Productivity loss among people with early multiple sclerosis: A Canadian study

Llorian, Elisabet Rodríguez; Zhang, Wei; Khakban, Amir; Patten, Scott B.; Traboulsee, Anthony; Oh, Jiwon; Kolind, Shannon; Prat, Alexandre; Tam, Roger; Lynd, Larry D.

doi:10.1177/13524585211069070

Cited by 15 publications

(31 citation statements)

References 34 publications

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“…We found that the symptom clusters ‘fatigue and cognitive symptoms’ and ‘pain and sensory symptoms’ had the strongest effect sizes with work productivity loss which is consistent with previous studies. 3,14,32,33 Our work highlights the important independent contribution of MS symptom severity and agrees with our previous work showing that individual changes in work productivity are largely driven by the changes in symptom severity rather than the absolute severity. 4 Several studies using objective and subjective measures have also highlighted the negative impact of fatigue, cognitive symptoms and pain on MS-related work productivity and employment outcomes.…”

Section: Discussionsupporting

confidence: 91%

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Estimating the impact of work difficulties, work self-efficacy and work psychological safety on MS-related work productivity loss

et al. 2022

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Background: A comprehensive understanding of factors associated with multiple sclerosis (MS)-related work productivity loss will inform targeted interventions. We have previously shown the strong impact of symptom severity on MS-related work productivity loss. However, the effect of work difficulties, work self-efficacy and work psychological safety is yet to be well evaluated in this context. Objectives: This study evaluates the association between work difficulties, work self-efficacy and work psychological safety, and MS-related presenteeism, absenteeism and total work productivity loss. Methods: We analysed data from employed participants of the Australian MS Longitudinal Study (AMSLS) who took part in both the 2015 Medication and Disease Course survey, and 2015 Employment survey ( n = 744). Data were analysed using Cragg Hurdle regression models. Results: We found that low workplace self-esteem, interpersonal difficulties at work and work self-efficacy were associated with total work productivity loss. In a multivariable model, a 10-unit decrease in workplace self-esteem, increase in interpersonal difficulties at work and 5-unit increase in work self-efficacy were independently associated with a 3.75% increase, 2.89% increase and 3.36% reduction in total work productivity loss, respectively. When separating total work productivity loss in presenteeism and absenteeism, stronger effects were seen for presenteeism than absenteeism. Surprisingly, work psychological safety was not associated with MS-related work productivity loss. Conclusion: Work psychosocial well-being such as self-confidence at work, work self-efficacy and interpersonal difficulties at work are crucial factors governing work productivity in people with MS (PwMS). Multidisciplinary support team assistance of PwMS in symptom self-care, skills around effective communication about MS in the workplace, the psychological impact of work and the modification of work demands may positively influence the employment outcomes.

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Section: Discussionsupporting

confidence: 91%

“…4 Several studies using objective and subjective measures have also highlighted the negative impact of fatigue, cognitive symptoms and pain on MS-related work productivity and employment outcomes. 3,5,14,32,33 Therefore, stabilising or improving MS symptoms may be critical to improve employment outcomes.…”

Section: Discussionmentioning

confidence: 99%

Estimating the impact of work difficulties, work self-efficacy and work psychological safety on MS-related work productivity loss

et al. 2022

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“…This could entail a broad range of difficulties, from the disease restricting choices of suitable jobs to implications for their routine work, such as presenteeism. Several studies have shown substantial levels of lost productivity among PwMS through both absenteeism and presenteeism [19–25]. In addition, comparative studies consistently illustrate higher levels of absenteeism and presenteeism in PwMS than in the general population [26, 27].…”

Section: Discussionmentioning

confidence: 99%

Self‐reported restrictions in different life domains and associated factors among people with multiple sclerosis in Sweden

