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

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          Abstract

          Objectives

          This study investigated the relationship between presenteeism and health-related quality of life (HRQoL) among Japanese adults with chronic lower back pain (CLBP).

          Design

          This was a retrospective, cross-sectional study.

          Setting

          Data were collected via a self-administered online survey of the Japanese adult general population.

          Participants

          The 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 measures

          Presenteeism 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).

          Results

          Presenteeism 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).

          Conclusions

          Most 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.

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          Most cited references18

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          Validation testing of a three-component model of Short Form-36 scores.

          The two-component factor structure underlying Short Form-36 (SF-36) summary scores may not be valid worldwide. We studied a three-component model of SF-36 scores in Japan. The SF-36 scores came from representative samples of the population of Japan. Factor analysis and structural equation modeling were used. The two-component model gave physical component summary (PCS) scores and mental component summary (MCS) scores. The three-component model gave scores on the PCS, the MCS, and also on the third component, which we call the role component summary (RCS) score. These were evaluated with external criteria. In the three-component model, the RCS was strongly associated with the role-physical, social functioning, and role-emotional subscales, whereas the PCS and MCS were associated with the physical functioning and mental health subscales, as expected. The goodness-of-fit index was 0.945 for the three-component model and 0.935 for the two-component model. The PCS discriminated between groups stratified by comorbid conditions, and the MCS discriminated between groups stratified by psychological depression. Absence from work was associated with both PCS and RCS. The three-component model is better than the two-component model, and it provides more useful PCS and MCS scores. Criteria for validation testing of the RCS are needed. Copyright © 2011 Elsevier Inc. All rights reserved.
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            Musculoskeletal pain in the workforce: the effects of back, arthritis, and fibromyalgia pain on quality of life and work productivity.

            To investigate the impact of musculoskeletal pain on health-related quality of life and work productivity losses among US workers. Data from the 2008 US National Health and Wellness Survey were used. Among those currently employed aged 20 to 64 years (N = 30,868), workers with arthritis (n = 2,670), back (n = 4,920), and fibromyalgia (n = 439) pain were compared with workers without those respective musculoskeletal pain conditions. Arthritis, back, and fibromyalgia pain were all associated with significantly lower levels of health-related quality of life, often at clinically meaningful levels. All pain conditions were associated with higher levels of work productivity loss, even after adjusting for demographic and health characteristics. Musculoskeletal pain conditions were highly prevalent and associated with a significant burden. Improved management of these conditions may lead to improved productivity, benefiting both employers and workers alike.
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              Prevalence of low back pain and factors associated with chronic disabling back pain in Japan.

              This study aimed to report lifetime and 4-week low back pain (LBP) prevalence and examine factors associated with chronic LBP and back pain disability over a lifetime in a Japanese adult population. In February 2011, 1,063,083 adults aged 20-79 years registered as internet research volunteers were randomly selected to participate in a questionnaire survey. The data from 65,496 respondents were analyzed to calculate age-standardized lifetime and 4-week prevalence. Chronic LBP and back pain disability were defined as LBP lasting for ≥ 3 months and a consecutive ≥ 4-day-long absence, respectively. Factors associated with chronic disabling back pain over a lifetime were examined by multiple logistic regression modeling. The lifetime LBP prevalence was 83 % and 4-week prevalence was 36 %; majority of the respondents had disability-free LBP. Smoking [adjusted odds ratio (aOR): 1.17; 95 % CI: 1.05, 1.30], lower educational level (aOR: 1.21; 95 % CI: 1.09, 1.34), history of disabling back pain among family members and/or significant others (aOR: 1.46; 95 % CI: 1.27, 1.67), occupational LBP (aOR: 1.34; 95 % CI: 1.16, 1.55), traffic injury (aOR: 2.81; 95 % CI: 2.07, 3.81), compensated work injury (aOR: 2.42; 95 % CI: 1.92, 3.05), radiating pain (aOR: 4.94; 95 % CI: 4.45, 5.48), low back surgery (aOR: 10.69; 95 % CI: 9.02, 12.68), and advice to rest upon back pain consultation (aOR: 3.84; 95 % CI: 3.36, 4.40) were associated with chronic disabling back pain over a lifetime. LBP is common in Japan as in other industrialized countries. The association between the advice to rest and chronic disabling back pain supports recent treatment guidelines emphasizing continuation of daily activities.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2018
                27 June 2018
                : 8
                : 6
                : e021160
                Affiliations
                [1 ] departmentMedical Affairs Department , Shionogi & Co., Ltd , Osaka, Japan
                [2 ] departmentDepartment of Medical Research and Management for Musculoskeletal Pain , 22nd Century Medical and Research Center, The University of Tokyo , Tokyo, Japan
                [3 ] departmentHealth Outcomes Practice , Kantar Health , Horsham, Pennsylvania, USA
                [4 ] departmentHealth Outcomes Practice , Kantar Health , Tel Aviv, Israel
                Author notes
                [Correspondence to ] Dr Dena H Jaffe; dena.jaffe@ 123456kantarhealth.com
                Author information
                http://orcid.org/0000-0001-5134-037X
                Article
                bmjopen-2017-021160
                10.1136/bmjopen-2017-021160
                6042623
                29950467
                147bef49-9816-4602-9a81-d843ba4a655a
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 16 December 2017
                : 14 March 2018
                : 13 April 2018
                Funding
                Funded by: Shionogi Ltd;
                Categories
                Occupational and Environmental Medicine
                Research
                1506
                1716
                Custom metadata
                unlocked

                Medicine
                chronic lower back pain,health-related quality of life,presenteeism
                Medicine
                chronic lower back pain, health-related quality of life, presenteeism

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