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PharmacoEconomics
Published in: PharmacoEconomics 4/2004

01-03-2004 | Review Article

A Review of Self-Report Instruments Measuring Health-Related Work Productivity

A Patient-Reported Outcomes Perspective

Authors: Manishi Prasad, Peter Wahlqvist, Rich Shikiar, Ya-Chen Tina Shih

Published in: PharmacoEconomics | Issue 4/2004

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Abstract

Health impairment often leads to work impairment in the form of both absenteeism and presenteeism (i.e. reduced productivity while at work). Several self-report productivity instruments have been designed over the past few years to measure the impact of illness on productivity at work and/or in non-work activities.
In a review of the literature we identified six generic subjective instruments — the Endicott Work Productivity Scale, Health and Labor Questionnaire, Health and Work Questionnaire, Health and Work Performance Questionnaire, Work Limitations Questionnaire (WLQ) and the Work Productivity and Activity Impairment Questionnaire (WPAI) — that could theoretically be used in any working population. These instruments were usually validated against other subjective measures (such as health-related QOL).
Each productivity instrument has benefits in certain research settings, but the psychometric properties of the WPAI have been assessed most extensively. It was the most frequently used instrument and has also been modified to measure productivity reductions associated with specific diseases (e.g. allergic rhinitis, gastro-oesophageal reflux disease, chronic hand dermatitis). The WLQ has also been tested extensively to measure the general health impact and impact of specific conditions. Two migraine-specific subjective instruments were also identified: the Migraine Disability Assessment questionnaire and the Migraine Work and Productivity Loss Questionnaire, of which the latter was found to have better psychometric properties.
Productivity outcomes are useful in that they characterise the impact of an illness in the workplace and show the effect of treatment on productivity. Evidence of psychometric properties and generalisability of different instruments was found to a varying degree. Thus, further research is needed to assess the accuracy and usefulness of individual instruments in certain research settings. Health-related productivity has been increasingly recognised as an important component of the burden of illness associated with a given disease; without it, one cannot reliably assess this burden.
Footnotes
1
Although the early generic version of the WPAI-GH was known simply as the WPAI, we refer to it as WPAI-GH to avoid confusion with disease-specific versions of the instrument. Additionally, an interviewer version of the WPAI-GH similar to the self-administered version is also available.
 
