Impairment in work and activities of daily life in patients with psoriasis: results of the prospective BioCAPTURE registry

Figures & data

Figure 1. Inclusion of patients and explanation of missing data.

Patients were included if they had filled out a PRODISQ questionnaire at baseline and at least 1 follow-up timepoint (i.e. 6 or 12 months). 102 patients provided data for all three timepoints, 67 patients provided data on baseline and 6 months only, and 25 patients provided data on baseline and 12 months only.

All patients provided data on their work-for-pay (WFP) status (inclusion criteria). Only patients with WFP could provide information on presenteeism and overall work impairment. Not all patients filled in the TIC-P questionnaire, and therefore not all patients provided data on impairment in activities of daily living (ADL). Only patients with a filled in TICP, who were taking care of underage children, could provide data about child care.

N/A = not applicable; WFP = work-for-pay.

Table 1. Sample characteristics at baseline.

N	194
Demographics
Age
Mean, SD	52 (13)
Sex, female^a
Mean, SD	79/189 (42%)
Relationship state^b
Single	54/186 (28%)
In a relationship	132/186 (71%)
Education level^c
Primary	9/191 (5%)
Secondary	127/191 (66%)
Tertiary	55/191 (29%)
Charlson Comorbidity Index
Low (0)	84/194 (43%)
Intermediate (1–2)	85/194 (44%)
High (≥3)	23 (13%)
Disease characteristics
Disease duration (years)^d
Median, IQR	19 (11, 35)
Concomitant PsA^e	53/185 (29%)
Current biological/smi
TNFa-inhibitors	110/194 (57%)
IL17-inhibitors	21/194 (11%)
IL23-inhibitors	13/194 (7%)
IL12/IL23 p40 inhibitors	44/194 (23%)
PDE4-inhibitors	6/194 (3%)

Parameters are expressed in number/percentages unless indicated otherwise.

Relationship status was dichotomized into having a partner, or being single, regardless of marital status. Education was categorized into primary, secondary and tertiary education. Primary education represents primary school only, tertiary education represents college or university, and secondary education represents high school or community college.

a = missing in 6 patients, b = missing in 8 patients; c = missing in 3 patients; d = missing in 17 patients; e = missing in 9 patients.

IL = interleukin; IQR = interquartile range; PDE = phosphodiesterase; PsA = psoriatic arthritis; TNFa = tumor necrosis factor alpha; SD = standard deviation; smi = small molecule inhibitor.

Table 2. Disease characteristics, work and ADL impairment at baseline and during follow-up.

	Baseline	6 months	12 months
N	194	169	127
Disease characteristics
Same biological/smi	194/194 (100%)	159/169 (94%)^a p > 0.05	99/127 (78%)^b p < 0.001
PASI
Mean, SD	11.2 (7.2)^c	3.9 (4.6)^d p < 0.001	3.9 (4.0)^e p < 0.001
DLQI
Median, IQR	4 (1, 10)^f	1 (0, 4)^g p < 0.001	2 (0, 5)^h p < 0.001
SF36
PCS
Mean, SD	43.6 (10.2)^i	46.1 (10.3)^j p < 0.001	45.4 (11.0)^k p = 0.04
MCS
Mean, SD	48.1 (11.4)^i	50.1 (10.8)^j p = 0.01	51.0 (10.0)^k p = 0.01
Work impairment
Work for pay	110/194 (57%)	90/169 (53%) p = 0.09	66/127 (52%) p = 0.13
Absenteeism
Median, IQR	0 (0,5)^l	0 (0, 0)^m p = 0.01	0 (0, 5)^n p = 0.76
Presenteeism
Median, IQR	5 (0, 18)^o	0 (0, 15)^p p = 0.17	0 (0, 10)^f p = 0.04
Overall work impairment
Median, IQR	14 (0,26)^l	3 (0, 20)^m p = 0.01	2 (0, 23)^q p = 0.49
ADL impairment
Household chores
Impaired	71/183 (37%)^r	60/160 (38%)^t p = 0.74	41/126 (32%)^o p = 0.13
Grocery shopping
Impaired	57/184 (31%)^s	48/160 (30%)^t p = 0.75	35/126 (28%)^o p = 0.44
Home maintenance
Impaired	89/184 (48%)^s	73/160 (46%)^t p = 0.43	53/126 (42%)^o p = 0.13
Childcare
Impaired	23/83 (28%)^u	18/83 (22%)^v p = 0.28	16/68 (23%)^y p = 0.50

Values are given in number and percentage unless stated otherwise. Differences were tested using generalized estimating equations (GEE). P-values are expressed in comparison to baseline. Significant differences are highlighted in bold.

a = missing in 25 patients; b = missing in 67 patients; c = missing in 19 patients; d = missing in 84 patients; e = missing in 110 patients; f = missing in 3 patients; g = missing in 27 patients; h = missing in 71 patients; i = missing in 14 patients; j = missing in 29 patients; k = missing in 72 patients; l = missing in 36 patients; m = missing in 32 patients; n = missing in 24 patients; o = missing in 1 patient; p = missing in 2 patients; q = missing in 25 patients; r = missing in 11 patients; s = missing in 10 patients; t = missing in 34 patients; u = missing in 12 patients, not applicable in 99 patients; v = missing in 33 patients, not applicable in 78 patients; y = missing in 1 patient, not applicable in 57 patients.

