Search Results (21)

Background/Objectives: Vestibular migraine is a frequently underdiagnosed cause of dizziness in adult females, often overlapping clinically with other vestibular and neurological conditions. Despite its recognition in diagnostic criteria, limited data exist on its prevalence and functional impact in women presenting with dizziness in clinical settings. This study assesses the frequency and diagnostic rate of vestibular migraine among females aged 20–50 years presenting with dizziness and evaluates its impact on quality of life and work productivity. Methods: A cross-sectional study was conducted, which included 196 female patients reporting dizziness who were evaluated. Vestibular migraine was diagnosed using ICHD-3 criteria. Functional impact was assessed using the Dizziness Handicap Inventory (DHI) and Work Productivity and Activity Impairment (WPAI) questionnaire. Group comparisons and regression analyses were conducted using SPSS version 24. Results: Vestibular migraine was diagnosed in 84 participants, yielding a prevalence rate of 42.86% (95% CI: 36.13–49.86%). Compared to non-migraine participants, those with vestibular migraine had longer dizziness duration (37.62 ± 11.34 vs. 24.58 ± 10.49 min, p = 0.032), higher DHI (58.34 ± 15.62 vs. 32.76 ± 14.83, p < 0.001) and WPAI scores (42.19 ± 13.45 vs. 23.47 ± 12.90, p < 0.001), and more missed workdays. Regression analysis identified vestibular migraine, poor sleep, anxiety/depression, and BMI as significant predictors of work impairment. Conclusions: Vestibular migraine is a prevalent and functionally disabling condition among women with dizziness, underscoring the importance of systematic diagnosis and multidisciplinary management. Full article

Background: Ulcerative colitis (UC) requires life-long disease management. This study aimed to investigate the disease burden and unmet medical needs in UC patients in Greece. Methods: Between October 2023 and January 2024, adult UC patients who were members of the Hellenic Society of Crohn’s Disease and Ulcerative Colitis Patients (HELLESCC) completed a structured self-reported questionnaire. The survey questionnaire included sociodemographic characteristics, smoking habits, history of comorbidities, disease activity, disease characteristics, medications, and patient-reported outcomes (PROs; Short Inflammatory Bowel Disease Questionnaire [SIBDQ], Work Productivity and Activity Impairment [WPAI], Patient Health Questionnaire-9 [PHQ-9], treatment satisfaction, and treatment adherence). Univariate and multivariate logistic regression analyses were used to identify associated factors. Results: Datasets were obtained from 181 UC patients, of whom 48% were on advanced therapies (biological/small-molecule agents) and 54% had active disease. Around 74% reported impaired quality of life (QoL) (SIBDQ < 60), 25% work productivity loss, and 29% daily activity impairment. About 40% reported moderate to severe depressive symptoms (PHQ-9 ≥ 10). Reduced adherence and treatment dissatisfaction were reported by approximately one-third of patients. Female gender and disease activity were associated with moderately to severely impaired QoL, work productivity, and mental health. Interestingly, three out of four patients receiving advanced therapy reported moderately to severely impaired QoL and had increased odds of experiencing moderate to severe depression. Conclusions: The disease burden remains very high in UC, characterized by poor QoL and increased work impairment, depression, and disease activity among Greek patients. Marked treatment dissatisfaction and non-adherence were observed in approximately one-third of patients. Full article

