Department of Health Sciences, University of Genoa, Genoa, Italy.
IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy.
PLoS One. 2022 Jul 28;17(7):e0272156. doi: 10.1371/journal.pone.0272156. eCollection 2022.
We aimed to summarise the prevalence of unemployment and early retirement among people with MS and analyze data according to a spatio-temporal perspective.
We undertook a systematic search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect, and Web of Science. We included any peer-reviewed original article reporting the prevalence of unemployment and early retirement in the working-age population with MS. We excluded articles off-topic, with other study designs, whose study sample were unlikely to be representative of the MS population and in case of unavailability of the full text or essential information. A random-effects meta-analysis was used to measure overall prevalence estimates of unemployment and early retirement. We used meta-regression and subgroup analysis to evaluate potential moderators of prevalence estimates and the leave-one-out method for sensitivity analyses.
Our research identified 153 studies across 29 countries encompassing 188436 subjects with MS. The pooled overall effect size for unemployment and early retirement was 35.6% (95% CI 32.8-38.4; I2 = 99.31) and 17.2% (95% CI 14.6-20.2; I2 = 99.13), respectively. The prevalence of unemployment varied according to the year of publication (p < 0.001) and there was a statistically significant decrease in the prevalence of unemployment over time (p = 0.042). Regarding early retirement, only seven (31.8%) estimates obtained from studies that were published before 2010 were below the overall effect size in comparison to 27 (60.0%) estimates extracted from data published between 2010 and 2021 (p = 0.039). There was a significant difference in prevalence according to countries (p < 0.001). Psychiatric illness was an important clinical feature responsible for patients leaving the workforce in regions with a high MS prevalence.
Unemployment and early retirement due to MS remain highly prevalent, despite a slight decline in the last decade. The prevalence of unemployment and early retirement varies globally.
我们旨在总结多发性硬化症患者失业和提前退休的流行率，并根据时空视角分析数据。
我们对 PubMed/MEDLINE、Scopus、SciVerse ScienceDirect 和 Web of Science 进行了系统检索。我们纳入了任何报告多发性硬化症患者劳动力中失业和提前退休流行率的同行评审原始文章。我们排除了非主题文章、其他研究设计的文章、研究样本不太可能代表多发性硬化症人群的文章，以及无法获取全文或重要信息的文章。使用随机效应荟萃分析来衡量失业和提前退休的总体流行率估计值。我们使用荟萃回归和亚组分析来评估流行率估计值的潜在调节因素，并使用逐一剔除法进行敏感性分析。
我们的研究在 29 个国家确定了 153 项研究，涵盖了 188436 名多发性硬化症患者。失业和提前退休的总体合并效应量分别为 35.6%（95%CI 32.8-38.4；I2=99.31）和 17.2%（95%CI 14.6-20.2；I2=99.13）。失业的流行率因发表年份而异（p<0.001），随着时间的推移，失业的流行率呈统计学显著下降（p=0.042）。关于提前退休，与 2010 年前发表的研究相比，只有 7 项（31.8%）估计值低于总体效应量，而 2010 年至 2021 年期间发表的数据中有 27 项（60.0%）估计值低于总体效应量（p=0.039）。流行率因国家而异（p<0.001）。精神病是导致高多发性硬化症流行地区患者离开劳动力的重要临床特征。
尽管过去十年略有下降，但多发性硬化症导致的失业和提前退休仍然高度流行。失业和提前退休的流行率在全球范围内有所差异。
