economic analyses that do not incorporate or appropriately measure indirect costs will underestimate the full economic impact of RA.
Topics: Absenteeism; Arthritis, Rheumatoid; Biological Products; Cost of Illness; Disabled Persons; Drug Costs; Employment; Health Care Costs; Humans
PubMed: 32245893
DOI: 10.1136/annrheumdis-2019-216243 -
BMC Public Health Dec 2019Healthy lifestyles play an important role in the prevention of premature death, chronic diseases, productivity loss and other social and economic concerns. However,...
BACKGROUND
Healthy lifestyles play an important role in the prevention of premature death, chronic diseases, productivity loss and other social and economic concerns. However, workplace interventions to address issues of fitness and nutrition which include work-related outcomes are complex and thus challenging to implement and appropriately measure the effectiveness of. This systematic review investigated the impact of workplace nutrition and physical activity interventions, which include components aimed at workplace's physical environment and organizational structure, on employees' productivity, work performance and workability.
METHODS
A systematic review that included randomized controlled trials and or non-randomized controlled studies was conducted. Medline, EMBASE.com, Cochrane Library and Scopus were searched until September 2016. Productivity, absenteeism, presenteeism, work performance and workability were the primary outcomes of our interest, while sedentary behavior and changes in other health-related behaviors were considered as secondary outcomes. Two reviewers independently screened abstracts and full-texts for study eligibility, extracted the data and performed a quality assessment using the Cochrane Collaboration Risk-of-Bias Tool for randomized trials and the Risk-of-Bias in non-randomized studies of interventions. Findings were narratively synthesized.
RESULTS
Thirty-nine randomized control trials and non-randomized controlled studies were included. Nearly 28% of the included studies were of high quality, while 56% were of medium quality. The studies covered a broad range of multi-level and environmental-level interventions. Fourteen workplace nutrition and physical activity intervention studies yielded statistically significant changes on absenteeism (n = 7), work performance (n = 2), workability (n = 3), productivity (n = 1) and on both workability and productivity (n = 1). Two studies showed effects on absenteeism only between subgroups.
CONCLUSIONS
The scientific evidence shows that it is possible to influence work-related outcomes, especially absenteeism, positively through health promotion efforts that include components aimed at the workplace's physical work environment and organizational structure. In order to draw further conclusions regarding work-related outcomes in controlled high-quality studies, long-term follow-up using objective outcomes and/or quality assured questionnaires are required.
TRIAL REGISTRATION
Registration number: PROSPERO CRD42017081837.
Topics: Absenteeism; Efficiency; Exercise; Humans; Non-Randomized Controlled Trials as Topic; Nutritional Status; Occupational Health Services; Program Evaluation; Randomized Controlled Trials as Topic; Work Performance
PubMed: 31830955
DOI: 10.1186/s12889-019-8033-1 -
BMC Public Health Dec 2023Randomized trials have shown that vitamin C shortens the duration of common colds. Some trials reported greater effects on severe cold symptoms compared with mild... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Randomized trials have shown that vitamin C shortens the duration of common colds. Some trials reported greater effects on severe cold symptoms compared with mild symptoms. This review systematically compares the effects of vitamin C on severe and mild common cold symptoms.
METHODS
We included all placebo-controlled trials of orally administered vitamin C in doses of at least 1 g/day for the common cold for people in good health at baseline. The analysis was restricted to trials which reported both the total duration of the common cold, and the severity of the common cold measured using severity scales, the duration of more severe stages of the cold, or proxies for severe colds such as days indoors. Findings were pooled using the inverse variance, fixed effect options of the metacont function of the R package meta to calculate the ratio of means estimate.
RESULTS
Fifteen comparisons from 10 trials which reported both mild and severe symptoms were identified. All trials were randomized and double-blind. Compared to placebo, vitamin C significantly decreased the severity of the common cold by 15% (95% CI 9-21%). The direct comparison of the effect of vitamin C on mild and severe symptoms was limited to five comparisons which found that vitamin C had a significant benefit on the duration of severe symptoms. In this subset, there was a significant difference in the size of the effect of vitamin C on the overall duration of colds versus the duration of severe colds (P = 0.002), and vitamin C had no significant effect on the duration of mild symptoms.
CONCLUSIONS
The common cold is the leading cause of acute morbidity and a major cause of absenteeism from work and school. However, absenteeism is dependent on the severity of symptoms. The finding that vitamin C may have a greater effect on more severe measures of the common cold is therefore important. Further research on the therapeutic effects of vitamin C on the common cold should measure outcomes of differing levels of severity.
