The effects of disease progression on work productivity: the Birmingham COPD Cohort

Introduction: People with COPD have greater absenteeism and poorer work performance (worse presenteeism) than those without COPD. Few longitudinal studies have examined how disease-related factors severity impacts on these outcomes. Methods: We used data from the Birmingham COPD Cohort study to examine the association between markers of disease progression (FEV1 decline, respiratory-related hospital admissions, worsening MRC score and worsening CAT score) and work productivity (absenteeism and presenteeism). Results: Prospective absenteeism data were available for 113 participants (mean f/up: 19.5m (SD: 5.3)). Worsening dyspnoea (IRR=3.06; 95% CI 1.29 – 7.26; p-value: 0.01) and respiratory hospital admissions (IRR=2.01; 95% CI 1.09 – 3.69; p-value: 0.03), but not FEV1 decline, were associated with an increased duration of sickness absence. Follow-up data on presenteeism were available for 163 participants, of whom 43 (26.4%) had worsening presenteeism. This was associated with worsening CAT score (OR=5.74; 95% CI 1.18 – 27.83; p-value: 0.03) and potentially with worsening dyspnoea score (OR=2.25; 95% CI 0.76 – 6.68; p-value: 0.14). Conclusions: Our findings suggest that worsening symptoms is the main marker of disease progression associated with poorer work productivity, and might be a more important target for interventions than other measures.