Changes in multiple sclerosis symptoms are associated with changes in work productivity of people living with multiple sclerosis

Background: While employment rates have increased in people with multiple sclerosis (PwMS), little isknown about the longitudinal trends of work productivity.Objective: To describe the longitudinal patterns of work productivity and examine the factors associatedwith annual change of work productivity of PwMS.Methods: Study participants were employed participants of the Australian MS Longitudinal Study(AMSLS) followed from 2015 to 2019 with at least two repeated measures (n= 2121). We used linearmixed models to examine if the within-individual variations in MS symptoms are associated with changesin work productivity.Results: The mean annual change in work productivity between 2015 and 2019 was −0.23% (SD =18.68%). Not the actual severity of symptoms but rather the changes in severity of symptoms that areassociated with change in work productivity in the same year. In a multivariable model, every unit increasein mean annual change in ‘pain and sensory symptoms’, ‘feelings of anxiety and depression’, and ‘fatigueand cognitive symptoms’ were independently associated with 2.43%, 1.55% and 1.01% annual reductionsin work productivity, respectively.Conclusion: Individual changes in work productivity are largely driven by the changes in symptomseverity rather than the absolute severity. Stabilising/improving MS symptoms might improve work productivity