Impact of MS on employment
Multiple sclerosis can have a devastating impact on a person’s ability to work, with many people becoming unemployed, underemployed or retired within a decade of receiving a diagnosis. MS symptoms, notably fatigue, mental difficulties, impaired hand function and mobility problems, create numerous challenges for people trying to maintain a full-time job.
The Australian MS Longitudinal Study is one of the few that has looked at how MS affects employment (Chen and colleagues. Mult Scler 2018:1352458518781971). The study examined data for 740 employed people and how MS affected their absenteeism (time missed from work) and presenteeism (lower productivity while on the job).
Overall, 56% of people experienced some form of lost productivity in a given month. The average number of lost work days was 2.5 per person (i.e. half of a work week) in the preceding four weeks. Much of this loss was reduced productivity on the job – which was three times more common than actually missing a day of work. The lost productivity added up to a loss of income of about $5000 per person annually.
MS symptoms can interfere with a person’s best efforts to be productive at work. This raises the question: would better control of symptoms help productivity? The Australian group examined this issue in a second study (Chen and colleagues. J Neurol Neurosurg Psychiatry 2018; epublished June 19, 2018). The key factor analysed was the type of MS drug that the person had been taking over the past five years. Data for 874 people were examined.
For the purposes of the study, MS drugs were divided into three categories: injectable drugs (Copaxone or one of the interferons); Aubagio and Tecfidera; and the more potent drugs (Tysabri, Gilenya and Lemtrada). The researchers found that people who took Tysabri, Gilenya or Lemtrada were 2-3 times more likely to report improvements in the amount of work they could do, their work attendance, and their productivity while on the job. The greatest impact on employment was seen with Tysabri, followed by Gilenya.
It should be noted that these drugs do require some time off work. Gilenya requires a day off work when you take the first dose, Tysabri requires monthly infusions at a healthcare centre, and Lemtrada infusions will require you to book off at least one week a year. But this lost work time can be scheduled, and appears to be made up by gains at work because you feel healthier and can function better.
Maintaining employment and functioning well at work are two of the hidden benefits of treating MS. Achieving better control of MS can have a significant impact on a person’s ability to function (physically and mentally), which may translate to better job (and financial) security over a person’s working life.
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