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

Abstract

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.