03566nas a2200565   4500000000100000008004100001100001200042700001300054700001500067700001300082700001300095700001500108700001200123700001400135700001300149700001300162700001500175700001200190700001500202700001300217700001400230700001000244700001400254700001400268700001600282700001800298700001000316700001500326700001400341700001400355700001800369700001200387700001600399700001800415700001900433700001300452700001300465700001600478700001700494700001200511700001100523700001100534700001000545700001300555245007700568300001200645490000700657520232200664022001402986       2018                            d1 aHiles S1 aHarvey E1 aMcDonald V1 aPeters M1 aBardin P1 aReynolds P1 aUpham J1 aBaraket M1 aBhikoo Z1 aBowden J1 aBrockway B1 aChung L1 aCochrane B1 aFoxley G1 aGarrett J1 aHew M1 aJayaram L1 aJenkins C1 aKatelaris C1 aKatsoulotos G1 aKoh M1 aKritikos V1 aLambert M1 aLangton D1 aA Rivero Lara1 aMarks G1 aMiddleton P1 aNanguzgambo A1 aRadhakrishna N1 aReddel H1 aRimmer J1 aSouthcott A1 aSutherland M1 aThien F1 aWark P1 aYang I1 aYap E1 aGibson P00aWorking while unwell: Workplace impairment in people with severe asthma.  a650-6620 v483 a<p>
<b>BACKGROUND: </b>Severe asthma affects quality of life; however, its impact on workplace productivity is poorly understood.
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<b>OBJECTIVE: </b>To compare workplace productivity-absenteeism and presenteeism-and impairment in daily activities in severe and non-severe asthma over time and identify characteristics associated with presenteeism in severe asthma.
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<b>METHODS: </b>The Severe Asthma Web-based Database is an ongoing observational registry from Australia, New Zealand and Singapore. At April 2017, 434 patients with severe asthma and 102 with non-severe asthma were enrolled (18-88&nbsp;years; 59% female). Participants provided comprehensive clinical and questionnaire data at baseline and were followed-up every 6&nbsp;months for 24&nbsp;months. Absenteeism (percentage of time not at work), presenteeism (self-reported impairment at work) and impairment in daily activities outside work due to health problems in the last week were calculated.
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<b>RESULTS: </b>At baseline, 61.4% of participants with severe asthma and 66.2% with non-severe asthma under 65&nbsp;years were employed. At younger ages (30-50&nbsp;years), fewer severe asthma participants were employed (69% vs 100%). Presenteeism and impairment in daily activity were more frequently reported in severe asthma and in participants with poorer asthma control, poorer lung function and more past-year exacerbations (P&nbsp;&lt;&nbsp;.01). Over time, deteriorating asthma control was associated with increasing presenteeism. Although absenteeism was not different between severe and non-severe asthma, worse asthma control was associated with absenteeism (P&nbsp;&lt;&nbsp;.001). In participants with severe asthma, presenteeism was reported more frequently in those with poorer asthma control, poorer asthma-related quality of life and symptoms of depression or anxiety (P&nbsp;&lt;&nbsp;.01).
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<b>CONCLUSION AND CLINICAL RELEVANCE: </b>Severe asthma was associated with impairment at work and outside the workplace. Improving asthma control and mental health may be important targets for optimizing workplace productivity in severe asthma. Presenteeism and absenteeism may represent key metrics for assessing intervention efficacy in people with severe asthma of working age.
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