Greater Symptom Burden Associated With Medical Disability Leave in Patients With MPNs

In a recent survey-based study, researchers analyzed the relationship between symptom burden and incidence of medical disability leave (MDL) among patients with myeloproliferative neoplasms (MPNs), including myelofibrosis, polycythemia vera, and essential thrombocythemia. The results were published in Annals of Hematology.

Commonly experienced symptoms in patients with MPNs include fatigue, early satiety, inactivity, night sweats, bone pain, and problems with concentration. Adverse effects associated with MPNs can lead to a burden on patients’ ability to work or their employment status.

Of the 904 patients who participated in the Living with MPNs survey conducted by the study authors, 592 were employed at the time of MPN diagnosis. Among employed patients, 147 (24.8%) reported going on at least 1 MDL because of their MPN, and 293 (49.5%) reported no employment changes resulting from their MPN. The remaining 152 employed patients (25.7%) reported other non—MDL-related changes in employment status (early retirement, work hour reduction) and therefore were excluded from the remainder of the analysis.

Researchers also determined that among patients who took MDL, most (62.6%) did not return to work. Nearly half of all patients who took MDL (46.3%) reported receiving Social Security benefits while on MDL. Additionally, although most patients (85.5%) who returned to work following MDL reported receiving a similar salary to that received before the leave, 10.9% reported a decrease in salary after returning to work.

The study authors found that patients who took MDL were more likely than those who did not to report functional impairment across physical, mental, and social domains, such as difficulty sleeping, feeling depressed, and difficulty remembering, among others.

Patients with a history of thrombotic events were more than 50% more likely to have taken MDL compared with patients without such a history. Researchers recommended that “future studies should explore whether effective prevention of [thrombotic events] and management of MPN-related symptoms influences the need for forced medical leave among patients with high symptom burden.”

Reference

Yu J, Paranagama D, Geyer H, Parasuraman S, Mesa R. Relationship between symptom burden and disability leave among patients with myeloproliferative neoplasms (MPNs): findings from the Living with MPN patient survey [published online January 29, 2019]. Ann Hematol. doi: 10.1007/s00277-019-03610-4.