Comorbidities are prevalent and detrimental for employment outcomes in people of working age with multiple sclerosis

Chen, Jing; Taylor, Bruce; Winzenberg, Tania; Palmer, Andrew J.; Kirk-Brown, Andrea; Dijk, Pieter Van; Simpson, Steve; Blizzard, Leigh; Mei, Ingrid van der

doi:10.1177/1352458519872644

Cited by 20 publications

(23 citation statements)

References 33 publications

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“…26 Another large cohort study in Sweden found that persons having MS with depression had a higher risk of reaching major disability milestones, including EDSS scores of 3.0, 4.0, and 6.0. 34 Mood and anxiety disorders, as well as migraine, another prevalent comorbidity among our immigrant cohort, have been shown to be major causes of limited work activities in the Australian MS Longitudinal Study of 929 persons with MS. 35 Depression, along with physical comorbidity, was correlated with decreased health-related quality of life in a Canadian cross-sectional study of 949 persons with MS. 36 Overall, depression and anxiety are known to be underdiagnosed and undertreated in individuals with MS. 37,38 Brief, self-reported psychometric scales can assist with screening for these conditions. 38 Pharmacotherapy, cognitive behavioral therapy, mindfulness-based therapy, and exercise programs may all offer therapeutic benefit although there is no gold standard approach to treatment.…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

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High prevalence of comorbidities at diagnosis in immigrants with multiple sclerosis

Rotstein

Maxwell

et al. 2021

Mult Scler

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Background: Multiple sclerosis (MS) has been associated with certain comorbidities in general population studies, but it is unknown how comorbidity may affect immigrants with MS. Objective: To compare prevalence of comorbidities in immigrants and long-term residents at MS diagnosis, and in matched control populations without MS. Methods: We identified incident MS cases using a validated definition applied to health administrative data in Ontario, Canada, from 1994 to 2017, and categorized them as immigrants or long-term residents. Immigrants and long-term residents without MS (controls) were matched to MS cases 3:1 on sex, age, and geography. Results: There were 1534 immigrants and 23,731 long-term residents with MS matched with 4585 and 71,193 controls, respectively. Chronic obstructive pulmonary disease (COPD), diabetes, hypertension, ischemic heart disease, migraine, epilepsy, mood/anxiety disorders, schizophrenia, inflammatory bowel disease (IBD), and rheumatoid arthritis were significantly more prevalent among immigrants with MS compared to their controls. Prevalence of these conditions was generally similar comparing immigrants to long-term residents with MS, although COPD, epilepsy, IBD, and mood/anxiety disorders were less prevalent in immigrants. Conclusion: Immigrants have a high prevalence of multiple comorbidities at MS diagnosis despite the “healthy immigrant effect.” Clinicians should pay close attention to identification and management of comorbidity in immigrants with MS.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

High prevalence of comorbidities at diagnosis in immigrants with multiple sclerosis

Rotstein

Maxwell

et al. 2021

Mult Scler

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“…Chen et al 18 report on MS days lost that there is a mean total absenteeism of 0.6 days per 4 weeks or 7.8 days per person annually. Symptom severity in people with MS most strongly explains workforce participation and productivity 19 . They assessed prevalence and impact of 30 comorbidities on participation and productivity in work, and the economic burden and productivity costs of comorbidities.…”

Section: Why Is This Important To People's Health?mentioning

confidence: 99%

“…Symptom severity in people with MS most strongly explains workforce participation and productivity. 19 They assessed prevalence and impact of 30 comorbidities on participation and productivity in work, and the economic burden and productivity costs of comorbidities. Depression (45%) followed by anxiety (42%), allergies (38%), migraine (30%), and high blood pressure (25%) were the five most prevalent comorbidities.…”

Section: Multiple Sclerosis: Costs To Individuals Families and The Economymentioning

confidence: 99%

Universal health coverage and primary health care: Their place in people's health

Walker

Peterson

2020

Evaluation Clinical Practice

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Sturmberg and Martin in 2020 argue that universal health coverage (UHC) is mainly about financing, and primary health care (PHC) is about the right care at the right time to ensure health. They maintain that the World Health Organization has recently sent the wrong message about the “pillars” of PHC in their relationship to UHC. An understanding of political economy is required in order to come to terms with the bases of PHC and the fundamentals of UHC that dealing with inequities is not only an economic issue but fundamentally a political issue. Neoliberal decision‐making can enhance inequities in society. Two chronic health conditions, diabetes and multiple sclerosis, are examples of conditions that lead to costly and debilitating consequences for patients but also lead to substantial economic costs in terms of lost workforce participation and lost productivity. These cases demonstrate the socio‐political issues involved in the management of care for a number of illnesses. The upsurge of COVID‐19 has placed an enormous strain on health and broader social and economic resources and challenged the pretext of UHC as health for all: substantial differences in equity and political commitment have emerged. Sturmberg and Martin argue that the joining of UHC and PHC needs leadership, which involves local communities and resourcing. PHC is a changing system based on power relationships involving funders and the health community. In Australia as in several countries, out‐of‐pocket costs have grown rapidly and have affected access for some groups to PHC and have challenged the pretext of equity in UHC. In the context of PHC and UHC, we support the position that health for all goes beyond health care for all, to embrace healthy lives promoting wellbeing.

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“…Symptom severity in people with MS most strongly explains workforce participation and productivity. 15 They assessed prevalence and impact of 30 comorbidities on participation and productivity in work, and the economic burden and productivity costs of comorbidities. Depression (45%) followed by anxiety (42%), allergies (38%), migraine (30%) and high blood pressure (25%) were the five most prevalent comorbidities.…”

Section: Multiple Sclerosis (Ms): Costs To Individuals Families and mentioning

confidence: 99%

Universal Health Coverage and Primary Health Care: Their Place in People’s Health

Walker¹,

Peterson

2020

Preprint

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Sturmberg and Martin in 2020 argue that Universal Health Care (UHC) is mainly about financing and Primary Health Care (PHC) is about the right care at the right time to ensure health. They maintain the World Health Organisation (WHO) has recently sent the wrong message about the "pillars" of PHC in their relationship to UHC. An understanding of political economy is required in order to come to terms with the bases of PHC and the fundamentals of UHC, that dealing with inequities is not only an economic issue but fundamentally a political issue. Neoliberal decision making can enhance inequities in society. Two chronic health conditions, diabetes and multiple sclerosis are examples of conditions that lead to costly and debilitating consequences for patients but also lead to substantial economic costs in terms of lost workforce participation and lost productivity. These cases demonstrate the socio-political issues involved in the management of care for a number of illnesses. The upsurge of COVID-19 has placed an enormous strain on health and broader social and economic resources and challenged the pretext of UHC as health for all: substantial differences in equity and political commitment have emerged. Sturmberg and Martin argue that the joining of UHC and PHC needs leadership which involves local communities and resourcing. PHC is a changing system based on power relationships involving funders and the health community. In Australia as in several countries out of pocket costs have grown rapidly and have affected access for some groups to PHC and have challenged the pretext of equity in UHC. In the context of PHC and UHC we support the position that health for all goes beyond healthcare for all, to embrace healthy lives promoting wellbeing.

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Comorbidities are prevalent and detrimental for employment outcomes in people of working age with multiple sclerosis

Cited by 20 publications

References 33 publications

High prevalence of comorbidities at diagnosis in immigrants with multiple sclerosis

High prevalence of comorbidities at diagnosis in immigrants with multiple sclerosis

Universal health coverage and primary health care: Their place in people's health

Universal Health Coverage and Primary Health Care: Their Place in People’s Health

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