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Risk factors for leaving employment due to multiple sclerosis and changes in risk over the past decades: using competing risk survival analysis


Chen, J and Taylor, B and Blizzard, L and Simpson-Yap, S and Palmer, AJ and Kirk-Brown, A and Van Dijk, P and van der Mei, I, Risk factors for leaving employment due to multiple sclerosis and changes in risk over the past decades: using competing risk survival analysis, Multiple Sclerosis Journal pp. 1-12. ISSN 1352-4585 (2020) [Refereed Article]

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Copyright Statement

The Author(s), 2020. This article has been accepted for publication and published online

DOI: doi:10.1177/1352458520954167


Background: No studies have assessed changes in employment survival in multiple sclerosis (MS) populations over recent decades, including the introduction of disease-modifying therapies (DMTs).

Objectives: To evaluate factors associated with leaving employment due to MS; to assess whether the risk of leaving employment has changed over recent decades in Australia, stratified by MS phenotype.

Methods: We included 1240 participants who were working before MS diagnosis. Information on employment status, reasons for leaving employment and year of leaving were collected. Data were analysed using competing risk survival analysis.

Results: Males, progressive MS, lower education level and older age at diagnosis were associated with a higher sub-distribution hazard of leaving employment. Compared to the period before 2010, the sub-distribution hazard during 2010-2016 for relapsing-remitting multiple sclerosis (RRMS) was reduced by 43% (sub-distribution hazard ratio (sHR) 0.67, 95% confidence interval (CI): 0.50 to 0.90), while no significant reduction was seen for primary-progressive multiple sclerosis (PPMS) (sHR 1.25, 95% CI: 0.72 to 2.16) or secondary-progressive multiple sclerosis (SPMS) (sHR 1.37, 95% CI: 0.84 to 2.25).

Conclusion: Males, people with progressive MS and those of lower education level were at higher risk of leaving employment. The differential changed risk of leaving employment between people with different MS phenotype after 2010 coincides with the increased usage of high-efficacy DMTs for RRMS.

Item Details

Item Type:Refereed Article
Keywords:multiple sclerosis, competing risks, disease-modifying therapies, employment, sex, survival analysis
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Central nervous system
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Chen, J (Miss Jing Chen)
UTAS Author:Taylor, B (Professor Bruce Taylor)
UTAS Author:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:Simpson-Yap, S (Dr Steve Simpson JR)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
UTAS Author:van der Mei, I (Professor Ingrid van der Mei)
ID Code:140799
Year Published:2020
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-09-08
Last Modified:2021-04-07

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