Background/Objectives: Inflammatory bowel disease (IBD) is a chronic gastrointestinal disorder marked by relapsing episodes of gastrointestinal inflammation, potentially causing severe symptoms. These unpredictable acute episodes, paired with chronic disabilities, such as fatigue and malabsorption, and extensive pharmacological and surgical treatments, can severely impact patients’ quality of life. This study aimed to assess which aspects of the patients’ lives IBD impacts, and how IBD patients perceive their disease. Methods: All IBD patients who had an appointment in our tertiary centre from 10 October 2022 to 21 February 2023, were invited to complete anonymous questionnaires. The questionnaires used were IBDQ-32, WPAI, and IBD Disk, all designed specifically to assess the IBD patients’ quality of life. Results: The questionnaires were completed by a total of 159 participants, 51% of whom were males, 47.9% who had UC, and 49.4% who had been or were currently treated with biologics. There was no statistically significant difference in the answers from patients with CD compared to UC, as well as those treated with conventional therapies compared to those with advanced options. Most of them considered their health to be good, but only a few (12.8%) claimed, with absolute certainty, that their health was at the level of healthy individuals, and only 13 (8.3%) claimed their health was excellent. A total of 95 (60.1%) participants expressed at least minor limitations when performing strenuous activities, but lighter forms of activities were not affected as much by the disease. A significant portion (48.7%) of the participants believed they were exposed to more stress than others, and their current pharmacological therapy was the cause of fear in 26.5%. A total of 119 (75.3%) participants believed that the disease affected their lives at least mildly during remission. Conclusions: Our study showed that IBD patients have diminished quality of life, not only in the periods of active disease but also during clinical remission. The decline in quality of life was not solely attributed to physical symptoms, as previously thought. Other factors, such as mental health issues, were found to impact quality of life as well. We firmly believe that restoring quality of life should be emphasised in guidelines as one of the most important therapeutic goals. Full article

Background: Low back pain (LBP) is a common occupational health issue among nurses, significantly affecting quality of life and work productivity. Despite awareness, it remains a major cause of absenteeism and presenteeism, highlighting the need for targeted interventions. This study aimed to assess the prevalence of LBP among Italian nurses and its impact on quality of life and work productivity. Methods: A cross-sectional, multicenter observational study was conducted from May to October 2024 using an online questionnaire distributed to members of the Provincial Orders of Nursing Professions across Italy. The questionnaire included sociodemographic variables and three validated instruments: the Quebec Back Pain Disability Scale (QBPDS), the Oswestry Disability Index (ODI), and the Work Productivity and Activity Impairment Questionnaire (WPAI). Results: A total of 318 nurses participated, with the majority from Southern Italy (57.1%) and female (74.6%). LBP was reported by 57.5% of respondents. Nurses working in Critical Care and those with 30–40 years of experience had significantly higher QBPDS and ODI scores, indicating moderate disability. Nurses working 12 h shifts and those with job restrictions or medical prescriptions reported significantly higher disability levels (ODI > 29, p < 0.001). Nurses on pharmacological therapy reported moderate pain levels, while those engaging in regular physical activity had significantly lower pain symptoms (<20, p < 0.001). The WPAI results showed that 67.0% of nurses reported impaired work productivity due to LBP. Conclusions: LBP is extremely prevalent among Italian nurses, especially affecting physical well-being and, accordingly, the health care quality provided by them. Factors exacerbating this problem are wrong manual handling of loads, not exercising, poor nutrition, and smoking, as well as wrong posture. Fundamental in order to avoid the occurrence of this problem are preventive programs and ergonomic training. Full article

Background: The prevalence of obesity and sleep disorders within the Italian workforce mirrors a global trend where sedentary lifestyles, poor eating habits, and elevated stress levels significantly contribute to these health issues. These conditions have profound economic implications, including rising healthcare costs and diminished productivity due to absenteeism and presenteeism, adversely affecting organizational sustainability and employee well-being. Addressing these problems necessitates a holistic approach that integrates individual health interventions, workplace policies, and broader societal changes to promote healthy lifestyles. This cross-sectional study examines the influence of obesity and insomnia, both individually and combined, on work productivity within the context of occupational health and sustainability. Materials and Methods: A cross-sectional analysis was conducted with 397 participants from various professions over a six-month period. Self-reported work productivity impairments were assessed using the Work Productivity and Activity Impairment (WPAI) questionnaire. Body Mass Index (BMI) and Insomnia Severity Index (ISI) scores were utilized to evaluate obesity and insomnia levels, respectively. Results: Statistical analyses revealed a significant association of higher BMI and ISI scores with reduced work productivity. Both obesity and insomnia independently and synergistically contributed to productivity losses, with obesity exerting a more substantial effect. These findings indicate that obesity and insomnia increase presenteeism, thereby negatively impacting organizational performance and workplace sustainability. Conclusions: Our study underscores the critical impact of obesity and insomnia on work productivity and highlights the necessity of addressing these health issues not only for individual well-being but also for organizational sustainability. Integrating targeted health management strategies within workplaces to address these conditions can enhance productivity, improve employee well-being, and promote occupational health and safety. These interventions align with the current concept of sustainable work and are essential steps toward achieving sustainability in the workplace. Full article

