title: Labour market participation and sick leave among patients diagnosed with myasthenia gravis in Denmark 1997-2011: a Danish nationwide cohort study.
abstract: BACKGROUND
  To examine labour market participation and long-term sick leave following a diagnosis with myasthenia gravis (MG) compared with the general Danish population and for specific subgroups of MG patients.
  
  
  METHODS
  A nationwide matched cohort study from 1997 to 2011 using data from population-based medical and social registries. The study includes 330 MG patients aged 18 to 65 years old identified from hospital diagnoses and dispensed prescriptions, and twenty references from the Danish population matching each MG patient on age, gender, and profession. Main outcome measures are labour market participation (yes/no) and long-term sick leave ≥9 weeks (yes/no) with follow-up at 1- and 2 years after the time of MG diagnosis or match. Based on complete person-level information on all public transfer payments in Denmark, persons having no labour market participation are defined as individuals receiving social benefits for severely reduced workability, flexijob, and disability pension.
  
  
  RESULTS
  MG is consistently associated with higher odds of having no labour market participation and long-term sick leave compared with the general Danish population (no labour market participation & ≥9 weeks sick leave at 2-year follow-up, adjusted OR (95% CI): 5.76 (4.13 to 8.04) & 8.60 (6.60 to 11.23)). Among MG patients, females and patients treated with both acetylcholinesterase inhibitors and immunosuppression have higher odds of lost labour market participation and long-term sick leave.
  
  
  CONCLUSIONS
  This study suggests that MG patients have almost 6 times higher odds of no labour market participation and almost 9 times higher odds of long-term sick leave 2 years after diagnosis compared with the general Danish population. In particular female MG patients and patients treated with both acetylcholinesterase and immunosuppression have high odds of a negative labour market outcome. Future research should focus on predictors in workplace and labour market policy of labour market participation among MG patients.
authors.affiliation: The National Rehabilitation Centre for Neuromuscular Disorders, Kongsvang Allé 23, DK-8000, Aarhus, Denmark.
authors.forename: Asger
authors.initials: A
authors.lastname: Frost
authors.affiliation: DEFACTUM, Olof Palmes Allé 15, DK-8200, Aarhus N, Denmark.
authors.forename: Marie Louise
authors.initials: ML
authors.lastname: Svendsen
authors.affiliation: The National Rehabilitation Centre for Neuromuscular Disorders, Kongsvang Allé 23, DK-8000, Aarhus, Denmark.
authors.forename: Jes
authors.initials: J
authors.lastname: Rahbek
authors.affiliation: DEFACTUM, P.P. Oerums Gade 11, Building 1B, DK-8000, Aarhus C, Denmark.
authors.forename: Christina Malmose
authors.initials: CM
authors.lastname: Stapelfeldt
authors.affiliation: DEFACTUM and Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 11, Building 1B, DK-8000, Aarhus C, Denmark.
authors.forename: Claus Vinther
authors.initials: CV
authors.lastname: Nielsen
authors.affiliation: DEFACTUM, Olof Palmes Allé 15, DK-8200, Aarhus N, Denmark. thomlund@rm.dk.|Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, DK-7400, Herning, Denmark. thomlund@rm.dk.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000453:epidemiology*; D010415:Pensions; D020127:Recovery of Function; D062707:Return to Work; D018582:Sick Leave; D055815:Young Adult
keywords: Cohort study; Labour market participation; Myasthenia gravis; Sick leave