Literature
1.
Gold MR. Cost-effectiveness in health and medicine. New York: Oxford University Press, 1996
2.
Lerner DJ, Amick III BC, Malspeis S, et al. A national survey of health-related work limitations among employed persons in the United States. Disabil Rehabil 2000; 22 (5): 225–32PubMedCrossRef
3.
Ware J. SF-36 health study: manual and interpretation guide. Boston (MA): Health Outcomes Trust, 1993
4.
Shumaker S, Anderson R. Psychological tests and scales. In: Spilker B, editor. Quality of life assessments in clinical trials. New York: Raven Press, 1990: 95–113
5.
Juniper E, Guyatt G, Jaeschke R. How to develop and validate a new health-related quality of life instrument. In: Spilker B, editor. Quality of life and pharmacoeconomics in clinical trials. Philadelphia (PA): Lippincott-Raven Publishers, 1996: 49–56
6.
Brazier J, Deverill M. A checklist for judging preference-based measures of health related quality of life: learning from psychometrics. Health Econ 1999; 8 (1): 41–51PubMedCrossRef
7.
McDowell I, Newell C. Measuring health: a guide to rating scales and questionnaires. 2nd ed. New York: Oxford University Press, 1996
8.
Bowling A. Measuring health: a review of quality of life measurement scales. 2nd ed. Buckingham (PA): Open University Press, 1997
9.
Nunnally JC, Bernstein IH. Psychometric theory. New York (NY): McGraw Hill, 1994
10.
Hays R, Anderson R. Assessing reliability and validity of measurement in clinical trials. In: Staquet M, Hays R, Fayers P. Quality of life assessment in clinical trials: methods and practice. Oxford: Oxford University Press, 1998
11.
Sudman S, Bradburn NM, Schwarz N. Thinking about answers: the application of cognitive processes to survey methodology. San Francisco (CA): Jossey-Bas Publishers, 1996
12.
Muldoon MF, Barger SC, Flory JD, et al. What are quality of life measurements measuring? BMJ 1998; 316: 542–5PubMedCrossRef
13.
Burke L, Piault E. Patient-reported measures in drug development: FDA perspective. In: Chassany C, Caulin C. Healthrelated quality of life and patient-reported outcomes: scientific and useful outcome criteria. Paris: Springer-Verlag, 2003: 117–22
14.
Stewart WF, Ricci J, Leotta CR, et al. Self-report of healthrelated lost productivity work time: bias and the optimal recall period [abstract]. Value Health 2001; 4: A421CrossRef
15.
Endicott J, Nee J. Endicott Work Productivity Scale (EWPS): a new measure to assess treatment effects. Psychopharmacol Bull 1997; 33 (1): 13–6PubMed
16.
van Roijen L, Essink-Bot ML, Koopmanschap MA, et al. Labor and health status in economic evaluation of health care: the health and labor questionnaire. Int J Technol Assess Health Care 1996; 12 (3): 405–15PubMedCrossRef
17.
Kessler RC, Barber C, Beck A, et al. The World Health Organization health and work performance questionnaire (HPQ). J Occup Environ Med 2003; 45: 156–74PubMedCrossRef
18.
Halpern MT, Shikiar R, Rentz AM, et al. Impact of smoking status on workplace absenteeism and productivity. Tob Control 2001; 10 (3): 233–8PubMedCrossRef
19.
Lerner D, Amick III BC, Rogers WH, et al. The work limitations questionnaire. Med Care 2001; 39 (1): 72–85PubMedCrossRef
20.
Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics 1993; 4 (5): 353–65PubMedCrossRef
21.
Reilly M, Tanner A, Meltzer EO. Work, classroom, and activity impairment instruments: validation studies in allergic rhinitis. Clin Drug Invest 1996; 11 (5): 278–88CrossRef
22.
Wahlqvist P, Carlsson J, Stalhammar NO, et al. Validity of a work productivity and activity impairment questionnaire for patients with symptoms of gastro-esophageal reflux disease (WPAI-GERD): results from a cross-sectional study. Value Health 2002; 5 (2): 106–13PubMedCrossRef
23.
Reilly MC, Lavin PT, Kahler KH, et al. Validation of the dermatology life quality index and the work productivity and activity impairment-chronic hand dermatitis questionnaire in chronic hand dermatitis. J Am Acad Dermatol 2003; 48 (1): 128–30PubMedCrossRef
24.
Stewart WF, Lipton RB, Kolodner K, et al. Reliability of the migraine disability assessment score in a population-based sample of headache sufferers. Cephalalgia 1999; 19 (2): 107–14PubMedCrossRef
25.
Stewart WF, Lipton RB, Kolodner KB, et al. Validity of the migraine disability assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain 2000; 88 (1): 41–52PubMedCrossRef
26.
Lerner DJ, Amick III BC, Malspeis S, et al. The migraine work and productivity loss questionnaire: concepts and design. Qual Life Res 1999; 8 (8): 699–710PubMedCrossRef
