Predictors of Change in Employment Status and Associations with Quality of Life: A Prospective International Study of People with Multiple Sclerosis.
Claudia H Marck, Zoe Aitken, Steve Simpson and 3 others
PMID 31392475WHAT IT FOUND
Among people with MS, moderate or severe disability and lower education predicted losing employment over 2.5 years.
Retiring because of MS was associated with a drop in mental health quality of life. So watch for mood changes after job loss.
Key findings
01Of 720 people employed at baseline, 151 lost employment; lower education and higher disability predicted loss.
02Retiring due to disability was associated with a decline in mental health quality of life of more than 5 points.
0362.0% of 774 participants reported MS had impacted employment; vocational training and progressive MS were predictive of impact.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
People with severe vision, cognitive or dexterity impairment, or non-English speaking were unlikely to be included. The sample may not represent those groups. 43.2% did not complete follow-up. Those lost to follow-up had more severe disability, lower quality of life, and were less likely to be employed at baseline. Estimates may be biased. All data were self-reported, including disability, fatigue, pain, depression screen, cognitive function, and employment status. Measurement error is possible. The 2.5-year follow-up was short. Only 7.4% gained employment. The study could not assess factors that help people return to work. The study did not measure job type, absenteeism, presenteeism, country-specific effects, or reasons for part-time work or retirement. Workplace factors cannot be separated. There were few men. The study may not have had enough power to detect sex differences. For quality of life, unobserved confounders and disease milestones such as relapse or entering progressive MS could explain associations.
Declared interests
Funded by National Health and Medical Research Council, Bloom Foundation, and Wal Pisciotta.
The easy way to misread this
Do not read the more than 5-point mental health decline as proof that retirement caused it. The study is observational, had 43.2% attrition biased toward healthier participants, and MS progression could affect both employment and quality of life.