scholarly journals 939Longitudinal trends of work productivity in a representative sample of Australians living with multiple sclerosis

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Barnabas Bessing ◽  
Leigh Blizzard ◽  
Mohammad A. Hussain ◽  
Suzi B. Claflin ◽  
Bruce V. Taylor ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Productivity Loss ◽  
Work Productivity ◽  
Longitudinal Change ◽  
Anxiety And Depression ◽  
Cognitive Symptoms ◽  
Mixed Effect ◽  
Longitudinal Patterns ◽  
Annual Changes ◽  
Walking Balance

Abstract Background studies have documented increased employment rates and MS-related work productivity loss in people living with multiple sclerosis (PwMS). Little is known about the longitudinal trends of work productivity of PwMS. Objectives To describe the longitudinal patterns of work productivity of PwMS, and examine the factors associated with longitudinal change of work productivity of PwMS. Methods Study participants were from the Australian MS Longitudinal Study (AMSLS) followed from 2015 to 2018 (n = 2724) who were employed. We described the longitudinal patterns of work productivity and determined the correlates of the changes in work productivity of PwMS. We used linear mixed effect modelling to analyse the data. Results From our mixed effect model analysis, feelings of depression, walking difficulties, and spasticity problems were independently associated with -1.45 (-1.95 to -0.95), -1.35 (-1.98 to -0.72) and -1.04 (-1.63 to -0.45) per annum change in work productivity respectively. Annual changes in MS symptom clusters: difficulties with walking, balance and spasticity; anxiety and depression; and fatigue and cognitive symptoms were independently associated with -2.53 (-3.53 to -1.52), -1.51 (-2.27 to -0.74), -0.86 (-1.67 to -0.06) percent annual change in work productivity of PwMS respectively. Conclusion Symptoms cluster like ‘difficulties with walking, balance and spasticity’, ‘feelings of anxiety and depression’, and ‘fatigue and cognitive symptoms’ impact significantly on work productivity. Key messages MS related annual work productivity loss is marginal but is strongly driven by annual changes in walking difficulties, feelings of depression and spasticity problems

Comorbidities are prevalent and detrimental for employment outcomes in people of working age with multiple sclerosis

2019 ◽  
Vol 26 (12) ◽  
pp. 1550-1559 ◽  
Author(s):  
Jing Chen ◽  
Bruce Taylor ◽  
Tania Winzenberg ◽  
Andrew J Palmer ◽  
Andrea Kirk-Brown ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Longitudinal Study ◽  
Symptom Severity ◽  
Productivity Loss ◽  
Work Productivity ◽  
Employment Outcomes ◽  
Working Age ◽  
Annual Population ◽  
Simultaneous Management

Background: More work is needed to understand the burden of comorbidities in people with multiple sclerosis (MS). Objective: To assess prevalence of 30 comorbidities and impacts of comorbidities on employment outcomes in a working-aged MS cohort. Methods: Participants were from the Australian MS Longitudinal Study ( n = 929). Information on specific comorbidity was obtained (whether or not each was present, doctor-diagnosed, limited their activities and being treated). Results: Comorbidities most frequently reported to limit activities were osteoarthritis (51%), migraines (40%), anxiety (33%), depression (29%) and allergies (18%). Mean MS-related work productivity loss in past 4 weeks was 1.3 days for those without comorbidities and 2.5 days for those with any comorbidity. The annual population costs of work productivity loss were highest for people with depression, allergies, anxiety, migraines and osteoarthritis. Higher number of comorbidities was associated with more work productivity loss and a higher likelihood of not working. These associations were substantially reduced after adjustment for MS symptom severity. Conclusions: Comorbidities substantially impact employment outcomes and these effects were mainly mediated through MS symptom severity. This suggests that optimal and simultaneous management of comorbidities may be a viable strategy to reduce MS symptom severity, which in turn could improve employment outcomes.

