title: Factors related to difficulties with employment in patients with multiple sclerosis: a review of 2002-2011 literature.
abstract: We assess the knowledge available on the difficulties experienced by multiple sclerosis (MS) patients in work-related activities. A literature review was carried out using the keywords 'multiple sclerosis' and 'employment' or 'work' through PubMed and EMBASE. Papers reporting patient-derived data on difficulties at work as primary or secondary outcome measures and published in the period 2002-December 2011 were searched. A total of 26 papers were selected, for a total of 32 507 patients (mean age 46.2 years; 42.1% with relapsing-remitting MS). Most papers reported observational studies or cross-sectional surveys focused on health-related quality of life and MS costs. Symptoms more frequently addressed are fatigue, mobility and cognitive impairments. Limited research has been carried out on the working environment. We found a relatively small number of papers published in the last 10 years on the difficulties that patients with MS can experience at work, and this kind of information always appeared as a secondary outcome. In general, it is possible to affirm that MS has a strong impact on patients' employment status, as the mean unemployment rate was 59%. Research on factors promoting maintenance of remunerative employment is required.
authors.affiliation: Department of Neurology, Neurological Institute C. Besta, IRCCS Foundation, Milano, Italy. silvia.schiavolin@istituto-besta.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Schiavolin
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
authors.forename: Ambra M
authors.initials: AM
authors.lastname: Giovannetti
authors.forename: Carlo
authors.initials: C
authors.lastname: Antozzi
authors.forename: Laura
authors.initials: L
authors.lastname: Brambilla
authors.forename: Paolo
authors.initials: P
authors.lastname: Confalonieri
authors.forename: Renato
authors.initials: R
authors.lastname: Mantegazza
authors.forename: Alberto
authors.initials: A
authors.lastname: Raggi
mesh_terms: D018450:Disease Progression; D004651:Employment; D006304:Health Status; D006801:Humans; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000534:rehabilitation; D016272:Occupational Health; D011788:Quality of Life; D012959:Socioeconomic Factors