Symptoms and quality of life of adults with multiple sclerosis by employment status.

TitleSymptoms and quality of life of adults with multiple sclerosis by employment status.
Publication TypeConference Proceedings
Year of Conference2012
AuthorsJohnson KL, Amtmann D, Verrall A, Weir VG, Salem R
Conference NameEuropean Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS)
Conference LocationPoster Presentation at European Committee for Treatment and Research in Multiple Sclerosis (ECTIRMS), Lyon, France

Background: Patients with multiple sclerosis (MS) face high unemployment rates as symptoms pose a significant barrier to finding and maintaining employment.  Secondary symptoms have not been extensively studied in relation to employment partly because of lack of common metrics across measures. The PROMIS initiative uses modern psychometric methods to develop instruments using the same metric and providing US population norms. The objective of the current study was to construct profiles of secondary symptoms and cognitive function in patients with MS compared to US population norms by employment status.

Methods: PROMIS symptom measures including fatigue, pain, physical and social function, depression, anxiety, and sleep disturbance and Neuro-QoL measures of executive functioning and general cognitive concerns were completed via telephone by 414 community-dwelling adults with MS as part of a needs assessment survey. Employment status, work preference, and demographics were also collected.  T-scores were compared to US population norms (mean of 50 and SD of 10) by employment status group (employed >20 hours/week, employed <20 hours/week, unemployed and satisfied and unemployed but prefer to work).

Results:  Most respondents were unemployed (70%) and only 14% were actively seeking work. Of the unemployed, 62% preferred to be working, but most (79%) were unable to work due to symptom burden. The employed group had significantly worse fatigue, pain interference, executive function and general cognitive concern scores in contrast to US population norms, (p<0.001). The unemployed and prefer to work group reported worse functioning than population norms on all measures, (p<0.001) and had greater symptom burden than the employed group on all measures but sleep disturbance, (p<0.001).

Conclusions: Employed patients with MS report fewer secondary conditions than unemployed. However, this group is still burdened with pain, fatigue and cognitive issues and should be counseled on how to use compensatory strategies to preserve employment. Unemployed patients with MS who prefer to be working report the highest symptom burden. This group is generally younger than those who are satisfied with their unemployment and may feel that they should be working, but are unable to do so because of MS symptoms.  Those who are unemployed but would prefer to work may benefit from interdisciplinary, in-depth consultation on symptom management, compensatory strategies, and employment options.

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