title: Demographic and clinical factors associated with changes in employment in multiple sclerosis.
abstract: OBJECTIVE
  The objective of this paper is to investigate demographic and disease factors associated with changes in employment role and status in multiple sclerosis (MS).
  
  
  METHODS
  Questionnaires on current symptoms, employment status and factors associated with changes in employment were sent to a community sample of 566 MS patients.
  
  
  RESULTS
  A total of 221 completed questionnaires were analysed. Of 169 employed at diagnosis, 43.3% had left employment at a mean of 11.9 years after disease onset. Of those still employed, 55% had changed their role or working hours to accommodate symptoms relating to their disease. These patients reported greater fatigue (p = 0.001), pain (p = 0.033) and memory problems (p = 0.038) than those whose employment had remained unaffected. Multinomial logistic regression revealed the factors most strongly predictive of employment status were disability level, years of education, disease duration and fatigue (p = 0.032).
  
  
  CONCLUSIONS
  Despite changes to public perceptions and legislative protection over the last 20 years, high rates of MS patients still leave the workforce prematurely, reduce working hours or change employment roles. These data have significant implications when considering social and economic impacts of MS, support the value of employment metrics as long-term outcome measures, and demonstrate the need to improve employment requirements and flexibility of working practices in individuals with MS.
authors: The Walton Centre for Neurology and Neurosurgery, UK.
authors: Phil
authors: P
authors: Moore
authors: Katharine E
authors: KE
authors: Harding
authors: Hannah
authors: H
authors: Clarkson
authors: Trevor P
authors: TP
authors: Pickersgill
authors: Mark
authors: M
authors: Wardle
authors: Neil P
authors: NP
authors: Robertson
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D016001:Confidence Intervals; D004185:Disability Evaluation; D018450:Disease Progression; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000523:psychology; D001523:Mental Disorders / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000191:economics* / Q000453:epidemiology* / Q000523:psychology; D016017:Odds Ratio; D011788:Quality of Life; D012044:Regression Analysis; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: Employment; disability; multiple sclerosis