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Variables Predict Patients With MS at Risk of Job Loss Who Can Benefit From Interventions


Interventions to prevent job loss for patients with multiple sclerosis (MS) should focus on increasing self-efficacy, especially for patients older than 50 years.

Multiple sclerosis (MS) is often diagnosed in adults in their prime working years, between the ages of 20 and 40, which can affect their employment. Given the adverse effect an MS diagnosis will have on a person’s working life, screening for work instability should take place in the clinical setting, according to a study in Multiple Sclerosis Journal.

Previous research has shown that up to 80% of people with MS lose their employment within a decade of disease onset and a variety of factors, such as gender, socioeconomic status, job type and working conditions, and course and disease progression, can predict who might have issues with work.

The study followed 208 patients with MS over 3 years who were employed at the start of the study. The mean age was 40.6 years with a disease duration of 7 years. The majority of the patients (88%) had relapsing-remitting MS.

Participants answered a baseline questionnaire as well as questionnaires sent out at months 8, 18, and 28 of the study. The standardized questionnaires included MS-specific Work Instability Scale (MS-WIS), MS Impact Scale-29, Hospital Anxiety and Depression Scale, and Unidimensional Self-efficacy Scale for MS.

By the end of the study, 22 patients (10.6%) had stopped working, and the authors found that 3 variables were key to keeping a job: work instability, self-efficacy, and age. Patients who had a high baseline risk according to the MS-WIS and low levels of self-efficacy had a higher rate of job loss. Patients older than age 50 were also more likely to have left their job.

The MS-WIS was highly effective at predicting job loss. After the baseline questionnaires, the authors identified the patients considered a high risk of job loss and those at low risk. Among those deemed at high risk, 26.8% had ceased working, compared with only 5.7% of patients considered at low risk.

Based on the result, the authors suggest that interventions to reduce work instability should focus on increasing self-efficacy, which can make a person more confident in raising problems at work.

“We suggest that an early screen using the MS-WIS and a measure of self-efficacy, especially for those over 50 years, could lead to improved [vocational rehabilitation] outcomes, particularly if methods were used that enhance self-efficacy and skills for negotiating workplace accommodations,” they concluded.


Ford HL, Wicks CR, Stroud A, Tennant A. Psychological determinants of job retention in multiple sclerosis. Mult Scler. 2019 Mar;25(3):419-426. doi: 10.1177/1352458518754362.

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