OBJECTIVES : Inflammatory-Bowel-Disease (IBD) is a lifelong illness with significant impact on quality-of-life (QoL) and burden as a result of work ability reduction, sick leave and restriction of leisure time. Productivity-loss often contributes significantly to the total costs in economic evaluations adopting a societal perspective. The aim of this study is to analyze the impact on work productivity (WP), to calculate the WP costs and to elaborate QoL factors that influence WP.

METHODS : A questionnaire was circulated among Austrian IBD patients by the Austrian Crohn's Disease/Ulcerative Colitis Association including general questions about demography and disease pattern, as well as a Work Productivity and Activity Impairment questionnaire and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). A representative number of 510 people (134 males) with median age of 40 years completed the questionnaire. Patients showed a median disease duration of 9 years: 46% were treated with biologics and 64% were employed.

RESULTS : The mean SIBDQ score was 45 (16-69). The difference between mean score in patients in self-assessed remission (n=319) and relapse (n=96) was -18 (95%-CI=-18.5 to -17.5). The QoL did not correlate with the disease duration (r=0.0314). The mean work productivity reduction amounted 7.3 hours (h) (95%-CI=±1.2) for the last 7 days. Work absenteeism accounted for 4.5h (95% CI=±1.1) and reduced productivity at the workplace (presenteeism) for 2.8h (95%-CI=±0.3). During a relapse 11 working hours were lost (P=<0.0001); for patients with biologics experiencing a relapse 9.6h hours were lost. Productivity reduction correlated with QoL (r=0.4106). On average, patients lost 4h (95%-CI=±0.3) of everyday life activities. In total 143 € per patient and week (95%-CI=±23.8) were lost (7,411 € per year).

CONCLUSIONS : IBD accounts for a substantial disease burden with indirect costs for society related to work ability reduction. QoL significantly influences loss of WP. Improving QoL should be a key factor to reduce disease burden.