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. 2016 Nov 17;6(11):e012731.
doi: 10.1136/bmjopen-2016-012731.

How does work disability of patients with MS develop before and after diagnosis? A nationwide cohort study with a reference group

Hanna Gyllensten  1   2 , Michael Wiberg  1   3 , Kristina Alexanderson  1 , Jan Hillert  1 , Petter Tinghög  1   4
Affiliations

How does work disability of patients with MS develop before and after diagnosis? A nationwide cohort study with a reference group

Hanna Gyllensten et al. BMJ Open. .

Abstract

Objectives: We compared work disability of patients with multiple sclerosis (MS) from 5 years before with 5 years after diagnosis, with that of matched controls, and analysed whether progression in work disability among patients with MS was associated with sociodemography.

Design: Population-based cohort study.

Setting: The adult Swedish general population.

Participants: Residents aged 24-57 diagnosed with MS (n=3685) in 2003-2006 and 18 425 matched controls without MS.

Primary and secondary outcome measures: Annual net days of sickness absence (SA) and disability pension (DP), used as a proxy for work disability, followed from 5 years before to 5 years after diagnosis (ie, T-5-T+5). For patients with MS, regression was used to identify sociodemographic factors related to progression in work disability.

Results: Work disability of patients with MS increased gradually between T-5 and T-1 (mean: 46-82 days) followed by a sharp increase (T+1, 142 days), after which only a marginal increase was observed (T+5, 149 days). The matched controls had less work disability, slightly increasing during the period to a maximum of ∼40 days. Men with MS had a sharper increase in work disability before diagnosis. High educational level was associated with less progression in work disability before and around diagnosis.

Conclusions: Patients with MS had more work disability days also 5 years before diagnosis. Several sociodemographic variables were associated with the absolute level and the progression in SA and DP.

Keywords: Disability pension; Insurance medicine; Sick leave; Work disability.

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Conflict of interest statement

HG, PT and MW were funded by Biogen. KA has received project grant from Biogen and several Swedish research councils. JH received honoraria for serving on advisory boards for Biogen and Novartis and speaker's fees from Biogen, Merck-Serono, Bayer-Schering, Teva and Sanofi-Aventis. He has served as P.I. for projects sponsored by, or received unrestricted research support from, Biogen, Merck-Serono, TEVA, Novartis and Bayer-Schering. His MS research is funded by the Swedish Research Council. Biogen reviewed and provided feedback on the paper to the authors. The authors had full editorial control of the paper, and provided their final approval of all content.

Figures

Figure 1
Figure 1
Annual net days with SA/DP per year, among patients with MS and controls, respectively, in relation to year of MS diagnoses (T0). DP, disability pension; MS, multiple sclerosis; SA, sickness absence.
Figure 2
Figure 2
Mean number of net days per year with sickness absence (SA) and disability pension (DP), respectively, among patients with MS, five years before the year of MS diagnosis (T0) to five years after. DP, disability pension; MS, multiple sclerosis; SA, sickness absence.
See this image and copyright information in PMC

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