Association between presenteeism and health-related quality of life among Japanese adults with chronic lower back pain: a retrospective observational study

• Published in: BMJ open Vol. 8; no. 6; p. e021160
• Main Authors: Tsuji, Toshinaga, Matsudaira, Ko, Sato, Hiroki, Vietri, Jeffrey, Jaffe, Dena H
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.06.2018; BMJ Publishing Group
• Subjects: Absenteeism; Adolescent; Adult; Adults; Back pain; Census of Population; Chronic Pain; Comorbidity; Cost of Illness; Cross-Sectional Studies; Female; Health Status; Humans; Japan - epidemiology; Low Back Pain - economics; Low Back Pain - epidemiology; Male; Middle Aged; Multivariate Analysis; Observational studies; Occupational and Environmental Medicine; Patients; Presenteeism - statistics & numerical data; Productivity; Quality of Life; Regression Analysis; Retrospective Studies; Self Report; Severity of Illness Index; Young Adult; Japan; New York; United States > US; presenteeism; chronic lower back pain; health-related quality of life
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-021160

ObjectivesThis study investigated the relationship between presenteeism and health-related quality of life (HRQoL) among Japanese adults with chronic lower back pain (CLBP).DesignThis was a retrospective, cross-sectional study.SettingData were collected via a self-administered online survey of the Japanese adult general population.ParticipantsThe present study used 2014 Japan National Health and Wellness Survey (NHWS) data (n=30 000). Specifically, data were included from NHWS respondents who self-reported being employed in the past week and having experienced LBP in the past month, with these symptoms lasting for at least 3 months (n=239). 84 (35.1%) participants in this study were female.Primary and secondary outcome measuresPresenteeism and HRQoL were measured using the Work Productivity and Activity Impairment Questionnaire-General Health (categorical (none: 0%, low: 10%–20%, high: ≥30%) and continuous) and Medical Outcomes Study 36-Item Short Form Health Survey, respectively. Covariates included patient demographics, health characteristics, pain characteristics and depression severity (Patient Health Questionnaire).ResultsPresenteeism was reported by 77.4% of respondents. High (vs no) presenteeism related to more severe pain in the prior week (4.9±2.2 vs 3.6±2.1, p=0.001) and currently (5.1±2.1 vs 3.9±3.9, p=0.007), more pain sites (1.9±1.6 vs 1.1±1.4, p=0.004) and greater depression severity (7.5±6.5 vs 3.6±3.6, p<0.001). Adjusting for covariates, high (vs no) presenteeism related to lower mental and physical HRQoL. For low versus no presenteeism, significant HRQoL differences were observed in general health (43.0, 95% CI 40.3 to 45.6 vs 46.9, 95% CI 43.9 to 49.8, p=0.015).ConclusionsMost respondents experienced presenteeism. Those with high or low presenteeism had poorer HRQoL than respondents with no presenteeism. Monitoring presenteeism rates may help identify workers with an unmet need for better CLBP-related pain management.