Balancing work and health: A cross-sectional study on the relationship between paid employment and treatment adherence in Dutch people with a chronic condition

Background: People with a chronic condition struggle with treatment adherence. At the same time, a majority of the working-age population with a chronic condition actively participates in the workforce. Having a paid job might affect the ability of people to incorporate treatments into their daily schedule, but it is currently unclear how and to which extent job-related factors affect treatment adherence. Methods: The Nivel Panel Stronger Together was used to collect self-reported data from 309 individuals with one or more chronic illnesses, who have paid work and use medication. Correlation analysis and univariate and multiple logistic regressions were performed to examine the effects of employment type, contract type, hours of work, extent of both physical and psychological demands, limitations at work, inclusion at work and work-related medication self-efficacy on treatment adherence. For this study, treatment adherence was defined as following the treatment plan as agreed with health professionals, and consisted of adherence to both medication and healthcare appointments. Results: The treatment adherence rate was 56%. Inclusion at work was positively associated with adherence (AOR 1.50, 95% CI 1.00–2.25, p = .049). Also, a relationship between moderate physical job demands and adherence was found (AOR 0.49, 95% CI 0.26–0.92, p = .026). No significant associations were found between adherence and the other studied variables. Conclusions: These results imply that the extent to which the working population with a chronic condition is able to adhere to their prescribed treatment, is not affected by practical workplace characteristics. Also, we found no evidence for an effect of self-efficacy, though results warrant further research. Still, working at a workplace where one feels acknowledged and valued improves the likelihood of being adherent, highlighting the importance of fostering an inclusive workforce for individuals with a chronic condition to improve adherence and workability.