Salter Amber, Thomas Nina, Tyry Tuula, Cutter Gary, Marrie Ruth Ann
a Division of Biostatistics , School of Medicine, Washington University in St Louis , St Louis , MO , USA.
b Genentech, Inc , South San Francisco , CA , USA.
J Med Econ. 2017 May;20(5):493-502. doi: 10.1080/13696998.2016.1277229. Epub 2017 Jan 25.
To better understand the impact of the clinical course of multiple sclerosis (MS) and disability on employment, absenteeism, and related factors.
This study included respondents to the North American Research Committee on Multiple Sclerosis Registry spring 2015 update survey who were US or Canadian residents, aged 18-65 years and reported having relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), or primary progressive MS (PPMS). The RRMS and SPMS participants were combined to form the relapsing-onset MS (RMS) group and compared with the PPMS group regarding employment status, absenteeism, and disability. Multivariable logistic regression was used to examine the relationship between employment-related outcomes and factors that may affect these relationships.
Of the 8004 survey respondents, 5887 (73.6%) were 18-65 years of age. The PPMS group (n = 344) had a higher proportion of males and older mean age at the time of the survey and at time of diagnosis than the RMS group (n = 4829). Female sex, age, age at diagnosis, cognitive and hand function impairment, fatigue, higher disability levels, ≥3 comorbidities, and a diagnosis of PPMS were associated with not working. After adjustment for disability, the employed PPMS sub-group reported similar levels of absenteeism to the employed RMS sub-group.
Limitations of the study include self-report of information and the possibility that participants may not fully represent the working-age MS population.
In MS, employment status and absenteeism are negatively affected by disability, cognitive impairment, and fatigue. These findings underscore the need for therapies that prevent disability progression and other symptoms that negatively affect productivity in persons with MS to enable them to persist in the workforce.
更好地了解多发性硬化症（MS）的临床病程和残疾对就业、缺勤及相关因素的影响。
本研究纳入了北美多发性硬化症研究委员会注册中心2015年春季更新调查的受访者，这些受访者为美国或加拿大居民，年龄在18 - 65岁之间，且报告患有复发缓解型MS（RRMS）、继发进展型MS（SPMS）或原发进展型MS（PPMS）。将RRMS和SPMS参与者合并组成复发型MS（RMS）组，并在就业状况、缺勤情况和残疾方面与PPMS组进行比较。采用多变量逻辑回归分析就业相关结果与可能影响这些关系的因素之间的关系。
在8004名调查受访者中，5887名（73.6%）年龄在18 - 65岁之间。与RMS组（n = 4829）相比，PPMS组（n = 344）在调查时和诊断时男性比例更高，平均年龄更大。女性、年龄、诊断时的年龄、认知和手部功能障碍、疲劳、更高的残疾水平、≥3种合并症以及PPMS诊断与未工作相关。在对残疾进行调整后，就业的PPMS亚组报告的缺勤水平与就业的RMS亚组相似。
本研究的局限性包括信息的自我报告以及参与者可能无法完全代表工作年龄的MS人群。
在MS中，就业状况和缺勤受到残疾、认知障碍和疲劳的负面影响。这些发现强调需要有预防残疾进展和其他对MS患者生产力有负面影响的症状的治疗方法，以使他们能够继续留在劳动力队伍中。
