Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Wilkie, Ross; Hay, Elaine M.; Croft, Peter; Pransky, Glenn (2015)
Publisher: Public Library of Science
Journal: PLoS ONE
Languages: English
Types: Article
Subjects: Q, R, Research Article, Science, Medicine, RA
OBJECTIVE: Osteoarthritis pain has become a leading cause of decreased productivity and work disability in older workers, a major concern in primary care. How osteoarthritis pain leads to decreased productivity at work is unclear; the aim of this study was to elucidate causal mechanisms and thus identify potential opportunities for intervention. METHODS: Population-based prospective cohort study of primary care consulters with osteoarthritis. Path analysis was used to test proposed mechanisms by examining the association between pain at baseline, and onset of work productivity loss at three years for mediation by physical limitation, depression, poor sleep and poor coping mechanisms. RESULTS: High pain intensity was associated with onset of work productivity loss (Adjusted Odds Ratio 2.5; 95%CI 1.3, 4.8). About half of the effect of pain on work productivity was a direct effect, and half was mediated by the impact of pain on physical function. Depression, poor sleep quality and poor coping did not mediate the association between high pain intensity and onset of work productivity loss. CONCLUSIONS: As pain is a major cause of work productivity loss, results suggest that decreasing pain should be a major focus. However, successfully improving function may have an indirect effect by decreasing the impact of pain on work productivity, especially important as significant pain reduction is often difficult to achieve. Although depression, sleep problems, and coping strategies may be directly related to work productivity loss, addressing these issues may not have much effect on the significant impact of pain on work productivity.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859):2197-223. doi: 10.1016/S0140-6736(12) 61689-4 PMID: 23245608
    • 2. Mody GM, Brooks PM. Improving musculoskeletal health: global issues. Best Pract Res Clin Rheumatol 2012; 26(2):237-49. doi: 10.1016/j.berh.2012.03.002 PMID: 22794096
    • 3. Jordan K, Clarke AM, Symmons DP, Fleming D, Porcheret M, Kadam UT et al. Measuring disease prevalence: a comparison of musculoskeletal disease using four general practice consultation databases. Br J Gen Pract 2007; 57:7-14. PMID: 17244418
    • 4. Dibonaventura MD, Gupta S, McDonald M, Sadosky A, Pettitt D, Silverman S. Impact of self-rated osteoarthritis severity in an employed population: cross-sectional analysis of data from the national health and wellness survey. Health Qual Life Outcomes 2012;15; 10:30. doi: 10.1186/1477-7525-10-30 PMID: 22420468
    • 5. Wilkie R, Phillipson C, Hay E, Pransky G. Frequency and predictors of premature work loss in primary care consulters for osteoarthritis: prospective cohort study. Rheumatology 2014; 53(3):459-64. doi: 10. 1093/rheumatology/ket336 PMID: 24136068
    • 6. Stewart WF, Ricci JA, Chee E, Morganstein D. Lost productive work time costs from health conditions in the United States: results from the American Productivity Audit. J Occup Environ Med 2003; 45 (12):1234-46. PMID: 14665809
    • 7. Tang K, Escorpizo R, Beaton DE, Bombardier C, Lacaille D, Zhang W, et al. Measuring the impact of arthritis on worker productivity: Perspectives, methodologic issues, and contextual factors. Journal of Rheumatology 2011; 38: 1776-1790. doi: 10.3899/jrheum.110405 PMID: 21807801
    • 8. Bieleman HJ, Bierma-Zeinstra SM, Oosterveld FG, Reneman MF, Verhagen AP, Groothoff JW. The effect of osteoarthritis of the hip or knee on work participation. J Rheumatol 2011; 38(9):1835-43. doi: 10. 3899/jrheum.101210 PMID: 21677000
    • 9. Wilkie R, Blagojevic-Bucknall M, Jordan KP, Lacey R, McBeth J. Reasons why multimorbidity increases the risk of participation restriction in older adults with lower extremity osteoarthritis: a prospective cohort study in primary care. Arthritis Care Res 2013; 65(6):910-9. doi: 10.1002/acr.21918 PMID: 23225783
    • 10. Golightly YM, Allen KD, Stechuchak KM, Coffman CJ, Keefe FJ. Associations of Coping Strategies with Diary Based Pain Variables Among Caucasian and African American Patients with Osteoarthritis. Int J Behav Med 2015; 22(1):101-8. doi: 10.1007/s12529-013-9365-3 PMID: 24590828
    • 11. Tang NK, Goodchild CE, Sanborn AN, Howard J, Salkovskis PM. Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: a multilevel daily process study. Sleep 2012; 35(5):675-87A. doi: 10.5665/sleep.1830 PMID: 22547894
    • 12. Shaw WS, Pransky G, Winters T. The Back Disability Risk Questionnaire for work-related, acute back pain: prediction of unresolved problems at 3-month follow-up. J Occup Environ Med 2009; 51(2):185- 94. doi: 10.1097/JOM.0b013e318192bcf8 PMID: 19209040
    • 13. Carroll LJ, Rothe JP, Ozegovic D. What does coping mean to the worker with pain-related disability? A qualitative study. Disabil Rehabil 2013; 35(14):1182-90. doi: 10.3109/09638288.2012.723791 PMID: 23020234
    • 14. Chou R, Baisden J, Carragee EJ, Resnick DK, Shaffer WO, Loeser JD. Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline. Spine 2009; 34:1094- 109. doi: 10.1097/BRS.0b013e3181a105fc PMID: 19363455
    • 15. Manchikanti L, Pampati V, Bakhit C, Rivera JJ, Beyer CD, Damron KS, et al. Effectiveness of lumbar facet joint nerve blocks in chronic low back pain: a randomized clinical trial. Pain Physician 2001; 4 (1):101-7.:1002-7. PMID: 16906173
    • 16. NHS Information. The clinical terms version 3 (The READ Codes). Birmingham: NHS Information Authority, 2000.
