OhioHealth Multiple Sclerosis Clinic, Riverside Methodist Hospital, Columbus, OH, USA.
Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, 07936, USA.
BMC Neurol. 2019 Oct 28;19(1):258. doi: 10.1186/s12883-019-1495-z.
BACKGROUND: Multiple sclerosis (MS) is prevalent among working age individuals (20-60 years), leading to high burden on work productivity. Few data are available about the absenteeism and presenteeism in employed individuals with MS in comparison to non-MS personnel. This study aimed to quantify the burden of illness of employed US adults with relapsing-remitting multiple sclerosis (RRMS) and examine burden by levels of work impairment. METHODS: A retrospective cross-sectional analysis was conducted using patient-reported responses from the US National Health and Wellness Survey (NHWS). Data from NHWS 2015-2016 were analyzed from 196 employed RRMS respondents who were matched 1:4 to employed respondents without MS based on demographic and general health characteristics. Demographic and general health characteristics for employed RRMS individuals were analyzed by levels of work impairment (none, 1-30%; 31-68%; 69-100%). Work productivity (absenteeism, presenteeism, and work impairment), decrements in health-related quality of life (HRQoL) (short form-36, EQ-5D), and healthcare resource utilization (HCRU) were compared to determine the burden of RRMS. RESULTS: After propensity score matching, the levels of absenteeism and presenteeism were 2 and 1.8 times higher in the employed RRMS population than the employed non-MS population, respectively (P < 0.001 for both). HRQoL was significantly lower in employed respondents with RRMS than those without MS (P < 0.001 for all). Employed respondents with RRMS had significantly more HCRU over 6 months compared to those without MS (P < 0.001). Furthermore, among employed RRMS respondents, greater levels of impairment were associated with increasing disease severity, greater healthcare resource use, fatigue, and cognitive impairment and inversely associated with mental and physical HRQoL (P < 0.0001 for all). CONCLUSIONS: Among employed individuals, respondents with RRMS had lower, work productivity, HRQoL, and higher HCRU as compared with those without MS. Given the large impact RRMS has on work impairment, a need exists to manage individuals on therapies that improve HRQoL, reduce symptoms, and improve their ability to perform in the workforce.
背景：多发性硬化症（MS）在工作年龄段人群（20-60 岁）中较为普遍，导致工作生产力负担沉重。与非 MS 人员相比，患有 MS 的在职人员的旷工和出勤情况的数据较少。本研究旨在量化美国在职复发性缓解型多发性硬化症（RRMS）患者的疾病负担，并通过工作障碍程度来检查负担。
方法：使用美国国家健康和健康调查（NHWS）的患者报告结果进行回顾性横断面分析。对 2015-2016 年 NHWS 的 196 名在职 RRMS 应答者的数据进行了分析，这些应答者根据人口统计学和一般健康特征与在职无 MS 应答者进行了 1:4 的匹配。根据工作障碍程度（无、1-30%；31-68%；69-100%）分析了在职 RRMS 个体的人口统计学和一般健康特征。比较了工作生产力（旷工、出勤和工作障碍）、与健康相关的生活质量（HRQoL）（短格式 36、EQ-5D）和医疗保健资源利用（HCRU）的下降，以确定 RRMS 的负担。
结果：在倾向评分匹配后，在职 RRMS 人群的旷工和出勤水平分别比在职无 MS 人群高 2 倍和 1.8 倍（均 P<0.001）。与无 MS 患者相比，RRMS 在职患者的 HRQoL 明显较低（均 P<0.001）。与无 MS 患者相比，RRMS 在职患者在 6 个月内的 HCRU 明显更多（均 P<0.001）。此外，在职 RRMS 应答者中，较高的障碍程度与疾病严重程度的增加、更多的医疗资源使用、疲劳和认知障碍相关，而与精神和身体 HRQoL 呈负相关（均 P<0.0001）。
结论：与无 MS 患者相比，在职人群中 RRMS 患者的工作生产力、HRQoL 和 HCRU 较低，旷工和出勤较多。鉴于 RRMS 对工作障碍的影响很大，需要管理那些能改善 HRQoL、减轻症状并提高其在劳动力中的工作能力的患者的治疗方法。
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