Employment in multiple sclerosis

Abstract

Multiple sclerosis (MS) is associated with significant economic burden and high rates of unemployment. This investigation evaluated patient and disease characteristics associated with work loss and work initiation using the NARCOMS patient registry. Patient and disease characteristics associated with transitions to unemployment or employment were evaluated crosssectionally and prospectively over the course of two assessment periods (mean interval of 1.56 ± 0.93 years). Eligible participants included 8,867 patients for the cross-sectional component, and 8,122 for longitudinal analyses. At Time 1 and Time 2 56-58 % of MS patients were not employed. At Time 1, unemployed participants more likely to have a progressive disease course, had a longer symptom duration, greater levels of disability as measured by the PDDS, and greater functional limitations across all domains of the performance scales (p < 0.0001 for all). At Time 2, increasing MS symptoms in the past 6 months increased the odds of becoming unemployed. In addition, specific problems in mobility, hand function, fatigue, and cognitive performance domains were associated with increased odds of becoming unemployed. Less severe problems in similar areas, including mobility, hand function, and cognitive functioning were also predictive of work initiation among patients not employed. MS is associated with high rates of unemployment. Specific physical and mental health limitations confer risk of employment cessation over time, as well as the likelihood of employment initiation. This study has implications for rehabilitation interventions to target specific MS related limitations that place patients at greatest risk for work status changes.

How does work disability of patients with MS develop before and after diagnosis? A nationwide cohort study with a reference group

“…DP has been reported to be significantly increased already 5 years after onset of MS, compared with controls from the general population. 5 Unemployment, or being outside the workforce, irrespectively of reason thereof, is very common among patients with MS. [6][7][8][9] However, knowledge about how work disability of patients with MS develops over time and whether sociodemographic factors influence this development is still scarce. In particular, there is a lack of longitudinal studies based on large population-based samples.…”

Alemtuzumab improves preexisting disability in active relapsing-remitting MS patients

“…1–7 Interest is growing in aiming for confirmed disability improvement (CDI), a higher standard for therapeutic efficacy than merely slowing disability accumulation. Because disability is a primary contributor to the burden of MS, 8–10 restoring function in patients with previously acquired neurologic impairments may lead to improved long-term prognosis, greater productivity and quality of life, and reduced economic costs.…”

Predictors of Fatigue Impact in Persons With Long-Standing Multiple Sclerosis

“…Fatigue negatively influences quality of life, interferes with activities of daily living, and impairs the ability to maintain gainful employment (Amato et al, 2001; Julian, Vella, Vollmer, Hadjimichael, & Mohr, 2008; Smith & Arnett, 2005). Mechanisms underlying the pathophysiologic determinants of fatigue in MS are poorly understood and effective treatments to manage fatigue present a challenge (Krupp, Christodoulou, & Serafin, 2010).…”