Earnings among people with multiple sclerosis compared to references, in total and by educational level and type of occupation: a population-based cohort study at different points in time

ObjectivesTo investigate earnings among people with multiple sclerosis (PwMS) before and after MS diagnosis compared with people without MS, and if identified differences were associated with educational levels and types of occupations. Furthermore, to assess the proportions on sickness absence (SA) and disability pension (DP) in both groups.DesignPopulation-based longitudinal cohort study, 10 years before until 5 years after MS diagnosis.SettingWorking-age population using microdata linked from nationwide Swedish registers.ParticipantsResidents in Sweden in 2004 aged 30–54 years with MS diagnosed in 2003–2006 (n=2553), and references without MS (n=7584) randomly selected by stratified matching.Outcome measuresQuartiles of earnings were calculated for each study year prior to and following the MS diagnosis. Mean earnings, by educational level and type of occupation, before and after diagnosis were compared using t-tests. Tobit regressions investigated the associations of earnings with individual characteristics. The proportions on SA and/or DP, by educational level and type of occupation, for the diagnosis year and 5 years later were compared.ResultsDifferences in earnings between PwMS and references were observed beginning 1 year before diagnosis, and increased thereafter. PwMS had lower mean earnings for the diagnosis year (difference=SEK 28 000, p<0.05), and 5 years after diagnosis, this difference had more than doubled (p<0.05). These differences remained after including educational level and type of occupation. Overall, the earnings of PwMS with university education and/or more qualified occupations were most like their reference peers. The proportions on SA and DP were higher among PwMS than the references.ConclusionsThe results suggest that the PwMS’ earnings are lower than the references’ beginning shortly before MS diagnosis, with this gap increasing thereafter. Besides SA and DP, the results indicate that educational level and type of occupation are influential determinants of the large heterogeneity of PwMS’ earnings.

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Earnings among people with multiple sclerosis in Sweden, by education and occupation

European Journal of Public Health ◽

10.1093/eurpub/ckz185.169 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C Murley ◽

M Wiberg ◽

P Tinghög ◽

K Alexanderson ◽

E Palmer ◽

...

Keyword(s):

Multiple Sclerosis ◽

Educational Level ◽

Population Based ◽

Individual Characteristics ◽

University Education ◽

P Value ◽

Aged People ◽

Before And After ◽

The Difference ◽

One Year

Abstract Background Multiple sclerosis (MS) may affect the individual’s working life. We aimed to 1) investigate the mean levels and distributions of earnings among people with MS (PwMS) before and after MS diagnosis compared to people without an MS diagnosis, and whether such differences in earnings were associated with educational level or occupation and 2) assess the prevalence of sickness absence (SA) and disability pension (DP). Methods Population-based cohort study (10 years prior to 5 years after MS diagnosis) using microdata linked from nationwide Swedish registers of all individuals aged 30-54 with MS diagnosed in 2003-2006 (n = 2553) and references without MS (n = 7584) randomly selected by stratified matching (sex and age). Annual mean earnings, by educational level and type of occupation, were compared with t-tests. Tobit regressions investigated the associations of earnings with individual characteristics. Lastly, the proportions on SA and DP, stratified by educational level and type of occupation, were examined in the diagnosis year and 5 years later. Results Differences in earnings between PwMS and references were observed beginning one year prior to diagnosis and increased with time. PwMS had lower mean earnings for the diagnosis year (difference=SEK 28,000, p-value<0.05), and the difference had more than doubled (p-value<0.05) 5 years later. These differences remained after taking educational level and type of occupation into account. PwMS with university education and/or more qualified occupations had mean earnings most like their respective references’. PwMS had higher prevalence of SA and DP than the references, in both the diagnosis year and 5 years later. Conclusions Earnings of people with MS were lower than references’ already one year before diagnosis, and the gap increased thereafter. Results indicate that educational level and type of occupation are of importance for earnings. Moreover, SA and DP were more common among people with MS. Key messages Our results indicate that working-aged people with MS have less earnings than references already one year before diagnosis and that thereafter this gap in earnings increases with time. Education and occupation were influential in explaining the people with MS’ heterogeneous earnings, with a hierarchal ordering of who maintained similar earnings to their respective peers.

