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.

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.

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

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.

Panel: The Need for System Solutions to Improve Employment Outcomes of Cancer Survivors

2007 ◽  
Vol 51 (16) ◽  
pp. 986-990
Author(s):  
Mary E. Sesto ◽  
Panel Participants: K. Robin Yabroff ◽  
Cathy J. Bradley ◽  
Michael Feuerstein ◽  
Gregg C. Vanderheiden
Keyword(s):  
Human Factors ◽  
Cancer Survivors ◽  
Occupational Injuries ◽  
Work Productivity ◽  
The United States ◽  
Employment Outcomes ◽  
Good News ◽  
Working Age ◽  
Human Factors Research

The good news is that the number of cancer survivors and length of survival has increased due to early detection and treatment improvements. Of the estimated 10.5 million cancer survivors in the United States, approximately 40% are of working age (NCI, 2006). Unfortunately, one out of five survivors experience cancer-related disabilities that affect employment. Survivors may experience long-term and late-effects (including functional and general health changes) resulting in less than optimal employment outcomes, including long-term employment and work productivity. Although employment issues have been recognized in this area, to date, the majority of research on work productivity and return to work in human factors and ergonomics has focused on common occupational injuries and illnesses. The application of theories, methodologies, and perspectives from human factors research may serve to optimize employment outcomes for cancer survivors.

Effects of multiple sclerosis disease-modifying therapies on employment measures using patient-reported data

2018 ◽  
Vol 89 (11) ◽  
pp. 1200-1207 ◽  
Author(s):  
Jing Chen ◽  
Bruce V Taylor ◽  
Leigh Blizzard ◽  
Steve Simpson Jr ◽  
Andrew J Palmer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Work Productivity ◽  
Dimethyl Fumarate ◽  
Employment Outcomes ◽  
Multinomial Regression ◽  
Beneficial Effects ◽  
Disease Modifying Therapies ◽  
Patient Reported ◽  
Disease Modifying ◽  
Reported Data

BackgroundThe direct comparative evidence on treatment effects of available multiple sclerosis (MS) disease-modifying therapies (DMTs) is limited, and few studies have examined the benefits of DMTs on employment outcomes. We compared the effects of DMTs used in the previous 5 years on improving the work attendance, amount of work and work productivity of people with MS.MethodsThe Australian MS Longitudinal Study collected data from participants on DMTs usage from 2010 to 2015 and whether DMTs contributed to changes in employment outcomes. We classified 11 DMTs into three categories based on their clinical efficacy (β-interferons and glatiramer acetate as category 1; teriflunomide and dimethyl fumarate as category 2; fingolimod, natalizumab, alemtuzumab and mitoxantrone as category 3). Each DMT used by a participant was treated as one observation and analysed by log-multinomial regression.ResultsOf the 874 participants included, 1384 observations were generated. Those who used category 3 (higher efficacy) DMTs were 2–3 times more likely to report improvements in amount of work, work attendance and work productivity compared with those who used category 1 (classical injectable) DMTs. Natalizumab was associated with superior beneficial effects on patient-reported employment outcomes than fingolimod (RR=1.76, 95% CI 1.02 to 3.03 for increased work attendance and RR=1.46, 95% CI 1.02 to 2.10 for increased work productivity).ConclusionsThose using the higher efficacy (category 3) DMTs, particularly fingolimod and natalizumab, reported significant increases in amount of work, work attendance and work productivity, suggesting they have important beneficial effects on work life in people with MS.

scholarly journals The Impact of Diabetes on Productivity in India

2021 ◽  
Author(s):  
Khyati K Banker ◽  
Danny Liew ◽  
Zanfina Ademi ◽  
Alice J Owen ◽  
Afsana Afroz ◽  
...  
Keyword(s):  
Labour Force ◽  
Productivity Loss ◽  
Work Productivity ◽  
Premature Mortality ◽  
Retirement Age ◽  
Years Of Life Lost ◽  
Life Years ◽  
Working Age ◽  
The Impact ◽  
Excess Deaths

<b>OBJECTIVE</b> Diabetes increases the risk of premature mortality and considerably impacts on work productivity. We sought to examine the impact of diabetes in India, in terms of excess premature mortality, years of life lost (YLL), productivity-adjusted life years (PALYs) lost and its associated economic impact. <p><b>RESEARCH DESIGN AND METHODS</b> A lifetable model was constructed to examine the productivity of the Indian working-age population currently aged 20–59 years with diabetes, until death or retirement age (60 years). The same cohort was re-simulated, hypothetically assuming that they did not have diabetes. The total difference between the two cohorts, in terms of excess deaths, YLL and PALYs lost reflected the impact of diabetes. Data regarding the prevalence of diabetes, mortality, labour force dropouts and productivity loss attributable to diabetes were derived from published sources. </p> <p><b>RESULTS</b> In 2017, an estimated 54.4 million (7.6%) people of working-age in India had diabetes. With simulated follow-up until death or retirement age, diabetes was predicted to cause 8.5 million excess deaths (62.7% of all deaths), 42.7 million YLL (7.4% of total estimated years of life lived) and 89.0 million PALYs lost (23.3% of total estimated PALYs), equating to an estimated INR 176.6 trillion (USD 2.6 trillion; PPP 9.8 trillion) in lost GDP<a>. </a></p> <p><b>CONCLUSIONS </b>Our study demonstrates the impact of diabetes on productivity loss and highlights the importance of health strategies aimed at the prevention of diabetes.</p>