Estimating MS-related work productivity loss and factors associated with work productivity loss in a representative Australian sample of people with multiple sclerosis

2018 ◽  
Vol 25 (7) ◽  
pp. 994-1004 ◽  
Author(s):  
Jing Chen ◽  
Bruce Taylor ◽  
Andrew J Palmer ◽  
Andrea Kirk-Brown ◽  
Pieter van Dijk ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Labour Force ◽  
Productivity Loss ◽  
Work Productivity ◽  
Labour Force Participation ◽  
Factors Associated ◽  
Lower Education Level ◽  
Australian Sample ◽  
Multivariable Analyses ◽  
Productive Time

Background: Little is known about the work productivity loss in multiple sclerosis (MS). Objectives: To quantify the MS-related work productivity loss and to compare factors associated with labour force participation and work productivity loss. Methods: Participants were from the Australian MS Longitudinal Study. MS-related work productivity loss included absenteeism (time missed from work) and presenteeism (reduced productivity while working). Data were analysed using log-binomial and Cragg hurdle regression. Results: Among 740 MS employees, 56% experienced any work productivity loss due to MS in the past 4  weeks. The mean total work productivity loss was 2.5  days (14.2% lost productive time), absenteeism 0.6  days (3.4%) and presenteeism 1.9  days (10.8%)), leading to AU$6767 (US$4985, EURO€4578) loss per person annually. Multivariable analyses showed that work productivity was determined most strongly by symptoms, particularly ‘fatigue and cognitive symptoms’ and ‘pain and sensory symptoms’, while older age, and lower education level were also predictive of not being in the labour force. Conclusion: MS-related presenteeism was three times higher than absenteeism, highlighting the importance of presenteeism being included in employment outcomes. The dominance of symptom severity as predictors of both work participation and productivity loss emphasises the need for improved management of symptoms.

scholarly journals Assessment in Work Productivity and the Relationship with Cognitive Symptoms (AtWoRC): primary analysis from a Canadian open-label study of vortioxetine in patients with major depressive disorder (MDD)

CNS Spectrums ◽  
2018 ◽  
Vol 24 (3) ◽  
pp. 338-347 ◽  
Author(s):  
Pratap Chokka ◽  
Joanna Bougie ◽  
Emmanouil Rampakakis ◽  
Jean Proulx
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Productivity Loss ◽  
Work Productivity ◽  
Inadequate Response ◽  
Cognitive Symptoms ◽  
Primary Analysis ◽  
Major Depressive ◽  
D 20 ◽  
The Relationship

ObjectiveThe Assessment in Work Productivity and the Relationship with Cognitive Symptoms (AtWoRC) study aimed to assess the association between cognitive symptoms and work productivity in gainfully employed patients receiving vortioxetine for a major depressive episode (MDE).MethodsPatients diagnosed with major depressive disorder (MDD) and treated with vortioxetine independently of study enrollment were assessed over 52 weeks at visits that emulated a real-life setting. Patients were classified as those receiving vortioxetine as the first treatment for their current MDE (first treatment) or having shown inadequate response to a previous antidepressant (switch). The primary endpoint was the correlation between changes in patient-reported cognitive symptoms (20-item Perceived Deficits Questionnaire [PDQ-D-20]) and changes in work productivity loss (Work Limitations Questionnaire [WLQ]) at week 12. Additional assessments included changes in symptom and disease severity, cognitive performance, functioning, work loss, and safety.ResultsIn the week 12 primary analysis, 196 eligible patients at 26 Canadian sites were enrolled, received at least one treatment dose, and attended at least one postbaseline study visit. This analysis demonstrated a significant, strong correlation between PDQ-D-20 and WLQ productivity loss scores (r=0.634; p<0.001), and this correlation was significant in both first treatment and switch patients (p<0.001). A weaker correlation between Digit Symbol Substitution Test and WLQ scores was found (r=−0.244; p=0.003).ConclusionAt 12 weeks, improvements in cognitive dysfunction were significantly associated with improvements in workplace productivity in patients with MDD, suggesting a role for vortioxetine in functional recovery in MDD.

scholarly journals 931Work productivity trajectories in a representative sample of Australians living with multiple sclerosis- group-based modelling

