Job Retention Among Individuals With Multiple Sclerosis: Relationship With Prediagnostic Employment and Education; Demographic Characteristics; and Disease Course, Severity, and Complications

Abstract

Objective: To identify how prediagnosis employment, education, demographic statuses, and disease factors relate to job retention among people with multiple sclerosis (MS).

Design: Cross-sectional logit model.

Setting: Data were collected at an academic Medical University and a specialty hospital, both in the Southeastern US.

Participants: People with MS (N=1126) who were employed at the time of MS diagnosis.

Interventions: Not applicable.

Main outcome measures: Job retention was measured by employment status at the time of follow-up assessment.

Results: Prediagnostic educational attainment was predictive of job retention. Among several prediagnostic employment characteristics, only working in production, transportation, and material moving was significantly related to a lower odds of job retention compared with those working in professional/managerial occupations. Aging factors were strongly related to job retention, with declines in job retention observed with increasing age and years since diagnosis. Non-Hispanic Black and Hispanic participants reported lower odds of job retention than non-Hispanic White participants, although there were no observed effects of sex. A significantly lower job retention rate was observed among those with progressive MS, compared with relapsing-remitting. Job retention was also less likely among people with greater MS severity and fatigue.

Conclusions: Job retention strategies and interventions should target people with greater MS complications and severity, as well as non-Hispanic Black and Hispanic persons, because these characteristics are more highly related to job retention than our prediagnostic employment and vocational history.

Keywords: Cognitive dysfunction; Employment; Fatigue; Multiple sclerosis; Rehabilitation; Rehabilitation, vocational.