scholarly journals The Impact of Diabetes on Productivity in India

2021 ◽  
Author(s):  
Khyati K Banker ◽  
Danny Liew ◽  
Zanfina Ademi ◽  
Alice J Owen ◽  
Afsana Afroz ◽  
...  
Keyword(s):  
Labour Force ◽  
Productivity Loss ◽  
Work Productivity ◽  
Premature Mortality ◽  
Retirement Age ◽  
Years Of Life Lost ◽  
Life Years ◽  
Working Age ◽  
The Impact ◽  
Excess Deaths

<b>OBJECTIVE</b> Diabetes increases the risk of premature mortality and considerably impacts on work productivity. We sought to examine the impact of diabetes in India, in terms of excess premature mortality, years of life lost (YLL), productivity-adjusted life years (PALYs) lost and its associated economic impact. <p><b>RESEARCH DESIGN AND METHODS</b> A lifetable model was constructed to examine the productivity of the Indian working-age population currently aged 20–59 years with diabetes, until death or retirement age (60 years). The same cohort was re-simulated, hypothetically assuming that they did not have diabetes. The total difference between the two cohorts, in terms of excess deaths, YLL and PALYs lost reflected the impact of diabetes. Data regarding the prevalence of diabetes, mortality, labour force dropouts and productivity loss attributable to diabetes were derived from published sources. </p> <p><b>RESULTS</b> In 2017, an estimated 54.4 million (7.6%) people of working-age in India had diabetes. With simulated follow-up until death or retirement age, diabetes was predicted to cause 8.5 million excess deaths (62.7% of all deaths), 42.7 million YLL (7.4% of total estimated years of life lived) and 89.0 million PALYs lost (23.3% of total estimated PALYs), equating to an estimated INR 176.6 trillion (USD 2.6 trillion; PPP 9.8 trillion) in lost GDP<a>. </a></p> <p><b>CONCLUSIONS </b>Our study demonstrates the impact of diabetes on productivity loss and highlights the importance of health strategies aimed at the prevention of diabetes.</p>

Work productivity loss in patients with tenosynovial giant cell tumors in the United States.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e22527-e22527 ◽  
Author(s):  
Feng Lin ◽  
Jackie Kwong ◽  
Raluca Ionescu-Ittu ◽  
Irina Pivneva ◽  
Willy Wynant ◽  
...  
Keyword(s):  
Giant Cell ◽  
Linear Models ◽  
Productivity Loss ◽  
Unmet Need ◽  
Work Productivity ◽  
Indirect Costs ◽  
The United States ◽  
Giant Cell Tumors ◽  
Medical Visits ◽  
Working Age

e22527 Background: Tenosynovial giant cell tumor (TGCT) is a rare, locally aggressive and debilitating tumor that generally affects young working-age adults. This study assessed work productivity loss in TGCT patients. Methods: Incident patients aged 18-64 years with diagnosis of TGCT, who had earning and disability data, were identified in the OptumHealth database (Q1 1999 – Q1 2017). Patients were classified into surgical and non-surgical groups depending on the presence of joint surgery claim in postindex period. Control patients without TGCT were matched 10:1 with TGCT patients on age, gender, year of TGCT diagnosis, and follow-up duration. The number of days missed from work due to disability and medical visits post diagnosis was compared using Poisson regressions. General linear models were used to compare indirect costs associated with productivity loss. Results: A total of 1,395 TGCT patients (724 surgical; 671 non-surgical) were matched to 13,950 controls (36% female; mean age = 47 years). Both surgical and non-surgical TGCT patients had more comorbidities (mean Charlson Comorbidity Index (CCI): 0.3 vs 0.2; 0.4 vs 0.2; p < 0.001), had greater use of analgesic drugs (44% vs 20%; 40% vs 21%; p < 0.001) and MRI tests (47% vs 4%; 26% vs 3%; p < 0.001) in the 12 months before TGCT diagnosis compared with controls. Both surgical and non-surgical TGCT patients missed more time from work due to disability and medical visits and had higher indirect cost associated with productivity loss than matched controls. Disability burden was greater in patients receiving surgery. Conclusions: Regardless of receiving surgery or not, TGCT is associated with significant work productivity loss. These findings highlight the unmet need for effective treatments to reduce disability and restore function in TGCT patients. [Table: see text]

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