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Barnabas Bessing ◽  
Mohammad A. Hussain ◽  
Leigh Blizzard ◽  
Suzi B. Claflin ◽  
Bruce V. Taylor ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Symptom Severity ◽  
Multinomial Logistic Regression ◽  
Productivity Loss ◽  
Multivariable Analysis ◽  
Work Productivity ◽  
Education Level ◽  
Relative Probability ◽  
Disability Score ◽  
Baseline Factors

Abstract Background Studies have documented loss of work capacity and work productivity loss in multiple sclerosis (MS). Little is known about the longitudinal trajectories of work productivity in MS. Objectives To explore trajectories of work productivity in people living with multiple sclerosis (PwMS) and examine the baseline factors linked with assignment to the trajectories group. Methods Study participants were from the Australian MS Longitudinal Study (AMSLS) from 2015 to 2018 who were employed with ≥2 datapoints (n = 1205). We used group-based trajectory modelling to identify unique work productivity trajectories in PwMS. Multinomial logistic regression was used to assess associations with the work productivity trajectories. Results We identified three distinct trajectories of work productivity: ‘moderately worsened’ (16.7%) with a mean work productivity of 47.6% in 2015, ‘mildly worsened’ (50.1%) with a mean work productivity of 86.3% in 2015 and ‘normal’ (33.2%) with a mean work productivity of 99.7% in 2015. On multivariable analysis, the relative probability of being in moderately or mildly worsened work productivity trajectory were higher for baseline factors such as higher education level, longer disease duration, higher disability score, and high MS symptom severity. For example, the relative probability of being in ‘moderately worsened’ rather than ‘normal’ work productivity trajectory increased by 94% (RRR:1.94 ; 95% confidence interval:1.68 - 2.25) for each unit increase in ‘fatigue and cognitive symptoms’ cluster. Conclusion Education level, disability and MS symptom severity increased the probability of following low work productivity trajectory. Key messages Work productivity interventions should target MS symptom severity and disability reduction.

Decrease in Secondary Neck Vessels in Multiple Sclerosis: A 5-year Longitudinal Magnetic Resonance Angiography Study

2019 ◽  
Vol 16 (3) ◽  
pp. 215-223 ◽  
Author(s):  
Dejan Jakimovski ◽  
Matthew Topolski ◽  
Kana Kimura ◽  
Virja Pandya ◽  
Bianca Weinstock-Guttman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Longitudinal Change ◽  
Repeated Measure ◽  
Cross Sectional ◽  
False Discovery ◽  
The Common ◽  
Neck Vessels

Background: Studies have previously shown greater arterial and venous extracranial vascular changes in persons with multiple sclerosis (PwMS) when compared to healthy controls (HCs). Objectives: To determine the change in the number and size of secondary neck vessels in PwMS and HCs over a 5-year follow-up period. Methods: Both at baseline and follow-up, 83 PwMS and 25 HCs underwent magnetic resonance angiography (MRA) imaging and analysis. The number and cross-sectional area (CSA) of all secondary neck vessels (excluding the common/internal carotid, vertebral artery, and internal jugular vein) measured at levels from C2-T1 were determined by semi-automated edge detection/ contouring software. The longitudinal change in the number and CSA of the secondary neck vessels from the PwMS and HCs were analyzed by non-parametric Wilcoxon repeated measure. Benjamini-Hochberg procedure adjusted for false discovery rate (FDR). Results: For over 5 years, PwMS demonstrated a consistent longitudinal decrease in both the number of secondary neck vessels (Z-change between -3.3 and -5.4, q=0.001) and their CSA (Zchange between -2.9 and -5.2, q=0.004). On the contrary, the HCs did not demonstrate a significant longitudinal change in secondary neck vessels over the follow-up period. Due to the longitudinal decrease, the PwMS showed a lower number of secondary neck vessels when compared to HCs measured at follow-up (p<0.029, except for C4 with trending p=0.071). The PwMS changes were also corroborated within each MS phenotype. Conclusion: PwMS demonstrate a significant mid-term decrease in the number and the size of the secondary neck vessels. The clinical relevance of these findings and the effect on intracranial blood flow are currently unknown.

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