Illness severity and sociodemographic characteristics of 7,053 employees with multiple sclerosis and 11,043 peers not in the workforce were compared (Hedges’ g with 95% confidence interval and p values). Pooled findings from 25 studies confirmed the main role of a relapsing–remitting disease course and higher education to employment. To a lesser extent, disease duration, fatigue and pain symptoms and age also differentiated the two groups. Vocational interventions for persons with multiple sclerosis should focus on job retention, including mechanisms to accommodate and facilitate functional independence. Longitudinal data are needed to distinguish the characteristics of those who achieve and maintain competitive employment.
BishopMRumrillPD (2015) Multiple sclerosis: Etiology, symptoms, incidence and prevalence, and implications for community living and employment. Work52(4): 725–734.
2.
BishopMFrainMPRumrillPD, et al. (2009) The relationship of self-management and disease modifying therapy use to employment status among adults with multiple sclerosis. Journal of Vocational Rehabilitation231(2): 119–128.
3.
*Boe LundeHMBTelstadWGryttenN, et al. (2014) Employment among patients with multiple sclerosis – A population study. PLoS ONE9(7): e103317.
4.
BorensteinMHedgesLVHigginsJPT, et al. (2009) Introduction to Meta-Analysis. New York: Wiley.
5.
BorensteinMHedgesLVHigginsJPT, et al. (2010) A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods1(2): 97–111.
6.
*BuscheKDFiskJDMurrayTJ, et al. (2003) Short term predictors of unemployment in multiple sclerosis patients. The Canadian Journal of Neurological Sciences30(2): 137–142.
7.
*CaddenMArnettP (2015) Factors associated with employment status in individuals with multiple sclerosis. International Journal of MS Care17(6): 284–291.
8.
ChiuCYChanFBishopM, et al. (2013) State vocational rehabilitation services and employment in multiple sclerosis. Multiple Sclerosis Journal19(12): 1655–1664.
9.
*ChiuCYChanFSharpS, et al. (2015a) Employment as a health promotion intervention for persons with multiple sclerosis. Work52(4): 749–756.
10.
ChiuCYTanseyTNChanF, et al. (2015b) Effect of rehabilitation technology services on vocational rehabilitation outcomes of individuals with multiple sclerosis. Rehabilitation Research, Policy, and Education29(2): 183–192.
11.
CohenJ (1992) A power primer. Psychol Bull112(1): 155–159.
12.
ConradACoenenMKesselringJ, et al. (2014) What explains functioning from the perspective of people with multiple sclerosis?Journal of Neurology261(12): 2283–2295.
13.
DorstynDSBlackRMpofuE, et al. (2017) Utilizing the ICF to understand depressive symptomology in multiple sclerosis: An exploratory systematic review. Rehabilitation Psychology62(2): 143–164.
14.
*DorstynDSRobertsRMMurphyG, et al. (2014) Piloting an email-based resource package for job seekers with multiple sclerosis. Disability and Rehabilitation39(9): 867–873.
15.
DorstynDSRobertsRMMurphyG, et al. (2019) Employment and multiple sclerosis: A meta-analytic review of psychological correlates. Journal of Health Psychology24(1): 38–51. DOI: 10.1177/1359105317691587.
16.
EhdeDMGibbonsLEChwastiakL, et al. (2003) Chronic pain in a large community sample of persons with multiple sclerosis. Multiple Sclerosis Journal9: 605–611.
17.
EhdeDMOsborneTLJensenMP (2005) Chronic pain in persons with multiple sclerosis. Physical Medicine and Rehabilitation Clinics of North America16: 503–512.
18.
*EhdeDMOsborneTLHanleyMA, et al. (2006) The scope and nature of pain in persons with multiple sclerosis. Multiple Sclerosis Journal12(5): 629–638.
19.
FisherJSRudickRACutterGR, et al. (1999) Multiple Sclerosis Functional Composite (MSFC): An integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force. Multiple Sclerosis Journal5: 244–250.
20.
GoldmanMAnn MarrieRCohenJA (2008) Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls. Multiple Sclerosis Journal14: 383–390.
21.
GreerJMMcCombePA (2011) Role of gender in multiple sclerosis: Clinical effects and potential molecular mechanisms. Journal of Neuroimmunology234(1): 7–18.
22.
*GulickEEYamETouwMM (1989) Work performance by persons with multiple sclerosis: Conditions that impede or enable the performance of work. International Journal of Nursing Studies26(4): 301–311.
23.
HarboHFGoldRTintoréM (2013) Sex and gender issues in multiple sclerosis. Therapeutic Advances in Neurological Disorders6(4): 237–248.
24.
HigginsJPTThompsonSGDeeksJJ, et al. (2003) Measuring inconsistency in meta-analyses. British Medical Journal327: 557–560.
25.
*HonanCABrownRFBatchelorJ (2015) Perceived cognitive difficulties and cognitive test performance as predictors of employment outcomes in people with multiple sclerosis. Journal of the International Neuropsychological Society21(2): 156–168.
