Impact socioprofessionnel précoce de la sclérose en plaques : une étude prospective d’une série de 24 patients

Factors associated with self-reported work ability among people with multiple sclerosis in Sweden

Background

Work ability index (WAI) is an instrument that measures work ability in workplace surveys and health examinations in occupational health and research. It has been used in different population groups. But research is limited among people with multiple sclerosis (PwMS).

Objective

To determine the factors associated with work ability among PwMS in Sweden.

Methods

A total of 4103 PwMS who answered a web-based survey were included in the analysis. Work ability was assessed using the work ability score (WAS) component of WAI. Univariable and multivariable linear regression analyses were performed to assess the association of sociodemographic, clinical, and self-reported health variables with WAS.

Results

Just over half of the PwMS reported good (37.0%) or excellent (16.3%) WAS. The overall mean WAS was 6.9 (standard deviation = 2.8). Health-related quality of life (R-squared = 31.6%), fatigue (28.3%), occupation (22.6%), and expanded disability status scale (EDSS) score (18.1%), explained the highest proportions of variation in WAS, individually. In the adjusted model, occupation, EDSS score, and fatigue had the strongest associations with WAS with significantly lower scores in those with no occupation, higher EDSS score, and severe fatigue levels.

Conclusion

Work ability among PwMS was lower than in the general population in Sweden. Occupation, EDSS score and fatigue were among the most important factors associated with work ability.

Work Barriers and Job Adjustments of People with Multiple Sclerosis: A Systematic Review

Purpose The aim was to carry out a systematic review dedicated to describing the work barriers and the job adjustments that are particularly sensitive to people with Multiple Sclerosis (PwMS). Methods Four electronic databases (PubMed/MEDLINE, Scopus, SciVerse ScienceDirect, and Web of Science) were searched for peer-reviewed original articles reporting the barriers at work and/or the job adjustments used by PwMS. MS must have been diagnosed according to accepted international criteria at the time of the study and/or confirmed by a doctor. No time limits were set for the search. Articles that were published in English, Italian, Spanish, French, and Portuguese were accepted. Each article was screened by three experienced and trained investigators. The protocol was registered in PROSPERO (CRD42022299994). Results The initial systematic search yielded 104,228 results, of which 49 articles provided sufficient information and were considered suitable for inclusion in the study. Overall, the studies included 30283 participants with MS. Thirteen (27.1%) studies reported on barriers to work, 14 (29.2%) addressed reasonable adjustments and 21 (43.7%) assessed both outcomes. Job characteristics are the most important barriers for PwMS. Other reported barriers concern the work environment, social relationships at work, negative work events and lack of information. PwMS are more vulnerable to the need for adjustments at the workplace, being the management of the workload the most commonly used one. Conclusions PwMS are exposed to a wide variety of work barriers and job adjustments. Future studies are still highly encouraged on the topic.

The impact of sociodemographic characteristics on diagnosis and access to disease-modifying treatment for patients with multiple sclerosis in Morocco

OBJECTIVE

This study aims to determine the link between sociodemographic factors, diagnosis, and access to disease-modifying treatment for patients with multiple sclerosis (MS) in Morocco.

METHODS

This study concerned a sample of 520 patients representing seven regions of Morocco. We obtained data from the patient record registers, the patient's files, and a questionnaire.

RESULTS

The results showed female dominance (69.4%) in patients with MS (69.4%). Besides, patients with this disease are generally young; their mean age is 35.36. The employment rate among the surveyed population was 24.9%. More than 74.6% have no health care coverage, and 70.4% of the patients investigated live without treatment. The results show a significant association between access to treatment and several sociodemographic factors, such as the patient's job, health care coverage, region, and marital status. There is also a link between these sociodemographic factors and access to diagnosis.

CONCLUSIONS

Diagnosis and access to treatment are associated with certain sociodemographic factors such as health insurance coverage, the patient's job, regional belonging, and marital status.

Occupational outcomes of people with multiple sclerosis: a scoping review

OBJECTIVES

To update the knowledge on the occupational outcomes associated with multiple sclerosis (MS), systematically examine the extent, scope and nature of the pre-existing literature and identify research gaps in the existing literature.

DESIGN

Scoping review.

DATA SOURCES

A comprehensive database search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect and Web of Science was performed. There were no time limits.

ELIGIBILITY CRITERIA

We included any peer-reviewed original article reporting the occupational outcomes of people with MS between the ages of 18 and 65 years. We excluded those off-topic and with insufficient information.

METHODS

This review was conducted following the Joanna Briggs Institute recommendations and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping review checklist. Screening, reading of full-texts and data extraction was performed in a standardised way by expert reviewers from 14 July 2021 to 31 October 2021. We provided a narrative synthesis and an overview of findings.

RESULTS

The initial systematic search yielded 104 228 results. After removing duplicates and applying the exclusion criteria, 403 articles were included in the review. In total, the studies evaluated 492 062 subjects with MS. One hundred fifty-four (38.2%) articles were published in the last 5 years, mostly from Europe and North America (50.9% and 33.0%, respectively). Concerning the occupational outcomes, studies mostly addressed unemployment (311, 77.2%), early retirement (120, 29.8%), disability pension (117, 29.0%), sick leave (77, 19.1%), the indirect cost of MS (74, 18.4%) and work characteristics (57, 14.1%). The results were categorised into seven subtopics: 'Changes in work and occupational status due to MS', 'work-related socio-economic consequences of MS', 'risk factors for unfavourable occupational outcomes', 'reported barriers to employment', 'reported job accommodations and vocational rehabilitation strategies', 'job satisfaction, stigma, and disclosing the diagnosis in the workplace' and 'rating clinical scales'.

CONCLUSIONS

There are several issues that deserve further in-depth study by the scientific community in order to improve the occupational outcomes of people with MS.