Changes in employment status over time in multiple sclerosis following a first episode of central nervous system demyelination, a Markov multistate model study

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dc.contributor.authorZarghami, A.
dc.contributor.authorFuh-Ngwa, V.
dc.contributor.authorClaflin, S.B.
dc.contributor.authorvan der Mei, I.
dc.contributor.authorPonsonby, A.L.
dc.contributor.authorBroadley, S.
dc.contributor.authorSimpson-Yap, S.
dc.contributor.authorLucas, R.
dc.contributor.authorDear, K.
dc.contributor.authorPonsonby, A.L.
dc.contributor.authorvan der Mei, I.
dc.contributor.authorBlizzard, L.
dc.contributor.authorSimpson-Yap, S.
dc.contributor.authorTaylor, B.V.
dc.contributor.authorBroadley, S.
dc.contributor.authorKilpatrick, T.
dc.contributor.authorWilliams, D.
dc.contributor.authorLechner-Scott, J.
dc.contributor.authorShaw, C.
dc.contributor.authorChapman, C.
dc.contributor.authoret al.
dc.date.issued2024
dc.descriptionFirst published: 31 July 2023
dc.description.abstractBackground and purpose: Understanding predictors of changes in employment status among people living with multiple sclerosis (MS) can assist health care providers to develop appropriate work retention/rehabilitation programs. We aimed to model longitudinal transitions of employment status in MS and estimate the probabilities of retaining employment status or losing or gaining employment over time in individuals with a first clinical diagnosis of central nervous system demyelination (FCD). Methods: This prospective cohort study comprised adults (aged 18–59 years) diagnosed with FCD (n = 237) who were followed for more than 11 years. At each review, participants were assigned to one of three states: unemployed, part-time, or full-time employed. A Markov multistate model was used to examine the rate of state-to-state transitions. Results: At the time of FCD, participants with full-time employment had an 89% chance of being in the same state over a 1-year period, but this decreased to 42% over the 10-year follow-up period. For unemployed participants, there was a 92% likelihood of remaining unemployed after 1 year, but this probability decreased to 53% over 10 years. Females, those who progressed to clinically definite MS, those with a higher relapse count, and those with a greater level of disability were at increased risk of transitioning to a deteriorated employment state. In addition, those who experienced clinically significant fatigue over the follow-up period were less likely to gain employment after being unemployed. Conclusions: In our FCD cohort, we found a considerable rate of employment transition during the early years post-diagnosis. Over more than a decade of follow-up post-FCD, we found that females and individuals with a greater disability and a higher relapse count are at higher risk of losing employment.
dc.description.statementofresponsibilityAmin Zarghami, Valery Fuh-Ngwa, Suzi B. Claflin, Ingrid van der Mei, Anne-Louise Ponsonby, Simon Broadley, Steve Simpson-Yap, Ausimmune/AusLong Investigator Group, Bruce V. Taylor
dc.identifier.citationEuropean Journal of Neurology, 2024; 31(1):e16016-1-e16016-11
dc.identifier.doi10.1111/ene.16016
dc.identifier.issn1351-5101
dc.identifier.issn1468-1331
dc.identifier.orcidDear, K. [0000-0002-0788-7404]
dc.identifier.urihttps://hdl.handle.net/2440/141938
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/316901
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/224215
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1127819
dc.rights© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
dc.source.urihttp://dx.doi.org/10.1111/ene.16016
dc.subjectdisease progression; employment; longitudinal studies; multiple sclerosis; risk factors
dc.subject.meshCentral Nervous System
dc.subject.meshHumans
dc.subject.meshMultiple Sclerosis
dc.subject.meshRecurrence
dc.subject.meshProspective Studies
dc.subject.meshAdult
dc.subject.meshEmployment
dc.subject.meshFemale
dc.titleChanges in employment status over time in multiple sclerosis following a first episode of central nervous system demyelination, a Markov multistate model study
dc.typeJournal article
pubs.publication-statusPublished

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