26.
*HonarmandKAkbarNKouN, et al. (2011) Predicting employment status in multiple sclerosis patients: The utility of the MS functional composite. Journal of Neurology258(2): 244–249.
27.
HowardJTrevickSYoungerDS (2016) Epidemiology of multiple sclerosis. Neurologic Clinics34(4): 919–939.
28.
Huedo-MedinaTBSánchez-MecaFMarín-MartínezF, et al. (2006) Assessing heterogeneity in meta-analysis: Q statistic or I2 index?Psychological Methods11(2): 193–206.
29.
*IncertiCCArgentoOMagistraleG, et al. (2017) Adverse working events in patients with multiple sclerosis. Neurological Sciences38(2): 349–352.
30.
International Federation of Multiple Sclerosis Societies (1984) Symposium on minimal record of disability for multiple sclerosis. Acta Neurologica Scandinavica: Supplementum101: 1–217.
31.
International Labour Organization (1982) Resolution concerning statistics of the economically active population, employment, unemployment and underemployment. In: Adopted by the thirteenth international conference of labour statisticians. Available at: http://www.ilo.org/ (accessed 3 October 2017).
32.
*JohanssonSYtterbergCHillertJ, et al. (2008) A longitudinal study of variations in and predictors of fatigue in multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry79(4): 454–457.
33.
JohnsonKLBamerAFraserRT (2009) Disease and demographic characteristics associated with unemployment among working-age adults with multiple sclerosis. International Journal of MS Care11(3): 137–143.
34.
*JulianLJVellaLVollmerT, et al. (2008) Employment in multiple sclerosis. Journal of Neurology255(9): 1354–1360.
35.
JüniPHolensteinFSterneJ, et al. (2002) Direction and impact of language bias in meta-analyses of controlled trials: Empirical study. International Journal of Epidemiology31(1): 115–123.
36.
KleinmanNLBerenIARajagopalanK, et al. (2010) Medication adherence with disease modifying treatments for multiple sclerosis among US employees. Journal of Medical Economics13(4): 633–640.
37.
KochMKingwellERieckmannP, et al. (2010) The natural history of secondary progressive multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry81(9): 1039–1043.
38.
*KrauseIKernSHorntrichA, et al. (2013) Employment status in multiple sclerosis: Impact of disease-specific and non-disease-specific factors. Multiple Sclerosis Journal19(13): 1792–1799.
39.
*KrokavcovaMNagyovaIRosenbergerJ, et al. (2012) Employment status and perceived health status in younger and older people with multiple sclerosis. International Journal of Rehabilitation Research35(1): 40–47.
40.
KurtzkeJF (1983) Rating neurologic impairment in multiple sclerosis: An Expanded Disability Status Scale (EDSS). Neurology33(11): 1444–1452.
41.
LaroccaNKalbRScheinbergL, et al. (1985) Factors associated with unemployment of patients with multiple sclerosis. Journal of Chronic Diseases38(2): 203–210.
42.
*LauKKLauAYLYuELM, et al. (2016) Employment among multiple sclerosis patients in Hong Kong. Neurology Asia21(2): 161–175.
43.
LearmonthYCAdamsonBCBaltoJM, et al. (2017) Multiple sclerosis patients need and want information on exercise promotion from healthcare providers: A qualitative study. Health Expectations20: 574–583.
44.
LiJFitzgeraldSMBishopM, et al. (2015) Disease-related and functional predictors of employment status among adults with multiple sclerosis. Work52(4): 789–797.
LublinFDReingoldSCCohenJA, et al. (2014) Defining the clinical course of multiple sclerosis: The 2013 revisions. Neurology83(3): 278–286.
47.
McDonaldWICompstonAEdanG, et al. (2001) Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the diagnosis of multiple sclerosis. Annals of Neurology50(1): 121–127.
48.
McFaddenEHortonMCFordHL, et al. (2012) Screening for the risk of job loss in multiple sclerosis (MS): Development of an MS-specific Work Instability Scale (MS-WIS). Multiple Sclerosis Journal18(6): 862–870.
49.
Meyer-MoockSFengY-SMaeurerM, et al. (2014) Systematic literature review and validity evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients with multiple sclerosis. BMC Neurology14(1): 58.
MoherDLiberatiATetzlaffJ, et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine151: 264–269.
52.
MohrDCKartSLJulianL, et al. (2004) Association between stressful life events and exacerbation in multiple sclerosis: A meta-analysis. British Medical Journal328(7442): 731.
53.
*MollaoğluMÜstünE (2009) Fatigue in multiple sclerosis patients. Journal of Clinical Nursing18(9): 1231–1238.
54.
*MoorePHardingKEClarksonH, et al. (2013) Demographic and clinical factors associated with changes in employment in multiple sclerosis. Multiple Sclerosis Journal19(12): 1647–1654.
55.
MorrisonJDStuifbergenAK (2014) Outcome expectations and physical activity in persons with longstanding multiple sclerosis. Journal of Neuroscience Nursing46(3): 171–179.