ADL = activities of daily life; DLQI = dermatology life quality index; IQR = interquartile range; MCS = mental component summary scale; PASI = psoriasis area and severity index; PCS = physical component summary scale; SD = standard deviation; SF36 = short form 36; smi = small molecule inhibitor.

Table 3. Associations between work-for-pay status, presenteeism, impairments in ADL, and disease-related characteristics/contextual factors.

	Work-for-pay		Presenteeism		Household chores		Grocery shopping		Home maintenance
	OR (95% CI)	P-value	B (95% CI)	P-value	OR (95% CI)	P-value	OR (95% CI)	P-value	OR (95% CI)	P-value
Female sex	0.48 (0.25, 0.93)	p = 0.03	−1.77 (−6.39, 2.86)	p = 0.45	1.17 (0.56, 2.41)	p = 0.68	1.12 (0.51, 2.42)	p = 0.78	1.31 (0.62, 2.78)	p = 0.48
Age	0.89 (0.86, 0.92)	p = <0.001	−0.01 (−0.25, 0.23)	p = 0.94	1.01 (0.98, 1.04)	p = 0.40	0.97 (0.94, 1.01)	p = 0.11	1.00 (0.97, 1.03)	p = 0.84
Being in a relationship	2.12 (1.04, 4.33)	p = 0.04	3.78 (−1.05, 8,63)	p = 0.13	0.40 (0.18, 0.87)	p = 0.02	0.53 (0.24, 1.18)	p = 0.12	0.51 (0.22, 1.18)	p = 0.11
Higher Education	1.87 (0.93, 3.79)	p = 0.08	1.19 (03.31, 5.69)	p = 0.60	0.88 (0.40, 1.96)	p = 0.76	0.87 (0.37, 2.04)	p = 0.74	1.15 (0.50, 2.64)	p = 0.74
Disease duration Pso	1.02 (1.00, 1.04)	p = 0.10	0.03 (−0.15, 0.20)	p = 0.79	1.00 (0.98, 1.03)	p = 0.98	0.99 (0.97, 1.02)	p = 0.57	1.02 (0.99, 1.04)	p = 0.20
Presence of PsA	1.32 (0.68, 2.56)	p = 0.41	−0.23 (05.14, 4.68)	p = 0.93	1.47 (0.67, 3.21)	p = 0.33	1.95 (0.85, 4.47)	p = 0.12	1.53 (0.68, 3.46)	p = 0.31
Comorbidity Low vs intermediate	0.54 (0.28, 1.04)	p = 0.07	5.75 (1.04, 10.46)	p = 0.02	1.57 (0.73, 3.39)	p = 0.25	3.95 (1.70, 9.17)	p = 0.001	2.01 (0.04, 4.51)	p = 0.07
Comorbidity Low vs High	0.22 (0.07, 0.67)	p = 0.01	−5.40 (−17.20, 6.40)	p = 0.37	1.22 (0.37, 4.00)	p = 0.74	2.45 (0.69, 8.76)	p = 0.17	3.39 (0.93, 12.33)	p = 0.06
Same biological	3.22 (1.00, 10.39)	p = 0.05	13.20 (2.52, 23.89)	p = 0.02	2.38 (0.63, 9.01)	p = 0.20	1.63 (0.40, 0.64)	p = 0.50	2.09 (0.52, 8.43)	p = 0.30
PASI	0.99 (0.95, 1.04)	p = 0.74	−0.25 (−0.54, 0.05)	p = 0.10	0.95 (0.91, 1.00)	p = 0.05	0.96 (0.92, 1.01)	p = 0.13	0.94 (0.89, 0.99)	p = 0.01
DLQI	0.97 (0.93, 1.03)	p = 0.33	0.42 (0.06, 0.79)	p = 0.02	1.00 (0.94, 1.06)	p = 0.94	1.04 (0.98, 1.10)	p = 0.11	1.00 (0.97, 1.03)	p = 0.84
PCS	1.00 (0.97, 1.04)	p = 0.95	−0.64 (−0.87, −0.41)	p < 0.001	0.85 (0.82, 0.89)	p < 0.001	0.85 (0.81, 0.89)	p < 0.001	0.82 (0.78, 0.87)	p < 0.001
MCS	1.02 (0.99, 1.05)	p = 0.32	−0.57 (−0.78, 0.37)	p < 0.001	0.94 (0.91, 0.97)	p < 0.001	0.94 (0.91, 0.98)	p < 0.001	0.94 (0.90, 0.97)	p < 0.001

This table shows associations between work-for-pay status, presenteeism, impairments in ADL, and disease/patient characteristics over all time points. Associations were explored using generalized estimating equations (GEE). Significant associations are highlighted in bold (p < 0.05). Education was defined as primary/secondary versus tertiary education.

B = regression coefficient; CI = confidence interval; DLQI = dermatology life quality index; MCS = mental component summary scale; OR = odds ratio; PASI = psoriasis area and severity index; PsA = psoriatic arthritis; Pso = psoriasis; PCS = physical component summary scale.

Figure 2. Impairments in ADL, from baseline to one year after start of biologicals/SMI.

The bar charts depict the amount of patients who report any impairment in the mentioned area of activities of daily life.

Data availability statement

The data underlying this article will be shared on reasonable request to the corresponding author.