scholarly journals Labor Market Attachment in Patients with Myeloproliferative Neoplasms: A Nationwide Matched Cohort Study

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3627-3627
Author(s):  
Sarah Friis Christensen ◽  
Lise Skovgaard Svingel ◽  
Anders Kjærsgaard ◽  
Anna Stenling ◽  
Björn Paulsson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Labor Market ◽  
Sick Leave ◽  
Disability Pension ◽  
Research Funding ◽  
Myeloproliferative Neoplasms ◽  
Symptom Burden ◽  
Population Based ◽  
Transfer Payment ◽  
Health Related

Abstract BACKGROUND Myeloproliferative neoplasms (MPNs) are characterized by a substantial symptom burden, risk of debilitating complications (e.g., thrombosis), and increased comorbidity. Recently, three comprehensive questionnaire studies (Mesa 2016, Harrison 2017, Jingbo 2018) have reported a high impact of MPNs on patients' ability to work. However, no registry-based studies have assessed labor market attachment (LMA) of MPN patients and matched nonMPN comparisons. AIM To assess the pre- and post-diagnostic LMA of MPN patients and matched nonMPN comparisons. METHODS We conducted a descriptive, registry-based nationwide cohort study, using data from the Danish National Chronic Myeloid Neoplasia Registry including all Danish MPN patients diagnosed between January 2010 and December 2016. Population-based cohorts of nonMPN comparisons were constructed by 1:10 matching on age, sex, level of education, and region of residence. Data on LMA were retrieved from the Danish Register for Evaluation of Marginalization, which holds information on all public transfer payments in Denmark. Data were linked using the unique civil registration number, which identifies all Danish citizens. The LMA endpoints were defined for each individual as working (not receiving any type of transfer payment), unemployed, receiving transfer payment for either sick leave, disability pension, age pension, or other health-related benefits (e.g., wage-subsidized employment). We assessed LMA weekly for each individual from two years before diagnosis until death, emigration, or two years after the diagnosis. For each cohort, we presented LMA as proportions with 95% confidence intervals (CIs), as well as the proportion of individuals who died during follow-up. RESULTS The study included 3,342 MPN patients (1,140 essential thrombocythemia [ET]; 1,109 polycythemia vera [PV]; 533 myelofibrosis [MF]; and 560 unspecified MPN [MPN-U]) and 32,737 nonMPN comparisons (11,181 nonET; 10,873 nonPV; 5,217 nonPMF; and 5,466 nonMPN-U). The median age at time of diagnosis was: ET 67 years (interquartile range [IQR], 55-76); PV, 69 years (IQR, 61-77); PMF, 73 years (IQR, 66-79); and MPN-U, 72 years (IQR, 63-80). At time of MPN diagnosis, the majority of MPN patients and nonMPN comparisons received age pension (range: ET, 52.1% [95% CI, 49.2-55.0] to nonMF, 70.3% [95% CI, 69.1-71.6]). The proportions working were: ET, 35.1% (95% CI, 32.3-37.9) vs. nonET, 37.3% (95% CI, 36.5-38.2); PV, 22.6% (95% CI, 20.2-25.1) vs. nonPV, 30.8% (95% CI, 29.9-31.7); MF, 23.8% (95% CI, 20.2-27.4) vs. nonMF, 23.6% (95% CI, 22.5-24.8); and MPN-U, 22.1% (95% CI,18.7- 25.6) vs. nonMPN-U, 27.8% (95% CI, 26.6-29.0). Across MPN subtypes, a larger proportion of patients than comparisons were on sick leave: ET, 3.5% (95% CI, 2.4-4.6) vs. nonET, 1.3% (95% CI, 1.1-1.5); PV, 5.5% (95% CI, 4.2-6.8) vs. nonPV, 0.9% (95% CI, 0.7-1.1); MF (not applicable due to small numbers) vs. nonMF, 0.6% (95% CI, 0.4-0.8); and MPN-U, 3.0% (95% CI, 1.6- 4.5) vs. nonMPN-U, 1.0% (95% CI, 0.7-1.3). Regarding disability pension, the proportions ranged from 4.1% (95% CI, 2.4-5.8) to 5.0% (95% CI, 3.7-6.3) among patients and from 3.1% (95% CI, 2.6-3.6) to 4.7% (95% CI, 4.3-5.1) among comparisons. For both MPN patients and nonMPN comparisons, few were unemployed (≤3.3%) or received other health-related benefits (≤1.6%). Two years preceding diagnosis, the proportion of PV and MPN-U patients working was slightly lower than the matched comparisons: PV, 31.0% (95% CI, 28.4-33.8) vs. nonPV, 34.3% (95% CI, 33.5-35.2) and MPN-U, 28.2% (95% CI, 24.6-32.1) vs. nonMPN-U, 32.0% (95% CI, 30.7-33.2), while this difference was not observed between ET and MF patients and their respective comparisons. From two years before to two years after diagnosis, we observed slightly larger reductions in the proportion working among MPN patients than among comparisons. Among MPN patients, the proportion on sick leave including other health-related benefits, increased during the study period, while it remained unchanged among comparisons. The proportion of patients and comparisons on disability pension remained stable. CONCLUSION Overall, our findings showed that Danish patients with ET, PV, MF, and MPN-U had slightly impaired LMA already two years before diagnosis and up to two years after diagnosis. Thus, fewer patients were working and more patients transferred to sick leave compared with matched individuals without MPN. Figure 1 Figure 1. Disclosures Stenling: Novartis: Current Employment. Paulsson: Novartis: Current Employment. Frederiksen: Novartis: Research Funding; Alexion: Research Funding; Gilead: Research Funding; Abbvie: Research Funding; Janssen Pharmaceuticals: Research Funding. Hasselbalch: Novartis, AOP Orphan: Consultancy, Other: Advisory Board.

