Real-world data and patient perspectives on the impact of multiple sclerosis, neuromyelitis optica spectrum disorder, and related disorders on employment.

OBJECTIVE

To examine the impact of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and related disorders on employment and income in Thailand.

METHODS

This questionnaire-based cross-sectional study was conducted at Siriraj Hospital in 2023-2024. Primary outcomes included sociodemographic characteristics and employment status. Employment-related factors were analyzed using log-binomial regression, focusing on employment loss, reduced work hours, and income loss.

RESULTS

This study included 204 participants aged > 18 years old, with 169 (82.8 %) females, a median age of 36.5 (IQR: 27.0-50.25), and a median disease duration of 8.0 years (IQR: 3.25-14.0). Diagnosis included 98 (48.0 %) NMOSD, 71 (34.8 %) MS, 13 (6.4 %) MOGAD, and 22 (10.8 %) other conditions. The average annual salary of 6205.11 USD (IQR: 2872.74-11,490.95) before diagnosis was reduced to 5745.46 USD (IQR: 1,378.91-11,490.95) USD after diagnosis, p = 0.079. Median weekly work hours dropped from 40 (IQR: 10-48) per week by half to 20 (0-40) hours, p < 0.001. Unemployment was reported in 52/184 (28.3 %) patients, 70/185 (37.8 %) experienced reduced work hours, and 60/117 (51.3 %) reported income loss. No association was found between factors and unemployment. Increased age (prevalence ratio [PR] = 1.02, 95 % CI 1.01-1.03, p = 0.050) and total number of attacks (PR= 1.03, 95 % CI 1.01-1.07, p = 0.021) were linked to reduced work hours. Increased pain score was associated with income loss (PR=1.11, 95 % CI: 1.04-1.19, p = 0.001).

CONCLUSIONS

The study emphasizes the importance of a holistic approach to managing these diseases. Prioritizing adequate disease management, avoidance, and treatment of disability, relapses, and pain is crucial for mitigating employment-related challenges.