MS Patients Miss Work Nearly 2 Times as Often, US Study Finds

People with multiple sclerosis (MS) are absent from their places of employment nearly twice as often as individuals without the neurodegenerative disease, according to a new study based on U.S. data.

The results also showed missing work is significantly more common for MS patients who are unmarried, experience chronic pain, have high blood pressure, or live in the Northeast U.S.

On average, individuals with MS in the U.S. miss work nearly nine days each year.

Given these findings — and that “an overwhelming majority” of the estimated 900,000-plus MS patients in the U.S. “belong to the working age group (18–64 years)” — the researchers called for further study into ways to improve employment productivity for people with multiple sclerosis.

The study, “Work productivity loss among adults aged 18–64 years with Multiple Sclerosis in the United States: A propensity score matched study,” was published in Research in Social and Administrative Pharmacy.

The research was funded by Sanofi-Genzyme, which markets some disease-modifying therapies for MS, such as Lemtrada (alemtuzumab) and Aubagio (teriflunomide).

MS symptoms may cause work challenges

Most people with MS are diagnosed between ages 20 and 50. The disease causes progressively worsening symptoms that can interfere with day-to-day life — and may cause challenges with work.

“In general, some of the common symptoms of MS such as fatigue, depression, spasticity [muscle stiffness], vision impairment, cognitive impairment as well the working environment and job demands can lead to loss in work productivity,” the researchers wrote.

“Only a handful of studies have examined the productivity loss among working age individuals with MS,” the investigators wrote. Further, they noted that these studies included only certain types of MS, specifically examined the impact of treatments, or were “conducted outside of the US.”

Now, the team — comprised of scientists from Sanofi and two American universities — set out to assess how MS affects work productivity for patients in the U.S.

The researchers noted that they retrospectively analyzed “national-level data with a comprehensive source of individual-level variables to examine the work productivity loss among individuals aged 18–64 years with MS” relative to that of people without the disease.

Their study used data collected from 2005 to 2015 by the Medical Expenditure Panel Survey, a nationwide survey of healthcare usage conducted by the Agency for Healthcare Research and Quality. Altogether, the team identified 104 employed adults with MS and 312 employed people without the disease, who were used as controls.

The controls were specifically selected to be comparable to the MS patients in terms of demographic factors like age, sex, and race/ethnicity.

The analyses focused on the participants’ household makeup and medical conditions survey files, and assessed information related to missed work days, some clinical characteristics, and any simultaneous medical conditions, called comorbidities.

Results showed that MS patients missed a mean of nearly nine workdays per year, while controls reported just over three missed workdays per year — a difference that was statistically significant.

After accounting for potential influencing factors, including comorbidities, pain, and ease of performing daily activities, MS patients showed a significantly higher rate of missed workdays, by nearly twofold, relative to controls.

These analyses also indicated that MS patients reporting pain were significantly more likely to miss work than those without pain: by 1.7 times for mild to moderate pain, and by 3.9 times for “quite or extreme pain.”

The researchers noted that increased pain has been previously reported to be a limiting factor for multiple sclerosis patients when it comes to employment.

“It is critical to take into consideration the pain severity while developing appropriate interventions to alleviate the effects of pain on work productivity loss among individuals with MS,” they wrote.

The effects of demographic factors

In addition, unmarried/divorced/separated/widowed patients reported a nearly twofold higher rate of missed work days compared with those who were married. Similar results were observed for patients with high blood pressure versus those without it.

The team speculated that having a positive caregiver might help patients stay active, and that individuals with co-occurring MS and high blood pressure “might be experiencing higher disease burden that leads to reduced work productivity.”

“Future research is warranted to evaluate the effect of comorbid condition burden on work productivity loss among individuals with MS,” the researchers wrote.

Rates of missed work days also varied geographically, with patients in the Northeast reporting significantly higher rates of absenteeism (by nearly 70%) than those in the Midwest or West.

“We can speculate that certain environmental conditions or other socio-cultural factors might play a role in this regional variation and future studies should examine this in detail,” the researchers wrote.

“For example, it can be speculated that the general cold weather conditions of the Northeastern US regions can have a negative effect on nerves and activities of muscles that can lead to increase in pain and mobility challenges that can subsequently increase missed workdays,” they added.

These findings highlight that, overall, MS patients in the U.S. “experience significantly higher productivity loss compared to propensity score matched non-MS controls,” the team wrote.

“Interventions (e.g., improved management of MS symptoms, use of occupational therapy interventions) are warranted to reduce productivity loss among individuals with MS,” the researchers concluded.