scholarly journals The effect of community-acquired bacteraemia on return to workforce, risk of sick leave, permanent disability pension and death: a Danish population-based cohort study

BMJ Open ◽  
2014 ◽  
Vol 4 (1) ◽  
pp. e004208 ◽  
Author(s):  
Michael Dalager-Pedersen ◽  
Kristoffer Koch ◽  
Reimar Wernich Thomsen ◽  
Henrik Carl Schønheyder ◽  
Henrik Nielsen
Keyword(s):  
Cohort Study ◽  
Sick Leave ◽  
Disability Pension ◽  
Population Based ◽  
Danish Population ◽  
Permanent Disability

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

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.

Future risk for disability pension among people with sickness absence due to otoaudiological diagnoses: a population-based cohort study with a 12-year follow-up

2011 ◽  
Vol 39 (5) ◽  
pp. 501-507 ◽  
Author(s):  
Klas Gustafsson ◽  
Gunnel Backenroth-Ohsako ◽  
Ulf Rosenhall ◽  
Elisabeth Ternevall-Kjerulf ◽  
Mats Ulfendahl ◽  
...  
Keyword(s):  
Cohort Study ◽  
Sickness Absence ◽  
Disability Pension ◽  
Population Based ◽  
Future Risk ◽  
Risk For Disability

scholarly journals A Standardized Equation Model of Quality of Life in Myeloproliferative Neoplasms

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2181-2181
Author(s):  
Robyn M. Scherber ◽  
Martin M. Goros ◽  
Jonathan Gelfond ◽  
Amylou C. Dueck ◽  
Sarah F Christensen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Research Funding ◽  
Structural Equation ◽  
Online Survey ◽  
Myeloproliferative Neoplasms ◽  
Linear Regression Analysis ◽  
Symptom Burden ◽  
Equation Model ◽  
Nccn Guidelines