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Trajectories of sickness absence and disability pension in colorectal cancer: a Swedish cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.697 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Chen ◽

K Alexanderson

Keyword(s):

Colorectal Cancer ◽

Cohort Study ◽

Sickness Absence ◽

Educational Level ◽

Disability Pension ◽

Population Based ◽

Work Situation ◽

Working Age ◽

Future Work ◽

Very High

Abstract Background Working-aged colorectal cancer (CRC) patients have a much better survival nowadays, indicating the importance of their future work situation. We aimed to investigate trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis and in references, and risk factors associated with different trajectories. Methods A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19-62 when first diagnosed with CRC in 2008-2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2 test and multinomial logistic regression. Results Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all, n = 2481), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level (R2=0.022), Charlson's Comorbidity Index (R2=0.029), and prediagnostic mental disorders (R2=0.066) were the strongest factors determining the SADP trajectory groups. In references, three trajectories (”constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified. Conclusions Approximately 80% of CRC survivors return to a low level of SADP (0-60 days/year) at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for CRC survivors. Key messages Most of working-age colorectal cancer survivors have low levels of sickness absence and disability pension days five years after their diagnosis. Trajectory analyses based on population-based register data can be used as a good approach in understanding future work situation regarding sick leave among working-age cancer survivors.

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Cost-of-Illness Progression Before and After Diagnosis of Multiple Sclerosis: A Nationwide Register-Based Cohort Study in Sweden of People Newly Diagnosed with Multiple Sclerosis and a Population-Based Matched Reference Group

PharmacoEconomics ◽

10.1007/s40273-021-01035-4 ◽

2021 ◽

Author(s):

Chantelle Murley ◽

Petter Tinghög ◽

Kristina Alexanderson ◽

Jan Hillert ◽

Emilie Friberg ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cohort Study ◽

Cost Of Illness ◽

Reference Group ◽

Population Based ◽

Newly Diagnosed ◽

Before And After ◽

Illness Progression

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Trajectories of sickness absence and disability pension before and after colorectal cancer: A Swedish longitudinal population-based matched cohort study

PLoS ONE ◽

10.1371/journal.pone.0245246 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245246

Author(s):

Lingjing Chen ◽

Kristina A. E. Alexanderson

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Cohort Study ◽

Mental Disorders ◽

Educational Level ◽

Disability Pension ◽

Population Based ◽

Matched Cohort ◽

Before And After ◽

Very High

Objectives Working-aged colorectal cancer (CRC) patients have a much better survival, indicating the importance of their future work situation. We investigated trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis, and risk factors associated with different trajectories. Methods A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19–62 when first diagnosed with CRC in 2008–2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2 test and multinomial logistic regression. Results Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level, Charlson’s Comorbidity Index, and prediagnostic mental disorders were the strongest factors determining the SADP trajectory groups. In references, three trajectories (“constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified. Conclusion Approximately 80% of CRC survivors return to a low level of SADP at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for them. CRC survivors will benefit from early rehabilitation programs with identified risk factors.

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Divergent patterns of anti-fracture medication use following fracture on therapy: A population-based cohort study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab696 ◽

2021 ◽

Author(s):

Gregory A Kline ◽

Suzanne N Morin ◽

Lisa M Lix ◽

William D Leslie

Keyword(s):