    • 17. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health Survey: Manual and Interpretation Guide. QualityMetric Incorporated: Rhode Island, 1993.
    • 18. Jenkins CD, Stanton BA, Niemcryk SJ, Rose RM. (1988). A scale for the estimation of sleep problems in clinical research. J Clin Epidemiol; 41(4):313-21. PMID: 3351539
    • 19. Hayward RA, Jordan KP, Croft P. The relationship of primary health care use with persistence of insomnia: a prospective cohort study. BMC Fam Pract 2012 Feb 16; 13:8. doi: 10.1186/1471-2296-13-8 PMID: 22340760
    • 20. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67:361-70. PMID: 6880820
    • 21. Jensen MP, Keefe FJ, Lefebvre JC, Romano JM, Turner JA. One- and two-item measures of pain beliefs and coping strategies. Pain 2003; 104(3):453-69. PMID: 12927618
    • 22. Streiner D. Finding our way: An introduction to path analysis. Can J Psychiatry 2005; 50:115-22 PMID: 15807228
    • 23. Karlson K, Holm A. Decomposing primary and secondary effects: using the Karlson-Holm-Breen decomposition method. Research in Social Stratification and mobility 2011; 29(2):221-37
    • 24. Buis M. Direct and indirect effects in a logit model. The Stata Journal 2010; 10:11-29 PMID: 22468140
    • 25. Li X, Gignac MA, Anis AH. The indirect costs of arthritis resulting from unemployment, reduced performance, and occupational changes while at work. Med Care 2006; 44(4):304-10. PMID: 16565630
    • 26. Ricci JA, Stewart WF, Chee E, Leotta C, Foley K, Hochberg MC. Pain exacerbation as a major source of lost productive time in US workers with arthritis. Arthritis Rheum. 2005 Oct 15; 53(5):673-81. PMID: 16208644
    • 27. Shaw WS, Pransky G, Patterson W, Winters T. Early disability risk factors for low back pain assessed at outpatient occupational health clinics. Spine 2005; 30(5):572-80. PMID: 15738793
    • 28. Vasseljen O, Woodhouse A, Bjørngaard JH, Leivseth L. Natural course of acute neck and low back pain in the general population: the HUNT study. Pain 2013; 154(8):1237-44. doi: 10.1016/j.pain.2013. 03.032 PMID: 23664654
    • 29. Linton SJ, Shaw WS. Impact of psychological factors in the experience of pain. Phys Ther 2011; 91 (5):700-11. doi: 10.2522/ptj.20100330 PMID: 21451097
    • 30. Burton WN, Chen CY, Schultz AB, Conti DJ, Pransky G, Edington DW. Worker productivity loss associated with arthritis. Dis Manag 2006; 9(3):131-43. PMID: 16764531
    • 31. Loisel P, Abenhaim L, Durand P, Esdaile JM, Suissa S, Gosselin L, et al. A population-based, randomized clinical trial on back pain management. Spine 1997; 22(24):2911-8. PMID: 9431627
    • 32. Chou R. In the clinic. Low back pain. Ann Intern Med 2014; 160(11):ITC6-1 PMID: 25009837
    • 33. Chaparro LE, Furlan AD, Deshpande A, Mailis-Gagnon A, Atlas S, Turk DC. Opioids compared to placebo or other treatments for chronic low-back pain. Cochrane Database Syst Rev 2013 Aug 27; 8
    • 34. Gignac MA, Cao X. "Should I tell my employer and coworkers I have arthritis?" A longitudinal examination of self-disclosure in the work place. Arthritis Rheum 2009; 61:1753-61. doi: 10.1002/art.24889 PMID: 19950308
    • 35. Pransky GS, Benjamin KL, Savageau JA, Currivan D, Fletcher K. Outcomes in work-related injuries: a comparison of older and younger workers. Am J Ind Med 2005; 47(2):104-12. PMID: 15662646
    • 36. Lacey RJ, Jordan KP, Croft PR. Does attrition during follow-up of a population cohort study inevitably lead to biased estimates of health status? PLoS One 2013; 8(12):e83948 doi: 10.1371/journal.pone. 0083948 PMID: 24386313
    • 37. Franche RL, Cullen K, Clarke J et al. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil 2005; 15:607-631. PMID: 16254759
    • 38. Altman RD. Early management of osteoarthritis. Am J Manag Care. 2010; 16 Suppl Management:S41- 7. PMID: 20297876
  • No similar publications.

Share - Bookmark

Cite this article