Employment and absenteeism in working-age persons with multiple sclerosis

Salter, Amber; Thomas, Nina; Tyry, Tuula; Cutter, Gary; Marrie, Ruth Ann

doi:10.1080/13696998.2016.1277229

Cited by 64 publications

(54 citation statements)

References 37 publications

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“…It has been suggested that the HRQOL of people with MS deteriorates when they leave the workforce, 16 and, therefore, employment has been suggested as a potential public health intervention for people with MS. 17 Exploring attributes or dimensions of HUI3 associated with employment status, we found that three (cognition impairment, physical disability [mobility impairment], and pain/discomfort) of eight attributes of HUI3 were strongly associated with not working due to MS. The present findings concur with previous studies that have found a higher likelihood of unemployment among people with MS who reported cognition impairment, 38,41,47 physical disability, [38][39][40][41]45 and pain. 48 As such, interventions targeting these specific HRQOL attributes may contribute to improving the overall quality of life of people with MS and subsequently their work productivity.…”

Section: Discussionsupporting

confidence: 93%

“…As expected and consistent with previous studies, 9,[38][39][40][41] we found that sociodemographic factors, including increasing age and higher education attainment, were associated with unemployment in people with MS. However, the sex of the person with MS was not associated with unemployment.…”

Section: Discussionsupporting

confidence: 92%

“…Note that the effect of sex on unemployment and work productivity loss among people with MS has not been consistently reported in previous studies. [41][42][43][44][45] Furthermore, not unexpectedly, we found that poor HRQOL was strongly associated with unemployment in people with MS, and this has previously been reported. 46 Although self-reported general health was not included in the present parsimonious model because it was collinear with HRQOL, we noted that poorer self-reported general health was strongly associated with not working due to MS when kept in the model and HRQOL was removed.…”

Section: Discussionsupporting

confidence: 65%

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Association of Unemployment and Informal Care with Stigma in Multiple Sclerosis

Hategeka¹,

Traboulsee²,

McMullen³

et al. 2019

International Journal of MS Care

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Background: Multiple sclerosis (MS) typically affects young adults during their primary productive years. We assessed the magnitude of, and factors associated with, employment status and informal care in people with MS in Canada. Methods: Data were compiled from the nationally representative cross-sectional Survey on Living with Neurological Conditions in Canada (SLNCC), which included adolescents and adults (age ≥15 years). Employment status was categorized as currently working or not working. The frequency of informal care that people with MS received was categorized as none, less than daily, or daily. Logistic regression analyses were undertaken to identify factors associated with employment status and informal care requirements in people with MS. Results: Of 4409 SLNCC respondents, 631 had MS, of whom 530 were included in the analysis. Of 358 respondents aged 18 to 65 years, 47.8% were not working because of MS; 44.0% reported receiving informal care, with more than half requiring daily care. For caregivers' employment, 15.5% reduced work and 8.2% stopped working because of caregiving. Greater feelings of stigmatization were associated with not working (adjusted odds ratio, 7.42 [95% CI, 2.59–21.28]) and greater informal care (adjusted odds ratio, 3.83 [95% CI, 1.84–7.96]), adjusting for sex, age, education, health-related quality of life, time since MS diagnosis, and comorbidity. Conclusions: People who feel stigmatized because of their MS are more likely to be unemployed and to require more informal care. Further research is needed to understand the temporal nature of the association between stigma and employment, productivity loss, and informal care.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 65%

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Association of Unemployment and Informal Care with Stigma in Multiple Sclerosis

Hategeka¹,

Traboulsee²,

McMullen³

et al. 2019

International Journal of MS Care

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“…Moderate to severe cognitive impairment, fatigue, and hand function problems were associated with both disability and absenteeism. 22 Of adults 65 years or older, 15% of patients without MS reported using an assistive device, whereas 81% of patients with MS required an assistive device in the NARCOMS cohort, a 6-fold difference. 23,24 Long-term follow-up studies of patients on platform agents reveal the risks of undertreatment An extension of the pivotal glatiramer acetate trial found that of patients who were maintained on treatment for an average of 13.6 years, 35% were likely to develop secondary progressive disease.…”

Section: Ms Is Rarely Benign Over the Long Term When Dysfunction Is Cmentioning

confidence: 87%

An argument for broad use of high efficacy treatments in early multiple sclerosis

Stankiewicz

Weiner

2020

Neurol Neuroimmunol Neuroinflamm

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Two different treatment paradigms are most often used in multiple sclerosis (MS). An escalation or induction approach is considered when treating a patient early in the disease course. An escalator prioritizes safety, whereas an inducer would favor efficacy. Our understanding of MS pathophysiology has evolved with novel in vivo and in vitro observations. The treatment landscape has also shifted significantly with the approval of over 10 new medications over the past decade alone. Here, we re-examine the treatment approach in light of these recent developments. We believe that recent work suggests that early prediction of the disease course is fraught, the amount of damage to the brain that MS causes is underappreciated, and its impact on patient function oftentimes is underestimated. These concerns, coupled with the recent availability of agents that allow a better therapeutic effect without compromising safety, lead us to believe that initiating higher efficacy treatments early is the best way to achieve the best possible long-term outcomes for people with MS. Multiple sclerosis following collection(s):This article, along with others on similar topics, appears in the Permissions & Licensing http://nn.neurology.org/misc/about.xhtml#permissions its entirety can be found online at: Information about reproducing this article in parts (figures,tables) or in Reprints http://nn.neurology.org/misc/addir.xhtml#reprintsus Information about ordering reprints can be found online: Academy of Neurology.. All rights reserved. Online

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“…The worldwide unemployment rates of people with MS range from 30% to 43% within 11 to 19 years of disease onset 5,6,7,8,9 and work availability decreases from 82% to 8% 10 . Having MS more than triples the chance of losing the current job 11 , and simply publicly disclosing the MS diagnosis has a major negative impact on the chance of becoming employed or having a remunerated activity 3,12 .…”

Section: Introductionmentioning

confidence: 99%

Employment status of people diagnosed with multiple sclerosis in Brazil

Estrutti

Cardoso²,

Novais

et al. 2019

Arq. Neuro-Psiquiatr.

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Objective: To describe the employment status of Brazilians with multiple sclerosis (MS). Methods: Analysis of a cross-sectional online survey including questions on demographic and occupational status at the time of diagnosis and survey completion, and time from the first symptom to diagnosis. Results: Of those who answered the survey, 804 Brazilians with MS were included. Median age of onset and current age were 28.3 and 36.2 years; median time to diagnosis and disease duration were 2.7 and 7.9 years; 67% held a university degree and 29% finished high school; 94% had a paid occupation contributing to the family income at least once in their lives, 77% were employed at the time of diagnosis but only 59% were employed at the time of survey. Longer disease duration, longer time to diagnosis and younger age at the first symptom, were identified as factors correlated with being unemployed. Conclusions: The rate of unemployment doubled after the first symptoms of MS, and only 59% of highly-educated people with MS in their productive years were employed. The longer time to diagnosis may imply treatment delay, and strategies focusing on early diagnosis and adequate treatment may favor employment retention and reduce disability related costs, such as social benefits and pension fund use.

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Employment and absenteeism in working-age persons with multiple sclerosis

Cited by 64 publications

References 37 publications

Association of Unemployment and Informal Care with Stigma in Multiple Sclerosis

Association of Unemployment and Informal Care with Stigma in Multiple Sclerosis

An argument for broad use of high efficacy treatments in early multiple sclerosis

Employment status of people diagnosed with multiple sclerosis in Brazil

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