Variation in Employment Status among People with MS in the United States, United Kingdom and Germany (P4.2-057)

Objective: To compare employment rates among people with MS living in three countries, including the United States, United Kingdom (UK) and Germany.

Background: Multiple sclerosis (MS) is associated with impairment of physical and cognitive function which contributes to high unemployment rates ranging from 40–80%. Variations in health systems and supports, as well as social policies regarding employment accommodations may also influence employment rates.

Design/Methods: We identified participants in three MS registries (North American Research Committee on MS [NARCOMS] Registry, UK MS Register [UK-MS], and German MS Register [GMSR]) between the ages of 18–62 (common working age in all three regions). Each registry captures information about demographics, disability status (categorized as mild, moderate or severe) and employment. Employment status (employed, unemployed), and whether employment was full-time or part-time were extracted. The overall and age-, gender- and disability-specific rates of employment was summarized across the registries. Comparisons were evaluated using chi-square tests.

Results: Overall, 31,011 persons with MS (NARCOMS: 5,436, UK-MS: 10,529, GMSR: 15,046) fulfilled the inclusion criteria. Of these 74.7% were women, of mean (SD) age 47.5 (10.2) years. Employment rates were highest in GMSR, 10,053 (66.8%), followed by the UK-MS, 5,064 (48.1%), and NARCOMS, 2,322 (42.7%; p<0.001). We observed a difference in the proportion of males and females employed in the GMSR (71.8% vs 64.9%, p<0.0001), but not in NARCOMS (40.7% vs 43.1%, p=0.169) or UK-MS (48.0% vs 48.2%, p=0.89). Employment was high for mild disability levels (UK-MS: 80.3%, GMSR: 79.3%, NARCOMS: 65.3%) and decreased with increasing disability. Generally, as age increased, the proportion employed decreased. Among those aged >30 years, higher proportions were employed in the GMSR and UK-MS than in NARCOMS (p<0.0001).

Conclusions: Employment rates varied across countries with the GMSR having higher rates of employment overall and stratified by gender and age, albeit having a greater proportion with lower disability.

Disclosure: Dr. Salter has received personal compensation in an editorial capacity as a statistical consultant for Circulation: Cardiovascular Imaging. Dr. Stahmann has received research support from Novartis Pharmaceuticals. Dr. Rodgers has nothing to disclose. Dr. Schrader has nothing to disclose. Dr. Nicholas has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen. Dr. Nicholas has received research support from Biogen, Novartis and Roche . Dr. Marrie has nothing to disclose. Dr. Middleton has nothing to disclose.