Long-term predictors of outcome in fatigued employees on sick leave: a 4-year follow-up study

Leone, Stephanie S.; Huibers, Marcus J.H.; Kant, IJmert; Schayck, C.P. van; Bleijenberg, Gijs; Knottnerus, J. André

doi:10.1017/s0033291706008099

Cited by 16 publications

(13 citation statements)

References 27 publications

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“…That disability was the main independent predictor of discontinuation of employment in a multivariable model is consistent with a study of employees on long-term sick leave due to fatigue [26]. Our finding suggests that people with CFS/ME continue in employment despite the primary (fatigue and pain) and secondary effects (depression and anxiety) of CFS/ME.…”

Section: Discussionsupporting

confidence: 91%

The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database

Collin

Crawley

May³

et al. 2011

BMC Health Serv Res

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BackgroundFew studies have investigated factors associated with discontinuation of employment in patients with CFS/ME or quantified its impact on productivity.MethodsWe used patient-level data from five NHS CFS/ME services during the period 01/04/2006-31/03/2010 collated in the UK CFS/ME National Outcomes Database. We used logistic regression to identify factors associated with discontinuation of employment. We estimated UK-wide productivity costs using patient-level data on duration of illness before assessment by a CFS/ME service, duration of unemployment, age, sex and numbers of patients, in conjunction with Office for National Statistics income and population data.ResultsData were available for 2,170 patients, of whom 1,669 (76.9%) were women. Current employment status was recorded for 1,991 patients (91.8%), of whom 811 patients (40.7%) were currently employed and 998 (50.1%) had discontinued their employment "because of fatigue-related symptoms". Older age, male sex, disability, fatigue, pain, and duration of illness were associated with cessation of employment. In a multivariable model, age, male sex, and disability remained as independent predictors. Total productivity costs among the 2,170 patients due to discontinuation of employment in the years preceding assessment by a specialist CFS/ME service (median duration of illness = 36 months) were £49.2 million. Our sample was equivalent to 4,424 UK adults accessing specialist services each year, representing productivity costs to the UK economy of £102.2 million. Sensitivity analyses suggested a range between £75.5-£128.9 million.ConclusionsCFS/ME incurs huge productivity costs amongst the small fraction of adults with CFS/ME who access specialist services.

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Section: Discussionsupporting

confidence: 91%

The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database

Collin

Crawley

May³

et al. 2011

BMC Health Serv Res

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“…This was confirmed by the above-mentioned evaluation of treatments in the NHS CFS clinics (n = 1643) by Crawley et al [45]. Leone et al [56] found that physical functioning at baseline, deterioration of physical functioning between the baseline measurement and 12-month follow-up predicted work disability at 4-year follow-up. Hill et al [47] who studied the natural history of severe ME, concluded that the prognosis for recovery was extremely poor.…”

Section: Illness Severitymentioning

confidence: 65%

“…In two studies with 18 months and three-year follow-up respectively, employment status decreased from 31% to 24% [49] and from 63% to 55% [34]. In a study with a follow-up of 3.8 years, 36.5% (19/52) of CFS like cases returned to work [56]. In a nine-year follow-up by Anderson et al [33], as a group, patients had not improved.…”

Section: Employment Status In Me/cfsmentioning

confidence: 93%

“…Knowledge of prognostic factors-discussed earlier in this paper-related to occupational outcomes is important because ME/CFS often leads to absenteeism and full work incapacity [56,59]. Since the role of the occupational physicians is to advise on questions relating to work it is important to have some insight into the work-related functions that ME/CFS can affect.…”

Section: Sickness Absencementioning

confidence: 95%

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Work Rehabilitation and Medical Retirement for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. A Review and Appraisal of Diagnostic Strategies

Vink¹,

Vink-Niese

2019

Diagnostics

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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome leads to severe functional impairment and work disability in a considerable number of patients. The majority of patients who manage to continue or return to work, work part-time instead of full time in a physically less demanding job. The prognosis in terms of returning to work is poor if patients have been on long-term sick leave for more than two to three years. Being older and more ill when falling ill are associated with a worse employment outcome. Cognitive behavioural therapy and graded exercise therapy do not restore the ability to work. Consequently, many patients will eventually be medically retired depending on the requirements of the retirement policy, the progress that has been made since they have fallen ill in combination with the severity of their impairments compared to the sort of work they do or are offered to do. However, there is one thing that occupational health physicians and other doctors can do to try and prevent chronic and severe incapacity in the absence of effective treatments. Patients who are given a period of enforced rest from the onset, have the best prognosis. Moreover, those who work or go back to work should not be forced to do more than they can to try and prevent relapses, long-term sick leave and medical retirement.

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“…CBT [10], or 48 months [11] of follow-up. We previously reported on short-term and long-term predictors of fatigue, work status, and chronic fatigue syndrome in the course of time [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Associations of fatigue and depression among fatigued employees over time: A 4-year follow-up study

Huibers

Leone

Amelsvoort

et al. 2007

Journal of Psychosomatic Research

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Long-term predictors of outcome in fatigued employees on sick leave: a 4-year follow-up study

Abstract: Background. Persistent fatigue is strongly associated with functional status and can lead to absenteeism and work disability. Despite several prognostic studies on chronic fatigue, little attention has been paid to occupational outcomes.

Cited by 16 publications

References 27 publications

The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database

The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database

Work Rehabilitation and Medical Retirement for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. A Review and Appraisal of Diagnostic Strategies

Associations of fatigue and depression among fatigued employees over time: A 4-year follow-up study

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