PURPOSE: To examine quality of life, worker productivity, and healthcare resource utilization among employed adults aged 65 and older with and without COPD.
METHODS: Data on employed adults (full-time, part-time, or self-employed) aged 65+ years from the 2009 National Health and Wellness Survey, a cross-sectional , internet-based survey representative of US adults were analyzed. There were 297 employed older adults with COPD versus 3061 without COPD. The impact of self-reported COPD diagnosis on mean levels of quality of life (using the mental (MCS) and physical component summary (PCS) scores and health utilities from SF-12v2), work productivity and activity impairment (using WPAI questionnaire), and resource use was examined. Multiple regression for normally-distributed outcomes and negative binomial regressions for skewed outcomes were conducted. Demographic and health characteristics (e.g., comorbidities) were adjusted for and weighted to project to the US population.
RESULTS: An estimated 560,657 workers 65+ have COPD (mean age=72.2) versus 5.57 million workers without COPD (mean age=70.6) After adjusting for demographic and health characteristics, older workers with COPD reported significantly lower mean levels of MCS (52.6 [95%CI:51.6-53.6] vs. 53.9 [95%CI:53.6-54.2], p< .05), PCS (40.3 [95%CI:39.2-41.4] vs. 47.2 [95%CI:46.9-47.5], p< .0001), and health utilities (0.73 [95%CI:0.71-0.74] vs. 0.79 [95%CI:0.79-0.80], p< .0001), than those without COPD . Similarly, older workers with COPD reported significantly greater percentage of missed work (absenteeism) (5.1% [95%CI:1.9-13.4%] vs. 1.9% [95%CI:1.5-2.4%], p< .05), impairment while at work (presenteeism) (12.0% [95%CI:9.2-15.6%] vs. 8.2% [95%CI:7.6-8.9%], p< .0001), overall work impairment (combination of absenteeism and presenteeism) (18.5% [95%CI:14.0-24.6%] vs. 9.6% [95%CI:8.9-10.4%], p< .01), and impairment in daily activities (23.2% [95%CI:19.0-28.3%] vs. 13.3% [95%CI:12.5-14.1%], p< .0001) than those without COPD. Minimal differences were observed between groups on healthcare use.
CONCLUSION: Employed adults aged 65+ years with COPD reported significantly worse quality of life and work productivity than those without COPD.
CLINICAL IMPLICATIONS: Effective programs and policies may be necessary to better manage COPD in the US workforce, particularly for the elderly population.
DISCLOSURE: Ryne Paulose-Ram, Grant monies (from industry related sources) Dr. DiBonaventura and Mr. Wagner are employed by Kantar Health, which received funding from Pfizer, Inc. and Boehringer Ingelheim to conduct this study.; Employee Drs. Paulose-Ram, McDonald, and Zou are currently employed at Pfizer, Inc. Drs. Su and Shah are currently employed at Boehringer Ingelheim.; No Product/Research Disclosure Information