Background: Moderate to severe (M2S) atopic dermatitis (AD) is a chronic condition impacting individuals, society, and healthcare systems. Considering the changing M2S-AD treatment landscape, this study assesses the M2S-AD burden in patients reaching referral centers in Greece. Methods: This was a multicenter, cross-sectional study. Patients aged 12 years or older with clinically diagnosed M2S-AD were enrolled. Data collected included clinical practice assessments and the following validated patient-reported instruments: Dermatology Life Quality Index (DLQI); EuroQol-5 Dimensions-3 Level scale (EQ-5D-3L); Patient Oriented Eczema Measure (POEM); Peak Pruritus Numerical Rating Scale (PP-NRS); and Work Productivity and Activity Impairment: General Health (WPAI:GH). A pain frequency/intensity/cause questionnaire and a sleep disturbance scale were also used. Results: Outcomes of 184 adults (51.1% female) with M2S-AD based on the Eczema Area and Severity Index (EASI) are presented (n = 117 moderate; n = 67 severe). Among the patients, 14.8% were obese, 59.2% had allergic comorbidities, and 88.0% were receiving AD-specific therapy (systemic: 38.6%). The median age, disease duration, body surface area, and total EASI scores were 38.8 years, 11.8 years, 30.0%, and 16.9, respectively. The median DLQI score was 12.0, with ‘symptoms/feelings’ being the most affected domain. EQ-5D dimensions ‘anxiety/depression’ and ‘pain/discomfort’ were also affected (65.2% and 64.1% reporting problems, respectively). The median POEM score was 17.0. Pain, severe pruritus (PP-NRS ≥ 7), and sleep disturbance were reported by 80.4%, 62.0%, and 88.5%, respectively. The median WPAI:GH ‘work productivity loss’ and ‘activity impairment’ scores were 23.8% and 30.0%, respectively. Conclusions: Both moderate and severe AD patients reaching Greek specialized centers experience significant symptom burden and impairments in quality of life, sleep, work, and daily activities. Full article

Female urinary incontinence (UI) is highly prevalent in the US (>60%). Pelvic floor muscle training (PFMT) represents first-line care for UI; however, access and adherence challenges urge new care delivery models. This prospective cohort study investigates the feasibility and safety of a remote digital care program (DCP) combining education and PFMT with real-time biofeedback with an average duration of 10 weeks. The primary outcome was the change in the Urinary Impact Questionnaire—short form (UIQ-7) from baseline to program-end, calculated through latent growth curve analysis (LGCA). Secondary outcomes included the impact of pelvic conditions (PFIQ-7), depression (PHQ-9), anxiety (GAD-7), productivity impairment (WPAI), intention to seek additional healthcare, engagement, and satisfaction. Of the 326 participants who started the program, 264 (81.0%) completed the intervention. Significant improvement on UIQ-7 (8.8, 95%CI 4.7; 12.9, p < 0.001) was observed, corresponding to a response rate of 57.3%, together with improvements in all other outcomes and high satisfaction (8.9/10, SD 1.8). This study shows the feasibility and safety of a completely remote DCP with biofeedback managed asynchronously by a physical therapist to reduce UI-related symptoms in a real-world setting. Together, these findings may advocate for the exploration of this care delivery option to escalate access to proper and timely UI care. Full article

