Rare Disease Report

Myeloproliferative Neoplasms Impair Patient Employment Status & Work Productivity

SEPTEMBER 25, 2018
Krista Rossi
While a pronounced symptom burden is not remarkable for patients with myeloproliferative neoplasms (MPNs), a recent study investigating the impact of MPNs on employment status, career potential, and work productivity is since few studies have investigated the rare blood cancers’ effects on patients’ professional lives.
 
In a recent study published in BMC Cancer, investigators found patients with MPNs experience changes in employment status and meaningful impairments on work productivity and activities of daily living, with the degree of impairment reflecting the severity of symptom burden.

For their research, the investigators recruited US respondents aged 18 to 70 years of age who have been diagnosed with MPNs, including myelofibrosis (MF), polycythemia vera (PV), and essential thrombocythemia (ET) to participate in their cross-sectional Living with MPNs survey. The survey included 100 questions related to MPN diagnosis, disease-related medical history, MPN-related symptoms and functional status, changes in employment and work productivity, and impact on daily activities since diagnosis.
 
Symptom burden was assessed by The MPN Symptom Assessment Form Total Symptom Score (MPN-SAF TSS), while the effects of MPNs on work productivity and activity (7-day recall) among currently employed respondents was assessed by The Work Productivity and Activity Impairment Specific Health Problem questionnaire (WPAI-SHP). Spearman’s coefficients were used to calculate correlations between MPN-SAF TSS and WPAI-SHP scores.

The survey was completed by 904 respondents with MPNs (MF, n = 270; PV, n = 393; ET, n=241). At the time of their diagnosis, 592 (65.5%) of the 904 respondents were employed (MF, n = 174; PV, n = 248; ET, n = 170) either full- or part-time with approximately half (50.5%) of the 592 employed survey respondents reporting ≥1 change in employment status due to their diagnosis. About 30.2% of the 592 respondents reported having “left a job,” 24.8% “went on medical disability leave,” and 21.8% “had reductions in work hours for at least 3 months.”

In addition, the mean WPAI-SHP scores for respondents who remained employed at the time of survey participation (n = 398) were as follows, according to study authors: absenteeism (6.9%), presenteeism (27.4%), overall work impairment (31.1%), and activity impairment (32.8%). MPN-SAF TSS positively correlated with WPAI-SHP scores (correlation coefficients, 0.37–0.70; P < 0.001).

Investigators also observed that the impact of MPNs on employment and work productivity correlated with other terminal cancers or chronic debilitating/disabling diseases that have significant symptom burdens.

The authors referenced a separate study of patients with metastatic breast, colorectal, lung, or prostate cancer in which 58% reported an unstable work status and 45% who had stopped working due to their disease. In another study mentioned by the authors, which included patients with moderate to severe rheumatoid arthritis, 17% reported changing jobs due to their disease; yet another study found that 61.2% of patients with heart disease and 44.5% with arthritis reported stopping work due to their disease.  

The authors note that their study was not without limitation. For one, there was limited MPN severity data due to possible inaccuracy of patient-reported disease stage/severity. In addition, the survey did not include respondents who were self-employed in the analysis in order to focus on patients in more structured work environments.

Despite these limitations, the authors concluded that a higher symptom burden correlated with a greater detrimental impact on work productivity and daily activity in patients with MPNs.

“The higher the symptom burden, the greater the detrimental impact on work productivity and daily activity,” the authors conclude. “Effective and timely management of MPNs and related symptoms could reduce the adverse impact on employment and work productivity and potentially abate losses in income.”

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