Comorbidities, which are medical conditions that occur simultaneously with another disease, are common in people with MS. A growing body of information suggests that in order to improve treatment outcomes and quality of life of people with MS, comorbidities must also be factored into our research efforts and the clinical management of MS. Research has shown that people of working age who are living with MS and comorbidities are more likely to be on a disability pension. However, for employed people with MS, the impact of comorbidities on work productivity is not known.
Investigating the impact of comorbidities on employment
To provide further information on the prevalence and impact of comorbidities on work-related outcomes in people with MS, researchers from the Menzies Institute for Medical Research in Tasmania led by Associate Professor Ingrid van der Mei conducted investigations on a nationally representative sample of working age people with MS. Findings from their studies have recently been published in Multiple Sclerosis Journal.
For this study, 929 working age people with MS from MS Research Australia’s long-running survey-based Australian MS Longitudinal Study, which is managed by the Menzies team, provided information on specific comorbidities. Information included whether each comorbidity assessed was present or not, had been diagnosed by a doctor, whether it was treated and the extent to which it limited their daily activities. The severity of 13 MS symptoms and the work productivity of these participants were also assessed using a well-established rating scale and MS specific Work Productivity and Activity Impairment Questionnaire, respectively.
What did the researchers find?
90% of people with MS who participated in this survey reported having at least one comorbidity, with 65% receiving treatments for them at the time. The most common comorbidities were identified as depression (45%), anxiety (42%), allergies (38%), migraines (30%) and high blood pressure (25%).
They also found 38% of people had one or more comorbidities that limited their activities. The comorbidities that were said to most limit daily activities were osteoarthritis (51%), migraines (40%), anxiety (33%), depression (29%) and allergies (18%). Some comorbidities, such as osteoporosis and inflammatory bowel disease, were rarer, but limited activities greatly.
The data also showed that the average number of days lost in work productivity in the 4 weeks prior to the collection of data was 1.3 days for those with MS without comorbidities and 2.5 days for those with comorbidities. This confirms the significant impact comorbidities have on work attendance in people with MS.
When these researchers looked at the total number of comorbidities for each person and their severity, they saw a proportional increase in the likelihood of not working in people with MS who participated in this study. This did not change even when age, gender and education levels were accounted for in the analyses. MS symptom severity also showed a clear link with the loss in work productivity of participants experiencing comorbidities.
What does this all mean?
These findings have shown that comorbidities are not only prevalent in people with MS, but also negatively impact the work status and work productivity of working age people with MS. It highlights the importance of simultaneously managing comorbidities and MS symptoms, which could in turn improve employment outcomes and quality of life.
This body of work contributes significantly towards improving our understanding of the comorbidities experienced by people with MS and how they add to the burden of the disease. The recent Health Economic Impact of MS Report, commissioned by MS Research Australia, showed that lost wages now accounts for just 32% of the economic burden of MS compared to almost 50% in 2010, which is an improvement possibly due to the increasing use of disease modifying therapies.
However, these new findings show that we can do even better to support people with MS in employment by also paying attention to the other health conditions experienced alongside MS.