Evidence on the impact of COVID-19 vaccination on symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Activity Impairment (WPAI) is scarce. We analyzed associations between bivalent BA.4/5 BNT162b2 (BNT162b2) and these patient-reported outcomes (PROs). Symptomatic US adults testing positive for SARS-CoV-2 were recruited between 2 March and 18 May 2023 (CT.gov NCT05160636). PROs were assessed using four questionnaires measuring symptoms, HRQoL and WPAI (a CDC-based symptom survey, PROMIS Fatigue, EQ-5D-5L, WPAI-GH), from pre-COVID to Week 4 following infection. Multivariable analysis using mixed models for repeated measures was conducted, adjusting for several covariates. The study included 643 participants: 316 vaccinated with BNT162b2 and 327 unvaccinated/not up-to-date. Mean (SD) age was 46.5 years (15.9), 71.2% were female, 44.2% reported prior infection, 25.7% had ≥1 comorbidity. The BNT162b2 cohort reported fewer acute symptoms through Week 4, especially systemic and respiratory symptoms. All PROs were adversely affected, especially at Week 1; however, at that time point, the BNT162b2 cohort reported better work performance, driven by less absenteeism, and fewer work hours lost. No significant differences were observed for HRQoL COVID-19 negatively impacted patient outcomes. Compared with unvaccinated/not up-to-date participants, those vaccinated with bivalent BA.4/5 BNT162b2 reported fewer and less persistent symptoms and improved work performance. Full article

COVID-19 infection adversely impacts patients’ wellbeing and daily lives. This survey-based study examined differences in patient-reported COVID-19 symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Activity Impairment (WPAI) among groups of patients defined based on age and symptom-based long COVID status. Symptomatic, COVID-19-positive US outpatients were recruited from 31 January–30 April 2022. Outcomes were collected via validated instruments at pre-COVID, Day 3, Week 1, Week 4, Month 3 and Month 6 following infection, with changes assessed from pre-COVID and between groups, adjusting for covariates. EQ-5D-5L HRQoL and WPAI scores declined in all groups, especially during the first week. Long COVID patients reported significantly higher symptoms burden and larger drops in HRQoL and WPAI scores than patients without long COVID. Their HRQoL and WPAI scores did not return to levels comparable to pre-COVID through Month 6, except for absenteeism. Patients without long COVID generally recovered between Week 4 and Month 3. Older (>50) and younger adults generally reported comparable symptoms burden and drops in HRQoL and WPAI scores. During the first week of infection, COVID-19-related health issues caused loss of 14 to 26 work hours across the groups. These data further knowledge regarding the differential impacts of COVID-19 on clinically relevant patient groups. Full article

