Sick Leave in Patients with Inflammatory Bowel Disease Before and After Diagnosis: A Retrospective Matched Cohort Study in Germany.

BACKGROUND/OBJECTIVES: Inflammatory bowel disease (IBD) can affect work participation. Evidence on sick leave among IBD patients in Germany is limited. We compared the occurrence and duration of certified sick leave between IBD patients and non-IBD controls. METHODS: Practice data from the Disease Analyzer database in Germany were used. Newly diagnosed IBD patients were matched to non-IBD controls using propensity scores. Sick leave occurrence and duration were evaluated in the year before and two years after diagnosis, using logistic and zero-inflated negative binomial regression, respectively. Stratified analyses explored variations by IBD subtype, sex, and age group. RESULTS: Sick leave occurred more frequently in IBD patients than controls pre-index (45.7% vs. 42.2%) and during the second year post-index (49.6% vs. 42.5%), consistent with higher odds in these periods (odds ratio (OR) 1.17, 95% confidence interval (CI) 1.11-1.22 and OR 1.35, 95% CI 1.29-1.42, respectively) but not during the first year post-index, when proportions were highest in both cohorts (56.2% vs. 56.4%). While median sick leave durations were low in both cohorts (0-2 days), mean durations were higher among IBD patients. In the second year post-index, IBD patients had 1.59 times (95% CI 1.50-1.69) more sick leave days than controls. Stratified analyses suggested higher sick leave estimates in ulcerative colitis than Crohn's disease, more frequent sick leave in younger patients, and longer mean sick leave durations in older patients. CONCLUSIONS: IBD is associated with a greater certified sick leave burden before and after diagnosis, although absolute differences compared with controls were modest.