The impact of hidradenitis suppurativa on work productivity and performance: a systematic review and meta-analysis.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder affecting the skinfold regions. There is growing appreciation of the need for socioeconomic factors to be included in multidisciplinary assessments of HS. However, knowledge regarding HS and workplace function is limited.

Objectives: To assess the relationship between HS and workplace function.

Methods: CINAHL, Embase, MEDLINE, PsycINFO and PubMed were systematically searched to collect data from studies in which validated surveys of workplace function were administered to patients with HS.

Results: Of 1932 publications, 12 studies were included in this review and 7 reported sufficient data for meta-analysis. The studies included in this review encompassed 5187 patients with HS and no controls. All studies used the Work Productivity and Activity Impairment questionnaire, reporting percentage scores for absenteeism, presenteeism, total work productivity impairment (TWPI) and total activity impairment (TAI). The pooled mean scores for HS were calculated as 10.17% [95% confidence interval (CI) 8.68-11.66] for absenteeism, 31.13% (95% CI 25.02-37.23) for presenteeism, 34.25% (95% CI 29.37-39.14) for TWPI and 42.23% (95% CI 38.56-45.89) for TAI. Significant heterogeneity was identified; most studies were of 'poor' to 'fair' quality.

Conclusions: Current evidence suggests considerable impairment of workplace functioning in patients with HS. Our findings point to a significant unmet treatment need with respect to improving working capability in HS. The existing literature is inadequate to reliably assess the mechanisms underlying this effect or to comparatively assess the capabilities of HS therapies to improve workplace function.