Teni

Machado

Murley

et al. 2023

Euro J of Neurology

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Background and purpose The heterogeneous symptoms of multiple sclerosis (MS) can considerably impact the lives of people with MS (PwMS). The aim of this study was to describe the extent of restrictions in different life domains that PwMS experience in relation to their symptoms and level of disability. Methods A cross‐sectional survey was conducted among working‐age PwMS in Sweden. The 4052 participants who answered the questions on restrictions in work and private life domains (family, leisure activities, and contact with friends/acquaintances) were included. Predictors of restrictions in the four domains were determined through multinomial logistic regression. Results Approximately one‐third of the PwMS reported no restrictions in the domains of work (35.7%), family (38.7%), leisure activities (31.1%) or contact with friends/acquaintances (40.3%), the remaining participants reported moderate to severe restrictions. Tiredness/fatigue was the most commonly reported most‐limiting symptom (49.5%). PwMS with Expanded Disability Status Scale (EDSS) scores of zero reported restrictions in life domains ranging from 39.6% (friends/acquaintances) to 45.7% (leisure activities). Age, sex, education, type of living area, MS type, type of most‐limiting symptom, and EDSS score predicted restrictions in work and private life domains. Conclusions Most PwMS reported similar levels of restrictions in both their work and private lives. Restrictions in these life domains were also reported by PwMS with low disability levels (EDSS = 0) and were often associated with invisible symptoms such as fatigue. Even in a contemporary MS cohort, close to 90% of PwMS report limitations due to MS.

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“…Average working hours do not vary substantially across Canadian provinces. 16 Based on Rodriguez Llorian et al, 7 and information collected as part of CanProCo, 13 a set of sociodemographic, disease, and performance-related indicators were selected to investigate their associations with productivity loss and employment status. Sociodemographic variables included sex and age.…”

Section: Productivity Loss Outcomes and Associated Factorsmentioning

confidence: 99%

“…6 Furthermore, many pwMS that are still working experience substantial productivity losses even at low severity levels, as reported in our previous study in Canada, which showed an estimated 60 hours of productivity lost among employed pwMS during a 3-month period, including, presenteeism, absenteeism, and unpaid work loss. 7 The relationship among demographic, clinical, physical, and cognitive impairment factors and employment and work-related outcomes (including employment status, working hours, and productivity loss) have been studied previously. 8,9 However, with a few exceptions, [10][11][12] a comprehensive set of factors have not been investigated conjointly and compared across several employment and work-related outcomes.…”

Section: Introductionmentioning

confidence: 99%

Employment status, productivity loss, and associated factors among people with multiple sclerosis

et al. 2023

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Background: Multiple Sclerosis (MS) affects people in their most productive years of life. Consequently, MS can substantially affect employment and work-related outcomes. Objectives: This study characterizes productivity loss and employment status of people with multiple sclerosis (pwMS) and investigates associated factors. Methods: We used baseline data collected as part of the Canadian Prospective Cohort Study to Understand Progression in Multiple Sclerosis (CanProCo). Using the Valuation of Lost Productivity questionnaire, we measured MS-related paid work productivity loss for those employed, productivity losses incurred by those unemployed (i.e. lost employment time), and unpaid work productivity losses for all. A set of sociodemographic, disease, and performance-related factors were investigated using a two-part regression model for productivity loss and a multinomial logistic model for employment status. Results: From the cohort of 888 pwMS enrolled at baseline (mostly showing mild to moderate disability), 75% were employed, and of those unemployed, 69% attributed their unemployment to health-related issues. Total productivity loss over a 3-month period averaged 64 and 395 hours for those employed and unemployed, respectively. Some factors that affected productivity loss and employment status included use of disease-modifying therapies, fatigue, and performance indicators such as cognitive processing speed. Conclusion: Productivity loss experienced by employed and unemployed pwMS is substantial. Targeting the identified modifiable factors is likely to improve work productivity and permanence of MS patients in the workforce.

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Productivity loss among people with early multiple sclerosis: A Canadian study

Cited by 15 publications

References 34 publications

Estimating the impact of work difficulties, work self-efficacy and work psychological safety on MS-related work productivity loss

Estimating the impact of work difficulties, work self-efficacy and work psychological safety on MS-related work productivity loss

Self‐reported restrictions in different life domains and associated factors among people with multiple sclerosis in Sweden

Employment status, productivity loss, and associated factors among people with multiple sclerosis

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