Background: Inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic and disabling diseases that affect patient health-related quality of life (HRQoL). IBD patients are frequently exposed to high levels of stress and psychological distress. Biological drugs have been proven to reduce inflammation, hospitalization, and most of the complications that characterize IBDs; their potential contribution to patients’ HRQoL remains to be explored. Aim: To evaluate and compare any change in the HRQoL and markers of inflammation in IBD patients undergoing biological drugs (infliximab or vedolizumab). Material and Methods: A prospective observational study was conducted on a cohort of IBD patients, aged >18 years, who were prescribed with infliximab or vedolizumab. Demographic and disease-related data at baseline were collected. Standard hematological and clinical biochemistry parameters, including C-reactive protein (CRP), white blood cells count (WBC), erythrocytes sedimentation rate (ESR), and α1 and α2 globulins were measured after a 12-h fast at baseline (T0), after 6 weeks (T1), and at 14 weeks (T2) of biological treatment. Steroid use, disease activity as measured by the Harvey–Bradshaw index (HBI) and partial Mayo score (pMS) for the CD and UC, respectively, were also recorded at each timepoint. The Short Form 36 Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy (FACIT-F), and Work Productivity and Activity Impairment–General Health Questionnaire (WPAI:GH) were administered to each patient at baseline, T1, and T2 to address the study aims. Results: Fifty eligible consecutive patients (52% with CD and 48% with UC) were included in the study. Twenty-two patients received infliximab and twenty-eight received vedolizumab. We noted a significant reduction in the CRP, WBC, α1, and α2 globulins from T0 to T2 (p = 0.046, p = 0.002, p = 0.008, and p = 0.002, respectively). Participants showed a significant decrease in steroid administration during the observation period. A significant reduction in the HBI of CD patients at all three timepoints and a similarly significant decrease in the pMS of UC patients from baseline to T1 were recorded. Statistically significant changes were observed in all questionnaires during follow-up as well as an overall improvement in the HRQoL. The interdependence analysis carried out between the biomarkers and the scores of the individual subscales showed a significant correlation between the variation (Δ) of the CRP, Hb, MCH, and MCV with physical and emotional dimensions of the SF-36 and FACIT-F tools; work productivity loss expressed by some of the WPAI:GH items negatively correlated with the ΔWBC and positively with the ΔMCV, ΔMCH, and Δ α1 globulins. A sub-analysis according to the type of treatment showed that patients receiving infliximab experienced a more pronounced improvement in their HRQoL (according to both SF-36 and FACIT-F) compared with patients receiving vedolizumab. Conclusions: Both infliximab and vedolizumab played an important role in contributing to the improvement of the HRQoL in IBD patients by also reducing inflammation and, consequently, steroid use in patients with an active disease. HRQoL, being one of the treatment goals, should also be assessed when taking charge of IBD patients to assess their clinical response and remission. The specific correlation between the biomarkers of inflammation and life’s spheres, as well as their possible role as clinical markers of HRQoL, should be further investigated. Full article

This study investigated the association between urticaria activity and health-related quality of life (HRQoL). Patient evaluations from the ligelizumab Phase 2b clinical trial (N = 382) were pooled (NCT02477332). Daily patient diaries assessed urticaria activity, sleep and activity interference, the dermatology life quality index (DLQI), and work productivity and activity impairment-chronic urticaria (WPAI-CU). The number of DLQI scores, weekly sleep interference scores (SIS7), weekly activity interference scores (AIS7), and overall work impairment (OWI) evaluations with a complete response per weekly urticaria activity score (UAS7) using bands (0, 1–6, 7–15, 16–27, and 28–42) were reported. Over 50% of the patients had a mean DLQI of > 10 at baseline, indicating a significant effect of chronic spontaneous urticaria (CSU) on their HRQoL. Complete response (UAS7 = 0) evaluations corresponded with no impacts on other patient-reported outcomes. In total, 91.1% of UAS7 = 0 evaluations corresponded to DLQI scores of 0–1, 99.7% to SIS7 scores of 0, 99.7% to AIS7 scores of 0, and 85.3% to OWI scores of 0. This was significantly different compared with the UAS7 = 1–6 evaluations (61.9%, 68.5%, 67.7%, and 65.4%, respectively; p < 0.0001). Complete responses to treatment were associated with no impairments on the dermatology-QoL, no interferences with sleep and activity, and significantly improved capacities to work compared to patients who continued to have signs and symptoms, even for those with minimal disease activity. Full article

Little is known about the associations between insomnia severity, insomnia symptoms, and key health outcomes. Using 2020 United States National Health and Wellness Survey (NHWS) data, we conducted a retrospective, cross-sectional analysis to determine the associations between insomnia severity and a number of health outcomes germane to patients (health-related quality of life (HRQoL), employers and government (workplace productivity), and healthcare payers (healthcare resource utilization (HCRU)). The Insomnia Severity Index (ISI) questionnaire was used to evaluate overall insomnia severity. HRQoL was assessed using the physical and mental component summary scores of the Short Form-36v2 (SF-36v2) questionnaire, and health utility status was measured using the Short Form-6D (SF-6D) and EuroQoL-5D (EQ-5D) questionnaires. Workplace productivity was measured using the Work Productivity and Activity Impairment (WPAI) questionnaire. After adjusting for confounders, greater insomnia severity was significantly associated with worsened quality of life, decreased productivity, and increased HCRU in an apparent linear fashion. These findings have important implications for future research, including the need for specific assessment of insomnia symptoms and their impact on key health outcomes. Full article

