Longitudinal Determinants of Employment Status in People with Relapsing-Remitting Multiple Sclerosis

Abstract

Purpose: To investigate longitudinal relationships between employment status and disease-related, (neuro)psychological, and work-related factors in people with multiple sclerosis (MS).

Methods: 170 employed people with MS underwent yearly neurological and neuropsychological examinations to assess MS-related disability and cognitive functioning. Additionally, they completed yearly questionnaires assessing depression, anxiety, fatigue, cognitive complaints, workplace support and coping. Multilevel models for change were fitted to examine progression of these factors over three years, and to assess possible relationships with change in employment status.

Results: People with a deteriorated employment status after three years reported more depression (p=0.009), a higher impact of fatigue (p<0.001), more cognitive complaints (p<0.001) and less workplace support (p=0.001) at baseline than people with a stable employment status. There were no differences in progression over time of the examined variables between people with a stable or deteriorated employment status.

Conclusion: More depression, a higher impact of fatigue, more cognitive complaints and less workplace support are predictive of a deteriorated employment status after three years in individuals with MS. How these factors progress over time is not different between those with a stable or deteriorated employment. MS-related disability, anxiety, objective cognition and coping were not related to a deterioration in employment status.

Note:
Funding Declaration: The MS@Work study was supported by ZonMw (TOP Grant, Project Number: 842003003), TeVa Pharmaceutical Industries, and Nationaal MS Fonds. Funding parties were not involved in any research activities.

Conflicts of Interest: E.E.A. van Egmond, K. van der Hiele, M.J. de Rooij, D.A.M. van Gorp, J.J.L. van der Klink, M.F. Reneman, E.A.C. Beenakker, S.T.F.M. Frequin, K. de Gans, O.H.H. Gerlach, J.P. Mostert, and H.A.M. Middelkoop declare no conflict of interest. P.J. Jongen received honoraria from Bayer Netherlands and Orikami Personalized Health Care for consultancy activities and is chairman of the MSmonitor Foundation. L.H. Visser received a research grant for the multicentre BIA study from Merck, received consultancy fees from Merck, Novartis and Janssen. J.J.J. van Eijk received consultancy fees and honoraria for lectures from Merck, Biogen, Novartis, Sanofi, Janssen and Roche. E. Hoitsma received honoraria for lectures and advisory boards from Bayer, Biogen, Roche, Sanofi Genzyme, Merck Serono, Novartis and Teva. W.I.M. Verhagen received consultancy fees from Merck and Biogen.

Ethical Approval: The current study was approved by the Medical Ethical Committee Brabant (NL43098.008.12 1307), and all participants signed an informed consent form before participation.

Keywords: multiple sclerosis, employment, work, Depression, fatigue, cognition