Background: Quality of life (QOL) is predictive of survival in many malignancy types, including myeloproliferative neoplasms (MPNs; Scherber 2017, Sloan 2012, Montazeri 2009, Nilsson 2017). We have previously characterized that an association exists between symptom burden and QOL among MPN patients, but due to the disease specificity of symptoms, symptoms rather than QOL remains a key therapeutic endpoint (Scherber 2017, NCCN Guidelines). Despite these advancements, our understanding of the extent that different patient and disease characteristics, including symptoms, contribute to overall QOL has remained elusive. In this analysis, we utilized information from a large survey of MPN patients to develop a model of QOL that establishes the degree that individual variables contribute to QOL, including psychosocial variables, comorbidities, and MPN disease symptoms. Methods: The FATIGUE survey of MPN patients (Scherber 2016) investigated self-reported symptoms using the MPN10 (Scherber 2012), depression utilizing the Profile of Mood States-Brief (POMS-B, McNair 1971), Patient Health Questionnaire (PHQ-2, Kroenke 2003) and Mental Health Inventory (MHI-5, Berwick 1991), and QOL utilizing a single numeric analog scale (range 0-10) regarding overall quality of life. Linear regression analysis was utilized to establish the relationship between individual symptoms and QOL, and a structural equation model (SEM) was used to identify complex relationships among patient demographics, behavioral factors, comorbidities, and QOL. Results: A total of 914 patients from the online survey lived in the USA and provided data for this analysis. Average age was 62 with 67% of patients being female and the mean BMI was 25. Education varied across middle school or high school education (22%), undergraduate or college degree (44%), masters (26%), to doctorate (8%). 43% of respondents were employed. Fatigue (β coefficient 0.23, p<0.001), inactivity (β 0.21, p<0.001), concentration difficulties (β 0.13, p<0.001), sad mood (β 0.18, p<0.001), and night sweats (β 0.05, p=0.03) showed statistically significant impact on QOL. SEM Model: We developed the SEM model in Figure 1. Out of all variables analyzed, MPN total symptom burden demonstrated the strongest association with (β 0.89) with QOL, followed by depression (β 0.76). Comorbidities, including COPD and renal issues, age, and body mass index abnormalities had some impact on symptoms (all β <0.40), but did not demonstrate a significant impact on QOL. Comparative Fit Index (CFI) was 0.905 and root mean square error of approximation (RMSEA) was 0.051 (0.048, 0.054) indicating good fit. Conclusions: Previous clinical trials of JAK inhibition have targeted improvement in symptoms as a key endpoint, and ultimately demonstrated improvements in overall survival. The mechanism of this survival benefit has not been fully explored. This analysis suggests that symptoms and mood are strongly associated and potentially a major contributor to QOL among MPN patients, whereas other major comorbidities and age are not as strongly correlated. Efforts are underway to analyze more comprehensive datasets to better understand the role of other variables, including marriage status and financial concerns, on QOL. Disclosures Scherber: Blueprint: Other: Ad board; Incyte: Consultancy; Gilead: Consultancy. Hasselbalch:Novartis: Research Funding; AOP Orphan Pharmaceuticals: Other: Data monitoring board. Mesa:Baxalta: Consultancy; LaJolla: Consultancy; Genentech: Consultancy; Celgene Corporation: Research Funding; Samus: Research Funding; AbbVie: Research Funding; NS Pharma: Research Funding; Novartis: Consultancy, Honoraria, Other: travel, accommodations, expenses; CTI: Research Funding; Galena Biopharma: Consultancy; Pfizer: Research Funding; Incyte: Other: travel, accommodations, expenses, Research Funding; Genotech: Research Funding; AOP Orphan Pharmaceuticals: Honoraria, Other: travel, accommodations, expenses; PharmaEssentia: Research Funding; Gilead Sciences: Research Funding; Promedior: Research Funding; Shire: Honoraria; Sierra Oncology: Consultancy.

scholarly journals Associations of sickness absence and disability pension due to mental and somatic diagnoses when aged 60–64 with paid work after the standard retirement age; a prospective population-based cohort study in Sweden

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aleksiina Martikainen ◽  
Alice Svensson Alavi ◽  
Kristina Alexanderson ◽  
Kristin Farrants
Keyword(s):  
Cohort Study ◽  
Sickness Absence ◽  
Disability Pension ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Outcome Variable ◽  
Retirement Age ◽  
Paid Work ◽  
Diagnosis Group ◽  
Lower Likelihood

