Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.
Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA.
Res Social Adm Pharm. 2022 Nov;18(11):3988-3994. doi: 10.1016/j.sapharm.2022.07.005. Epub 2022 Jul 14.
Scarce data exists regarding United States (US) national-level work productivity loss among adults with Multiple Sclerosis (MS).
To address this significant knowledge gap, we examined the national-level productivity loss among adults (18≤ age ≤64 years) with MS compared to propensity score matched non-MS controls.
We adopted a retrospective, cross-sectional, matched cohort study design with pooled data from alternate years (2005/2007/2009/2011/2013/2015) of the Medical Expenditure Panel Survey (MEPS). We included adults who were employed and alive during the calendar year. Clinical Classification System code of "80" was used to identify individuals with MS. We matched adults with MS to non-MS adults utilizing propensity scores generated based on age, gender, and race/ethnicity using a greedy matching algorithm (8:1-digit matching). Missed workdays measured productivity loss of MEPS respondents. We selected Negative Binomial Regression (NBR) analysis as the count data model for this study. Analyses were conducted using SAS 9.4 and STATA 15.0 and accounted for the complex survey design of MEPS to generate US national-level estimates.
The final propensity-score matched sample consisted of 104 and 312 (unweighted) adults with and without MS, respectively. US national-level mean [Standard Error (SE)] annual missed workdays among individuals with MS [8.94 (SE:1.59)] was significantly higher (p = 0.001) compared to propensity score matched non-MS controls [3.15 (SE:0.40)]. After adjusting for several factors, NBR showed an approximately two-fold higher rate of missed work days among individuals with MS compared to propensity score matched non-MS controls (Incidence Rate Ratio: 1.98, 95% Confidence Interval: 1.18-3.33). Severity of pain, marital status, region, and hypertension also negatively impacted work productivity in this sample.
Individuals with MS in the US experience significantly higher productivity loss compared to propensity score matched non-MS controls. Interventions (e.g., improved management of MS symptoms) are warranted to reduce productivity loss among individuals with MS.
关于美国成年人多发性硬化症（MS）的工作生产力损失，数据非常有限。
为了填补这一重要知识空白，我们比较了患有 MS 的成年人（18≤年龄≤64 岁）与匹配的非 MS 对照组之间的全国生产力损失。
我们采用了回顾性、横断面、匹配队列研究设计，使用医疗支出面板调查（MEPS）的交替年份（2005/2007/2009/2011/2013/2015 年）进行了汇总数据。我们纳入了在日历年内就业且存活的成年人。使用“80”临床分类系统代码来识别患有 MS 的个体。我们使用基于年龄、性别和种族/民族的倾向得分生成，通过贪婪匹配算法（8:1 位匹配）对 MS 成人与非 MS 成人进行匹配。MEPS 受访者的旷工天数衡量了生产力损失。我们选择负二项回归（NBR）分析作为本研究的计数数据模型。使用 SAS 9.4 和 STATA 15.0 进行分析，并考虑了 MEPS 的复杂调查设计，以生成美国全国水平的估计值。
最终的倾向评分匹配样本包括 104 名（未加权）和 312 名（未加权）患有和不患有 MS 的成年人。患有 MS 的个体每年平均[标准误差（SE）]旷工天数为 8.94（SE：1.59），显著高于倾向得分匹配的非 MS 对照组[3.15（SE：0.40）]（p=0.001）。在调整了多个因素后，NBR 显示患有 MS 的个体比倾向得分匹配的非 MS 对照组的旷工天数高出近两倍（发病率比：1.98，95%置信区间：1.18-3.33）。疼痛严重程度、婚姻状况、地区和高血压也对该样本的工作生产力产生负面影响。
与倾向得分匹配的非 MS 对照组相比，美国患有 MS 的个体经历了显著更高的生产力损失。需要采取干预措施（例如，改善 MS 症状管理）来减少患有 MS 的个体的生产力损失。