56.
*NiinoMMifuneNKohriyamaT, et al. (2014) Association of cognitive impairment with magnetic resonance imaging findings and social activities in patients with multiple sclerosis. Clinical and Experimental Neuroimmunology5(3): 328–335.
57.
OrwinR (1983) A fail-safe N for effect size. Journal of Educational Statistics8: 157–159.
58.
*PearsonJFAllaSClarkeG, et al. (2017) Multiple Sclerosis impact on employment and income in New Zealand. Acta Neurologica Scandinavica136(3): 223–232.
59.
*PiwkoCDesjardinsOBBerezaBG, et al. (2007) Pain due to multiple sclerosis: Analysis of the prevalence and economic burden in Canada. Pain Research and Management12(4): 259–265.
60.
PolliackMLBarakYAchironA (2001) Late-Onset multiple sclerosis. Journal of the American Geriatrics Society49(2): 168–171.
61.
PolmanCHReingoldSCBanwellB, et al. (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Annals of Neurology69(2): 292–302.
62.
PolmanCHReingoldSCEdanG, et al. (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the ‘McDonald Criteria’. Annals of Neurology58(6): 840–846.
63.
RoesslerRTFitzgeraldSMRumrillPD, et al. (2001) Determinants of employment status among people with multiple sclerosis. Rehabilitation Counseling Bulletin45(1): 31–39.
64.
RoesslerRTRumrillPDTimblinR (2017) Focus group perspectives on high-priority employment barriers facing Americans with multiple sclerosis. Journal of Vocational Rehabilitation47(2): 223–233.
65.
RoesslerRTTurnerRCRobertsonJL, et al. (2005) Gender and perceived illness severity: Differential indicators of employment concerns for adults with multiple sclerosis. Rehabilitation Counseling Bulletin48: 66–74.
66.
*SalterARCutterGRTyryT, et al. (2010) Impact of loss of mobility on instrumental activities of daily living and socioeconomic status in patients with MS. Current Medical Research and Opinion26(2): 493–500.
67.
*SalterARThomasNTyryT, et al. (2017) Employment and absenteeism in working-age persons with multiple sclerosis. Journal of Medical Economics20(5): 493–502.
68.
SchiavolinSLeonardiMGiovannettiAM, et al. (2013) Factors related to difficulties with employment in patients with multiple sclerosis: A review of 2002–2011 literature. International Journal of Rehabilitation Research36(2): 105–111.
69.
ShahrbanianSAuaisMDuquetteP, et al. (2013) Does pain in individuals with multiple sclerosis affect employment? A systematic review and meta-analysis. Pain Research and Management18(5): e94–e100.
70.
SimmonsRDTribeKLMcDonaldEA (2010) Living with multiple sclerosis: Longitudinal changes in employment and the importance of symptom management. Journal of Neurology257: 926–936.
71.
*SmithMMArnettPA (2005) Factors related to employment status changes in individuals with multiple sclerosis. Multiple Sclerosis Journal11(5): 602–609.
72.
SolaroCTrabuccoEUccelliMM (2013) Pain and multiple sclerosis: Pathophysiology and treatment. Current Neurology and Neuroscience Reports13(1): 320.
73.
StroberLBArnettPA (2016) Unemployment among women with multiple sclerosis: The role of coping and perceived stress and support in the workplace. Psychology, Health & Medicine21(4): 496–504.
74.
*StroberLBChiaravallotiNMooreN, et al. (2014) Unemployment in multiple sclerosis (MS): Utility of the MS Functional Composite and cognitive testing. Multiple Sclerosis Journal20(1): 112–115.
75.
*StroberLBChristodoulouCBenedictRH, et al. (2012) Unemployment in multiple sclerosis: The contribution of personality and disease. Multiple Sclerosis Journal18(5): 647–653.
76.
SweetlandJHowseEPlayfordED (2012) A systematic review of research undertaken in vocational rehabilitation for people with multiple sclerosis. Disability and Rehabilitation34(24): 2031–2038.
77.
TrojanoMLiguoriMBosco ZimatoreG, et al. (2002) Age-related disability in multiple sclerosis. Annals of Neurology51(4): 475–480.
78.
ValentineJCPigottTDRothsteinHR (2010) How many studies do you need? A primer on statistical power for meta-analysis. Journal of Educational and Behavioral Statistics35(2): 215–247.
79.
*Van der HieleKMiddelkoopHARuimschotelR, et al. (2014) A pilot study on factors involved with work participation in the early stages of multiple sclerosis. PLoS ONE9(8): e105673.
80.
*Van der HieleKvan GorpDRuimschotelR, et al. (2015) Work participation and executive abilities in patients with relapsing-remitting multiple sclerosis. PLoS ONE10(6): e0129228.
81.
YorkstonKMJohnsonKKlasnerER, et al. (2003) Getting the work done: A qualitative study of individuals with multiple sclerosis. Disability and Rehabilitation25(8): 369–379.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