There is limited information on myofascial trigger points (MTrPs) and specific symptoms of chronic pelvic pain and, more specifically, dysmenorrhea. The objective of this study was to determine whether patients suffering from primary dysmenorrhea present alterations in mechanosensitivity and pain patterns, and greater presence of MTrPs in the abdominal and pelvic floor muscles. A case-control study was carried out with a total sample of 84 participants distributed based on primary dysmenorrhea and contraceptive treatment. The sample was divided into four groups each comprising 21 women. Data on pain, quality of life, and productivity and work absenteeism were collected; three assessments were made in different phases of the menstrual cycle, to report data on pressure pain threshold, MTrP presence, and referred pain areas. One-way ANOVA tests showed statistically significant differences (p < 0.01) between the groups, for the Physical Health domain and the total score of the SF-12 questionnaire, and for all the domains of the McGill questionnaire; but no significant differences were found in the data from the WPAI-GH questionnaire. Statistically significant data (p < 0.01) were found for mechanosensitivity in the abdominal area and limbs, but not for the lumbar assessment, within the group, with very few significant intergroup differences. The frequency of active MTrPs is higher in the groups of women with primary dysmenorrhea and during the menstrual phase, with the prevalence of myofascial trigger points of the iliococcygeus muscle being especially high in all examination groups (>50%) and higher than 70% in women with primary dysmenorrhea, in the menstrual phase, and the internal obturator muscle (100%) in the menstrual phase. Referred pain areas of the pelvic floor muscles increase in women with primary dysmenorrhea. Full article

There is a lack of valid instruments for measuring productivity loss due to illness. This study aimed to compare the validities of traditional Chinese versions of the Work Productivity and Activity Impairment: General Health (C-WPAI:GH) and the World Health Organization’s Health and Work Performance Questionnaire (C-WHO-HPQ), and to define the factors associated with productivity loss. We conducted a cross-sectional study of 165 Taiwanese employees in technology companies. Spearman’s correlation coefficients and ANOVAs were used to test the validities of the C-WPAI:GH and C-WHO-HPQ. Bayesian model averaging was used for multiple linear regression to define the factors related to productivity loss. The C-WPAI:GH had acceptable validities for assessing the productivity loss of Taiwanese employees. The C-WHO-HPQ had acceptable content validity and concurrent criterion validity. However, the construct validity of the C-WHO-HPQ was insufficient (less than 75% of results were consistent with our hypotheses). Absenteeism in the C-WPAI:GH was associated with education, physical functioning and job satisfaction. There were significant associations of bodily pain, social functioning and general health with presenteeism, overall work impairment and activity impairment in the C-WPAI:GH. A linear correlation was found between education and activity impairment in the C-WPAI:GH. The C-WPAI:GH can be used to evaluate productivity loss due to illness. Full article

Individuals with irritable bowel syndrome (IBS) are more likely to miss work (absenteeism), have reduced work effectiveness (presenteeism) and experience activity impairment. This study compared the effect of a comprehensive self-management (CSM) intervention program (incorporating cognitive behavioral therapy, diet education and relaxation) versus usual care on work- and activity-impairments in adults with IBS. This secondary data analysis used daily diaries and Work Productivity and Activity Impairment in Irritable Bowel Syndrome (WPAI-IBS) questionnaire data collected at baseline, 3, 6 and 12 months post-randomization from 160 adults with IBS. Mixed-effects modeling was used to compare the effect of CSM versus usual care on work- and activity-related outcomes. The effect of CSM was shown to be superior to usual care in improving WPAI-IBS and diary-measured presenteeism, overall work productivity loss and activity impairment with sustained effects up to 12 months post-randomization (all p < 0.05). Moreover, the CSM intervention was found to be particularly beneficial for IBS patients with greater baseline work and activity impairments (all p < 0.05). The CSM intervention may bring benefits to individuals and society through improving symptoms and reducing presenteeism associated with IBS. Full article