27.
Davies GM, Santanello N, Gerth W, et al. Validation of a migraine work and productivity loss questionnaire for use in migraine studies. Cephalalgia 1999; 19 (5): 497–502PubMedCrossRef
28.
Chirban JT, Jacobs RJ, Warren J, et al. The 36-item short form health survey (SF-36) and the work productivity and activity impairment (WPAI) questionnaire in panic disorder. Dis Manage Health Outcomes 1997; 1 (3): 154–64CrossRef
29.
Lerner D, Reed JI, Massarotti E, et al. The work limitations questionnaire’s validity and reliability among patients with osteoarthritis. J Clin Epidemiol 2002; 55 (2): 197–208PubMedCrossRef
30.
Osterhaus JT, Gutterman DL, Plachetka JR. Healthcare resource and lost labour costs of migraine headache in the US. Pharmacoeconomics 1992; 2 (1): 67–76PubMedCrossRef
31.
Koopmanschap MA, van Ineveld BM. Towards a new approach for estimating indirect costs of disease. Soc Sci Med 1992; 34 (9): 1005–10PubMedCrossRef
32.
Koopmanschap MA, Rutten FF. The impact of indirect costs on outcomes of health care programs. Health Econ 1994; 3 (6): 385–93PubMedCrossRef
33.
Brouwer WB, Koopmanschap MA, Rutten FF. Productivity costs measurement through quality of life?: a response to the recommendation of the Washington panel. Health Econ 1997; 6 (3): 253–9PubMedCrossRef
34.
Ettigi P, Meyerhoff AS, Chirban JT, et al. The quality of life and employment in panic disorder. J Nerv Ment Dis 1997; 185 (6): 368–72PubMedCrossRef
35.
Meltzer EO, Casale TB, Nathan RA, et al. Once-daily fexofenadine HCl improves quality of life and reduces work and activity impairment in patients with seasonal allergic rhinitis. Ann Allergy Asthma Immunol 1999; 83 (4): 311–7PubMedCrossRef
36.
Thompson AK, Finn AF, Schoenwetter WF. Effect of 60mg twice-daily fexofenadine HCl on quality of life, work and classroom productivity, and regular activity in patients with chronic idiopathic urticaria. J Am Acad Dermatol 2000; 43 (1 Pt 1): 24–30PubMedCrossRef
37.
Jacobs RJ, Davidson JR, Gupta S, et al. The effects of clonazepam on quality of life and work productivity in panic disorder. Am J Manag Care 1997; 3 (8): 1187–96PubMed
38.
Tanner L, Reilly M, Meltzer EO, et al. Effect of fexofenadine HCl on quality of life and work, classroom and daily activity impairment in patients with seasonal allergic rhinitis. Am J Manag Care 1999; 5 Suppl. 4: S235–47
39.
Wittchen HU, Beloch E. The impact of social phobia on quality of life. Int Clin Psychopharmacol 1996; 11 Suppl. 3: 15–23PubMedCrossRef
40.
Dean BB, Crawley JA, Schmitt CM, et al. The burden of illness of gastro-oesophageal reflux disease: impact on work productivity. Aliment Pharmacol Ther 2003; 17: 1309–17PubMedCrossRef
41.
42.
Morris LA, Miller DW. The regulation of patient-reported outcome claims: need for a flexible standard. Value Health 2002; 5 (4): 372–81PubMedCrossRef
43.
Radensky P. Regulation of pharmacoeconomics and outcomes research. Value Health 2001; 4 (1): 12–5PubMedCrossRef
44.
Berndt ER, Bailit HL, Keller MB, et al. Health care use and atwork productivity among employees with mental disorders. Health Aff (Millwood) 2000; 19 (4): 244–56CrossRef
45.
Burton WN, Conti DJ, Chen CY, et al. The role of health risk factors and disease on worker productivity. J Occup Environ Med 1999; 41 (10): 863–77PubMedCrossRef
46.
Burton WN, Conti DJ, Chen CY, et al. The impact of allergies and allergy treatment on worker productivity. J Occup Environ Med 2001; 43 (1): 64–71PubMedCrossRef
47.
Landy FJ, Farr JL. The measurement of work performance: methods, theory, and applications. New York: Academic Press, 1983
48.
Lerner D, Amick BC, Lee JC, et al. Relationship of employeereported work limitations to work productivity. Med Care 2003; 41 (5): 649–59PubMed
49.
Berger ML, Murray JF, Xu J, et al. Alternative valuations of work loss and productivity. J Occup Environ Med 2001; 43 (1): 18–24PubMedCrossRef
50.
Lynch W, Riedel JE, editors. Measuring employee productivity: a guide to self-assessment tools. 2001 ed. Scottsdale (AZ): Institute for Health and Productivity Management, 2001
Metadata
Title
A Review of Self-Report Instruments Measuring Health-Related Work Productivity
A Patient-Reported Outcomes Perspective
Authors
Manishi Prasad
Peter Wahlqvist
Rich Shikiar
Ya-Chen Tina Shih
Publication date
01-03-2004
Publisher
Springer International Publishing
Published in
PharmacoEconomics / Issue 4/2004
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200422040-00002

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