Cohort Study ◽

Medication Adherence ◽

Vertebral Fracture ◽

Drug Efficacy ◽

Population Based ◽

Duration Of Treatment ◽

Traumatic Fracture ◽

Before And After ◽

One Year

Abstract Context Fracture-on-therapy should motivate better anti-fracture medication adherence. Objective Describe osteoporosis medication adherence in women before and following a fracture. Design Retrospective cohort study. Setting Manitoba BMD Registry (1996-2013). Patients Women who started anti-fracture drug therapy after a DXA-BMD with follow-up for 5 years during which a non-traumatic fracture occurred at least one year after starting treatment. Main Outcome Linked prescription records determined medication adherence (estimated by medication possession ratios, MPR) in one-year intervals. The variable of interest was MPR in the year before and after the year in which the fracture occurred with subgroup analyses according to duration of treatment pre-fracture. We chose an MPR of ≥0.50 to indicate minimum adherence needed for drug efficacy. Results There were 585 women with fracture-on-therapy, 193(33%) had hip or vertebral fracture. Bisphosphonates accounted for 82.2% of therapies. Median MPR the year prior to fracture was 0.89(IQR 0.49-1.0) and 0.69(IQR 0.07-0.96) the year following the year of fracture(p< 0.0001). The percentage of women with MPR ≥ 0.5 pre-fracture was 73.8%, dropping to 57.3% post-fracture(p<0.0001); restricted to hip/vertebral fracture results were similar (58.2% to 33.3%, p <0.002). Among those with pre-fracture MPR <0.5, only 21.7% achieved a post-fracture MPR ≥ 0.5. Conclusions Although fracture-on-therapy may motivate sustained/improved adherence, MPR remains low or even declines after fracture in many. This could reflect natural decline in MPR with time but is paradoxical to expectations. Fracture-on-therapy represents an important opportunity for clinicians to re-emphasize treatment adherence.

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Quality of life before and after sinonasal surgery: a population-based matched cohort study

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-016-4272-2 ◽

2016 ◽

Vol 274 (2) ◽

pp. 795-802 ◽

Cited By ~ 7

Author(s):

Antti I. Alakärppä ◽

Timo J. Koskenkorva ◽

Petri T. Koivunen ◽

Olli-Pekka Alho

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Population Based ◽

Matched Cohort ◽

Matched Cohort Study ◽

Before And After

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Cerebrospinal Fluid Biomarkers for Predicting Development of Multiple Sclerosis in Acute Optic Neuritis: A Population-Based Prospective Cohort Study

SSRN Electronic Journal ◽

10.2139/ssrn.3237723 ◽

2018 ◽

Author(s):

Mads N Olesen ◽

Kerstin Soelberg ◽

Birgit Debrabant ◽

Anne C Nilsson ◽

Soren T Lillevang ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cerebrospinal Fluid ◽

Cohort Study ◽

Optic Neuritis ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Population Based ◽

Acute Optic Neuritis ◽

Cerebrospinal Fluid Biomarkers

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Incidence of chronic immune-mediated inflammatory diseases after diagnosis with Kawasaki disease: a population-based cohort study

Rheumatology ◽

10.1093/rheumatology/keab680 ◽

2021 ◽

Author(s):

Stephen G Fung ◽

Richard Webster ◽

M Ellen Kuenzig ◽

Braden D Knight ◽

Michelle Batthish ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cohort Study ◽

Liver Disease ◽

Kawasaki Disease ◽

Sclerosing Cholangitis ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

Population Based ◽

Immune Mediated ◽

Increased Risk

Abstract Objectives Kawasaki disease (KD) is an immune-mediated vasculitis of childhood with multi-organ inflammation. We determined the risk of subsequent immune-mediated inflammatory disease (IMID), including arthritis, type 1 diabetes, IBD, autoimmune liver disease, primary sclerosing cholangitis and multiple sclerosis. Methods We conducted a matched population-based cohort study using health administrative data from Ontario, Canada. Children aged <18 years born between 1991 and 2016 diagnosed with KD (n = 3753) were matched to 5 non-KD controls from the general population (n = 18 749). We determined the incidence of IMIDs after resolution of KD. Three- and 12-month washout periods were used to exclude KD-related symptoms. Results There was an elevated risk of arthritis in KD patients compared with non-KD controls, starting 3 months after index date [103.0 vs 12.7 per 100 000 person-years (PYs); incidence rate ratio 8.07 (95% CI 4.95, 13.2); hazard ratio 8.08 (95% CI 4.95, 13.2), resulting in the overall incidence of IMIDs being elevated in KD patients (175.1 vs 68.0 per 100 000 PYs; incidence rate ratio 2.58 (95% CI 1.93, 3.43); hazard ratio 2.58, 95% CI 1.94, 3.43]. However, there was no increased risk for diabetes, IBD, autoimmune liver disease, primary sclerosing cholangitis or multiple sclerosis in KD patients. Similar results were observed using a 12-month washout period. Conclusion Children diagnosed with KD were at increased risk of arthritis following the acute KD event, but not other IMIDs. Health-care providers should monitor for arthritis in children following a diagnosis of KD.

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