Topics: Humans; Common Cold; Ascorbic Acid; Vitamins; Double-Blind Method; Absenteeism; Randomized Controlled Trials as Topic
PubMed: 38082300
DOI: 10.1186/s12889-023-17229-8 -
La Tunisie Medicale Jun 2023To assess the impact of non-insulin-requiring Type 2 diabetes (T2D) on professional activity in terms of absenteeism, presenteeism, reduced productivity and daily...
AIM
To assess the impact of non-insulin-requiring Type 2 diabetes (T2D) on professional activity in terms of absenteeism, presenteeism, reduced productivity and daily activities.
METHODS
We conducted a comparative cross-sectional survey of two groups of employees in the Cap Bon textile sector: 75 diabetic and 75 workers free from any endocrinological pathology, seen in the occupational medicine group of Nabeul. The study was spread over 10 months from March 2020.A questionnaire was administered containing the Arabic version of WPAI-GH « Work Productivity and Activity Impairment Questionnaire-General Health » to assess absenteeism, presenteeism, decreased productivity and daily activity.
RESULTS
A total of 150 workers participated in our study. Diabetes was responsible for absenteeism of 5.1 ± 8.9%, presenteeism of 4.8 ± 6,4%, a decrease in productivity of 7.3 ± 7.8% and a decrease in the daily activity of 14,6 ± 10%. The rate of presenteeism, decrease in productivity and daily activity were significantly higher in T2D (p = 0.015). Absenteeism was associated with degenerative complications (p< 0,001). Presenteeism was associated with the duration of the course of diabetes (p < 0,001).
CONCLUSION
Diabetes has a negative impact in productivity and general activity. Early and multidisciplinary management of these patients improves their professional performance.
Topics: Humans; Diabetes Mellitus, Type 2; Cross-Sectional Studies; Efficiency; Surveys and Questionnaires; Absenteeism
PubMed: 38372549
DOI: No ID Found -
The Spine Journal : Official Journal of... May 2022Health can impact work performance through absenteeism, time spent away from work, and presenteeism, inhibited at-work performance. Low back pain is common and costly,...
BACKGROUND CONTEXT
Health can impact work performance through absenteeism, time spent away from work, and presenteeism, inhibited at-work performance. Low back pain is common and costly, both in terms of direct medical expenditures and indirect reduced work performance.
PURPOSE
Surgery for lumbar spinal pathology is an important part of treatment for patients who do not respond to nonsurgical management. While the indirect costs of return to work and absenteeism among employed patients undergoing lumbar spine surgery have been studied, little work has been done to quantify presenteeism before and after lumbar spine surgery.
STUDY DESIGN/SETTING
Prospective cohort study at a single high-volume urban musculoskeletal specialty hospital.
PATIENT SAMPLE
Patients undergoing single-level lumbar spinal fusion and/or decompression surgery.
OUTCOME MEASURES
Presenteeism and absenteeism were measured using the World Health Organization's Health and Work Performance Questionnaire before surgery, as well as 6 weeks, 6 months, and 12 months after surgery.
METHODS
Average presenteeism and absenteeism were evaluated at pre-surgical baseline and each follow-up timepoint. Monthly average time lost to presenteeism and absenteeism were calculated before surgery and 12 months after surgery. Study data were collected and managed using REDCap electronic data capture tools with support from Clinical and Translational Science Center grant, UL1TR002384. One author discloses royalties, private investments, consulting fees, speaking/teaching arrangements, travel, board of directorship, and scientific advisory board membership totaling >$300,000.
RESULTS
We enrolled 134 employed surgical patients, among whom 115 (86%) responded at 6 weeks, 105 (78%) responded at 6 months, and 115 (86%) responded at 12 months. Preoperatively, mean age was 56.4 years (median 57.5), and 41.0% were women; 68 (50.7%) had only decompressions, while 66 (49.3%) had fusions. Among respondents at each time point, 98%, 92%, and 92% were still employed, among whom 76%, 96%, and 96% had resumed working, respectively (median 29 days). Average at-work performance among working patients (who responded at each pair of timepoints) moved from 75.4 to 78.7 between baseline and 6 weeks, 71.8 to 85.9 between baseline and 6 months, and 73.0 to 88.1 between baseline and 12 months. Gains were concentrated among the 52.0% of patients whose at-work performance was declining (and low) leading up to surgery. Average absenteeism was relatively unmoved between baseline and each follow-up. Before surgery, the monthly average time lost to presenteeism and absenteeism was 19.8% and 18.9%, respectively; 12 months after surgery, these numbers were 9.7% and 16.0%; changes represent a mitigated loss of 13.0 percentage points of average monthly value.