Abstract Background The proportion of people working beyond age 65 is increasing. We aimed to explore whether sickness absence (SA) and disability pension (DP) due to mental, somatic, or both diagnoses when aged 60–64 were associated with being in paid work when aged 66–71. Methods This prospective population-based cohort study included all 98,551 individuals who in 2010 turned 65 years, lived in Sweden, and were in paid work at some point when aged 60–64. Data from three nationwide registers were used with 2010 as baseline, with SA or/and DP as the exposure variables (2005–2009) and paid work as the outcome variable (2011–2016). Logistic regression was conducted to calculate odds ratios (OR) with 95% confidence intervals (CI) for the association between exposures and outcome, controlling for sociodemographic factors. The analyses were also stratified by sex. Results Nearly half were in paid work during follow-up. Those with SA due to mental diagnoses had lower likelihood of being in paid work among both sexes (women OR: 0.76; 95% CI: 0.69–0.84; men 0.74; 0.65–0.84), while this association was smaller for SA due to somatic diagnoses (women 0.87; 0.84–0.91; men 0.92; 0.89–0.96). SA due to both mental and somatic diagnoses was associated with a lower likelihood of paid work for men (0.77; 0.65–0.91), but not women (0.98; 0.88–1.09). Regardless of diagnosis group and sex, DP had the strongest association with not being in paid work (women mental DP 0.39; 0.34–0.45; women somatic DP 0.38; 0.35–0.41; women mental and somatic DP 0.28; 0.15–0.56; men mental DP 0.36; 0.29–0.43; men somatic DP 0.35; 0.32–0.38; men mental and somatic DP 0.22; 0.10–0.51). Combined SA and/or DP demonstrated ORs in-between the diagnosis groups of SA and DP alone (e.g., mental SA and/or DP women and men combined 0.61; 0.57–0.65). Conclusions SA and DP were negatively associated with being in paid work after the standard retirement age of 65. The association was especially strong for DP, irrespective of diagnosis group. Moreover, compared to somatic diagnoses, SA due to mental diagnoses had a stronger association with not being in paid work. More knowledge is needed on how mental SA impedes extending working life.

scholarly journals Have associations between mental health and health related behaviours changed between 2005 and 2015? A population based cross-cohort study

2020 ◽  
Author(s):  
Suzanne H. Gage ◽  
Praveetha Patalay
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Cohort Study ◽  
Mental Health Problems ◽  
Weight Perception ◽  
Population Based ◽  
Parents And Children ◽  
Health Related ◽  
Avon Longitudinal Study ◽  
Over Time

AbstractBackgroundPoor adolescent mental health is a growing concern over recent decades with evidence of increasing internalising mental health problems corresponding with decrease in anti-social, smoking and alcohol behaviours. However, understanding whether and how the associations between mental health and health-related behaviours such as substance use, anti-social behaviour and obesity have changed over time is less well-understood.ObjectivesWe investigate whether the associations between different health-related outcomes in adolescence are stable or changing over time in two recent cohorts of adolescents born ten years apart.MethodData from two UK birth cohort studies, the Avon Longitudinal Study of Parents and Children (ALSPAC, born 1991-92, N=5627, 50.7% female) and Millennium Cohort Study (MCS, born 2000-1, N=11318, 50.6% female) at age 14 sweeps are used. The health outcomes of focus are depressive symptom score, substance use (alcohol, smoking, cannabis and other drugs), antisocial behaviours (assault, graffiti, vandalism, shoplifting and rowdy behaviour), weight (BMI), weight perception (perceive self as overweight) and sexual activity (had sexual intercourse).ResultsOur results suggest although directions of associations between mental-health and health-related behaviours (eg smoking) are similar over time, their strength across the distribution has changed. While smoking and alcohol use behaviours are decreasing in adolescents, those that endorse these behaviours in 2015 are more likely to have co-occurring mental-health and other problems than those born in 2005. Similarly, higher body mass index is more strongly associated with depressive symptoms in 2015.ConclusionsOur findings suggest that associations between these factors has changed over time, which has implications for public health and our understanding of the mechanisms underlying their observed associations in the population.

Sign in / Sign up

Export Citation Format

Share Document