PURPOSES: To assess predictors of presenteeism (reduced productivity at work) 
and activity impairment outside work in patients with spondyloarthritis (SpA).
METHODS: Multivariate logistic regression analysis was used to study predictors 
of presenteeism and activity impairment in 1,253 patients with SpA based on a 
2.5 year follow-up questionnaire. The Work Productivity and Activity Impairment 
(WPAI) questionnaire was used as main outcome. Age, gender, lifestyle factors, 
subgroups, disease duration, and different patient reported outcome measures 
(PROMs) were studied as possible predictors. The association between 
presenteeism and WPAI activity impairment outside work was assessed.
RESULTS: Out of 1,253 patients, 757 reported being in work and of these 720 
responded to the WPAI questionnaire. The mean (confidence interval, CI) reported 
presenteeism was 25% (23-27%) and mean activity impairment 33% (31-35%) (0-100%, 
0 = no reduction). Significant predictors of presenteeism and activity 
impairment at follow-up (controlled for gender, age, spondyloarthritis subgroups 
and presenteeism at baseline) were presenteeism at baseline, poor quality of 
life, worse disease activity, decreased physical function, lower self-efficacy 
pain and symptom, higher scores of anxiety, depression, smoking and low 
education level, and for activity impairment also female sex. There was a strong 
association between presenteeism and activity impairment outside work (OR 16.7; 
95% CI 11.6-24.3; p < 0.001).
CONCLUSIONS: Presenteeism and activity impairment were not only predicted by 
presenteeism at baseline, but also by several PROMs commonly used in clinical 
rheumatology practice. Impaired activity outside work could indicate problems 
also at work suggesting why both areas need to be addressed in the clinical 
situation.