Predictors of employment status and work absenteeism in relapsing-remitting Multiple Sclerosis

Multiple Sclerosis (MS) is the most common cause of disability in young and
middle-aged adults. At this stage in life most people are in the midst of their
working career. However, the majority of MS patients are unable to retain
employment within 10 years from disease onset. Leading up to unemployment, many
may experience a reduction in hours or work responsibilities and increased time
missed from work. Cross-sectional studies have identified several factors
associated with decreased employment status and work absenteeism in MS. These
include cognitive impairments, physical dysfunction, psychological problems and
type of treatment. Prospective studies are rare, or take into account a limited
number of factors. By examining possible predictors of (changes in) employment
status and work absenteeism in patients with relapsing-remitting MS and
subjects without a chronic disease during a period of three years, we aim to
provide useful information about preventative factors for physicians,
psychologists and vocational rehabilitation therapists.

The main aim of this study is to examine predictors of (changes in) employment
status and work absenteeism in relapsing-remitting MS patients and subjects
without a chronic disease over a period of three years

An observational, prospective cohort study

At four time points (i.e. baseline, after 1, 2 and 3 years) participants will
be asked to complete questionnaires (1-2 hours), and undergo neurological (half
an hour) and neuropsychological examinations (2 hours). After 6 months
participants will be asked to complete questionnaires without undergoing a
neurological or neuropsychological examination. The subjects without a chronic
disease will undergo a neuropsychological examination (2 hours) at baseline
only. At four time points (i.e. baseline, after 1, 2 and 3 years) the subjects
without a chronic disease will be asked to complete questionnaires (1-2 hours).
Several MS-specific questionnaires, questionnaires for caregivers and the
neurological examination will not be part of their examination. The
questionnaires can be completed at home, and contain questions about the
patient's cognitive functioning, work situation and psychological functioning.
The neurological and neuropsychological examinations will be performed on the
same day (including as many breaks as necessary) and should preferably take
place at the outpatient clinic where the patient is treated. If this is not
possible, testing can take place at the patient*s home. A subset of MS patients
will be approached for the interviews (appendix 5 protocol), and/or will be
asked to provide a blood sample (10 ml) for the genome wide association study
(appendix 7 protocol).

For the subjects without a chronic disease testing will take place at their
homes, at the National MS Foundation, or Leiden University.
The examinations will be performed by a research nurse or psychologist and a
neurologist in training. There are no risks involved. The participants may not
benefit individually, but the study should reveal typical patterns leading to
unemployment in MS and aims to identify preventative factors.