CONCLUSIONS
Presenteeism and absenteeism contributed roughly evenly to preoperative average monthly lost time. Although average changes in absenteeism and 6-week at-work performance were small, average changes in at-work performance at 6 and 12 months were significant. Cost-benefit analyses of lumbar spine surgery should therefore consider improved presenteeism, which appears to offset some of the direct and indirect costs of surgical treatment.
Topics: Absenteeism; Female; Humans; Male; Middle Aged; Presenteeism; Prospective Studies; Spinal Fusion; Surveys and Questionnaires
PubMed: 34706279
DOI: 10.1016/j.spinee.2021.10.017 -
The Journal of Arthroplasty May 2021Absenteeism is costly, yet evidence suggests that presenteeism-illness-related reduced productivity at work-is costlier. We quantified employed patients' presenteeism...
BACKGROUND
Absenteeism is costly, yet evidence suggests that presenteeism-illness-related reduced productivity at work-is costlier. We quantified employed patients' presenteeism and absenteeism before and after total joint arthroplasty (TJA).
METHODS
We measured presenteeism (0-100 scale, 100 full performance) and absenteeism using the World Health Organization's Health and Work Performance Questionnaire before and after TJA among a convenience sample of employed patients. We captured detailed information about employment and job characteristics and evaluated how and among whom presenteeism and absenteeism improved.
RESULTS
In total, 636 primary, unilateral TJA patients responded to an enrollment email, confirmed employment, and completed a preoperative survey (mean age: 62.1 years, 55.3% women). Full at-work performance was reported by 19.7%. Among 520 (81.8%) who responded to a 1-year follow-up, 473 (91.0%) were still employed, and 461 (88.7%) had resumed working. Among patients reporting at baseline and 1 year, average at-work performance improved from 80.7 to 89.4. A Wilcoxon signed-rank test indicated that postoperative performance was significantly higher than preoperative performance (P < .0001). The percentage of patients who reported full at-work performance increased from 20.9% to 36.8% (delta = 15.9%, 95% confidence interval = [10.0%, 21.9%], P < .0001). Presenteeism gains were concentrated among patients who reported declining work performance leading up to surgery. Average changes in absences were relatively small. Combined, the average monthly value lost by employers to presenteeism declined from 15.3% to 8.3% and to absenteeism from 16.9% to 15.5% (ie, mitigated loss of 8.4% of monthly value).
CONCLUSION
Among employed patients before TJA, presenteeism and absenteeism were similarly costly. After, employed patients reported increased performance, concentrated among those with declining performance leading up to surgery.
Topics: Absenteeism; Arthroplasty, Replacement, Knee; Efficiency; Female; Humans; Male; Middle Aged; Presenteeism; Surveys and Questionnaires
PubMed: 33358309
DOI: 10.1016/j.arth.2020.11.024 -
CMAJ : Canadian Medical Association... Jul 2021
Topics: Absenteeism; Adolescent; Anti-Inflammatory Agents, Non-Steroidal; Endometriosis; Female; Humans; Menstruation Disturbances; Pain; Progestins; Prostaglandins; Sports
PubMed: 34281974
DOI: 10.1503/cmaj.201972-f -
Journal of Occupational Health Jan 2020
Topics: Absenteeism; Humans; Presenteeism; Sick Leave; Workplace
PubMed: 32741028
DOI: 10.1002/1348-9585.12158 -
Current Rheumatology Reports Jul 2020Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that typically affects people of working age. Work-related outcomes are therefore important to study,... (Review)
Review
PURPOSE OF REVIEW
Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that typically affects people of working age. Work-related outcomes are therefore important to study, both from an individual but also a societal perspective. Through this review of the literature, we explore the impact of axSpA on key work outcomes including work and productivity loss and predictors for these.
RECENT FINDINGS
Recent evidence confirms that axSpA is associated with substantial consequences on the ability to work. Reassuringly, early treatment and use of biologics have been associated with improved wok outcomes highlighting the importance of prompt diagnosis and management. High disease activity, labour-intensive jobs, poor physical function and impaired spinal mobility are among identified predictors of adverse work outcomes in axSpA. The impact of axSpA on work outcomes is considerable and necessitates optimal intervention, including suppression of disease activity, to enhance people's chances of remaining in work.
Topics: Absenteeism; Biological Products; Disability Evaluation; Efficiency; Humans; Spondylarthritis
PubMed: 32719993
DOI: 10.1007/s11926-020-00932-5