Author Of 2 Presentations
P0789 - Benchmarks of meaningful improvement on neurocognitive tests (ID 1372)
Abstract
Background
Background: The Brief International Cognitive Assessment for MS (BICAMS) and Multiple Sclerosis Outcomes Assessment Consortium (MSOAC) battery are frequently used to monitor cognitive and motor function in people with MS (PwMS). While previous studies established benchmarks of clinically meaningful change on these tests, the real-world anchors were based on deterioration in function. Little is known about meaningful testing benchmarks based on gains in function, an increasingly relevant anchor considering improvements that may arise with higher efficacy disease modifying medication.
Objectives
Objective: We aimed to investigate ‘work status gains’ in PwMS, and compare BICAMS and MSOAC test scores of those with said gains to patients reporting work stability or decline.
Methods
Methods: A retrospective analysis was performed on a longitudinal database of 783 PwMS. All subjects were monitored with an online tool called the Buffalo Vocational Monitoring Survey. This analysis included 208 patients with a follow-up timepoint coincident with BICAMS and MSOAC tests.
Results
Results: At follow-up, 36.1% of PwMS reported at least one type of work status gain, such as a reduction in negative work events (25.5%) or an actual improvement in work status, such as from part-time to full-time (6.7%), among others. 8.2% reported a decrease in work status (e.g., full-time to unemployed) and 43.3% reported being work stable without any positive work gains. ANCOVA models comparing those with and without work status gains showed significant differences between the groups in longitudinal change on the Symbol Digit Modalities Test (SDMT), F(1)=3.92, p=0.049. Among the work status improved group, subjects showed an average increase (or clinically meaningful improvement) of 4.87 points on the SDMT.
Conclusions
Conclusions: Benchmarks for clinically meaningful improvement on the SDMT mirror those previously established for clinically meaningful decline. The importance of such benchmarks is reaffirmed, particularly that of score increases, and is especially relevant in considering the efficacy of certain interventions for maintaining and/or improving employment outcomes.
P1026 - Employment outcomes in multiple sclerosis (ID 852)
Abstract
Background
Multiple sclerosis (MS) causes physical and cognitive deficits that are known to impact employment.1 Approximately 50% of people with MS (PwMS) will lose their job 5 years after diagnosis.2 This quick vocational deterioration emphasizes a need to study MS specific work problems prior to job loss.
Objectives
Report descriptive statistics and analyze differences of baseline time points comparing an employed sample of 607 PwMS and 140 healthy controls (HC).
Methods
Using the Buffalo Vocational Monitoring Survey, respondents were asked questions about demographics, work status, job-type, work duties, income, hours worked, disclosure, negative work events (NWEs), and work accommodations.
Results
MS and HC groups were matched on age, sex, and education. Of the PwMS, 89.9% had relapsing remitting MS with an average disease duration of 10.1±8.8 years and of this group 58.9% self-reported having physical disability.3 Additionally, 76.1% and 85.4% of PwMS disclosed their MS diagnosis to an employer or co-workers respectively. The five most common job descriptions among both PwMS and HCs were healthcare support/technician, office/administrative support, education/training or library work, sales, and business or financial operations. PwMS worked significantly more years for their employer (10.4±9.6 vs. 7.8±8.8, p=0.003), worked more hours unpaid (3.0±5.9 vs. 1.9 ± 4.2, p=0.014), and experienced significantly more NWEs (0.5±1.0 vs. 0.2±0.5, p<0.001) than HCs. Specifically, verbal criticism (p=0.012), removal of job responsibility (p=0.005), harassment (p=0.013), and “other” (p=0.019), coded as attendance complaints, poor performance reviews, deteriorated employer/co-worker relationships, dissatisfied clients, and unspecified. Groups were equivalent in annual income/hourly wage, hours worked, years working their current position (p>0.05), but trended toward significant difference when comparing missed work days (p=0.108). PwMS used significantly more work accommodations than HCs (2.4±3.5 vs. 1.1±2.5, p<0.001), most frequently flexible work hours (28.9%), air-conditioning (18.4%), and working from home (14.8%).
Conclusions
PwMS and HCs share similar jobs and incomes but the impact from MS is clear. PwMS use more accommodations to maintain job performance, work more hours unpaid, report a higher number of NWEs, and experience more harassment. Further study into factors and interventions that prevent negative work outcomes is warranted.