Financial hardship is associated with employment challenges and reduced quality of life in early Parkinson's disease

Miriam R. Rafferty; Sydney Achler; Han Su; Masha Kocherginsky; Danny Bega; Allen W. Heinemann; Kurt Johnson

doi:10.1016/j.prdoa.2023.100225

Financial hardship is associated with employment challenges and reduced quality of life in early Parkinson's disease

Miriam R. Rafferty^*, Sydney Achler, Han Su, Masha Kocherginsky, Danny Bega, Allen W. Heinemann, Kurt Johnson

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Motor and nonmotor Parkinson's disease (PD) symptoms can negatively influence employment, which may contribute to financial hardship. This article explores the association between financial hardship, employment challenges, and quality of life in people with early PD. Methods: We measured financial hardship with a validated summary item (5-point scale, lower score - less hardship) and the Comprehensive Score for Financial Toxicity (0–44, lower score worse toxicity) in a cohort of 60 employed individuals with early PD (<5 years). We used Spearman's Correlations and nonparametric tests to identify associations between financial hardship, demographic characteristics, PD-related factors, employment factors, and quality of life (Neuro-QOL computer adapted measures). Results: The sample was mostly white (93 %) and male (65 %). The plurality were highly-educated with graduate degrees (42 %). Of the 60 participants, 23 (38 %) reported a little bit and 14 (23 %) reported somewhat or more hardship. Comprehensive financial toxicity (22.0 ± 8.7) was correlated moderately (ρ = −0.56) with the single-item summary score. High financial hardship was associated with reduced confidence in job retention (ρ = −0.43, p = 0.001) and reduced perceived workplace success (ρ = −0.352, p = 0.006). Financial hardship was also associated with poorer quality of life in five Neuro-QOL domains: lower extremity function, satisfaction with social roles and activities, depression, anxiety, and stigma (p < 0.05). Conclusion: Financial hardship was common and was associated with employment challenges and poor quality of life. Further work should explore the effects of medical and psychosocial interventions to alleviate financial and employment challenges in individuals with early PD.

Original language	English (US)
Article number	100225
Journal	Clinical Parkinsonism and Related Disorders
Volume	9
DOIs	https://doi.org/10.1016/j.prdoa.2023.100225
State	Published - Jan 2023

Funding

Financial Disclosures for the previous 12 months: Over the last 12 Months, Dr. Rafferty received funding from Office of the Assistant Secretary of Defense for Health Affairs United States Department of Defense CDRMP Neurotoxin Exposure Treatment Parkinson's (W81XWH-19-PRP-EIRA, PI Rafferty), National Institutes of Health's National Institute on Aging (P30AG059988, PI Linder/Wolf), Parkinson’s Foundation, Eunice Kennedy Shriver National Institute of Child Health and Human Development’s National Center on Medical Rehabilitation Research (1P2CHD101899-01, PI Lieber/Rymer), National Institute on Disability, Independent Living, and Rehabilitation Research Sensor Technology RERC-90REGE0010 PI Rymer/Jayaraman). Danny Bega, MD is on the speaker’s bureau for Teva Pharmaceuticals, Neurocrine Biosciences, Supernus Pharmaceuticals, Acorda Therapeutics, AbbVie, and Kyowa Kirin. He has served as a consultant for Teva, Guidepoint, GE Healthcare, LEK Consulting, Deerfield Institute, Alexion Pharmaceuticals, Acsel Health, ACADIA, WebMD, Atheneum, and Clearview Consulting. He has received honoraria from the American Academy of Neurology, and the American Neurological Association. He has received grants from the Huntington Disease Society of America and the Parkinson Foundation. Funding Sources: Funding for this work was provided by the Research and Training Center on Employment for People with Physical Disabilities (RRTC), funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (Project Grant No. 90RTEM0001-01). The authors declare that there are no conflicts of interest relevant to this work. This work was supported by the Research and Training Center on Employment for People with Physical Disabilities (RRTC), funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (Project Grant No. 90RTEM000101).

Keywords

Disability
Employment
Financial toxicity
Parkinson's disease
Patient reported outcome measures

ASJC Scopus subject areas

Clinical Neurology
Cellular and Molecular Neuroscience

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10.1016/j.prdoa.2023.100225

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title = "Financial hardship is associated with employment challenges and reduced quality of life in early Parkinson's disease",

abstract = "Introduction: Motor and nonmotor Parkinson's disease (PD) symptoms can negatively influence employment, which may contribute to financial hardship. This article explores the association between financial hardship, employment challenges, and quality of life in people with early PD. Methods: We measured financial hardship with a validated summary item (5-point scale, lower score - less hardship) and the Comprehensive Score for Financial Toxicity (0–44, lower score worse toxicity) in a cohort of 60 employed individuals with early PD (<5 years). We used Spearman's Correlations and nonparametric tests to identify associations between financial hardship, demographic characteristics, PD-related factors, employment factors, and quality of life (Neuro-QOL computer adapted measures). Results: The sample was mostly white (93 %) and male (65 %). The plurality were highly-educated with graduate degrees (42 %). Of the 60 participants, 23 (38 %) reported a little bit and 14 (23 %) reported somewhat or more hardship. Comprehensive financial toxicity (22.0 ± 8.7) was correlated moderately (ρ = −0.56) with the single-item summary score. High financial hardship was associated with reduced confidence in job retention (ρ = −0.43, p = 0.001) and reduced perceived workplace success (ρ = −0.352, p = 0.006). Financial hardship was also associated with poorer quality of life in five Neuro-QOL domains: lower extremity function, satisfaction with social roles and activities, depression, anxiety, and stigma (p < 0.05). Conclusion: Financial hardship was common and was associated with employment challenges and poor quality of life. Further work should explore the effects of medical and psychosocial interventions to alleviate financial and employment challenges in individuals with early PD.",

keywords = "Disability, Employment, Financial toxicity, Parkinson's disease, Patient reported outcome measures",

author = "Rafferty, {Miriam R.} and Sydney Achler and Han Su and Masha Kocherginsky and Danny Bega and Heinemann, {Allen W.} and Kurt Johnson",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = jan,

doi = "10.1016/j.prdoa.2023.100225",

language = "English (US)",

volume = "9",

journal = "Clinical Parkinsonism and Related Disorders",

issn = "2590-1125",

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T1 - Financial hardship is associated with employment challenges and reduced quality of life in early Parkinson's disease

AU - Rafferty, Miriam R.

AU - Achler, Sydney

AU - Su, Han

AU - Kocherginsky, Masha

AU - Bega, Danny

AU - Heinemann, Allen W.

AU - Johnson, Kurt

PY - 2023/1

Y1 - 2023/1

N2 - Introduction: Motor and nonmotor Parkinson's disease (PD) symptoms can negatively influence employment, which may contribute to financial hardship. This article explores the association between financial hardship, employment challenges, and quality of life in people with early PD. Methods: We measured financial hardship with a validated summary item (5-point scale, lower score - less hardship) and the Comprehensive Score for Financial Toxicity (0–44, lower score worse toxicity) in a cohort of 60 employed individuals with early PD (<5 years). We used Spearman's Correlations and nonparametric tests to identify associations between financial hardship, demographic characteristics, PD-related factors, employment factors, and quality of life (Neuro-QOL computer adapted measures). Results: The sample was mostly white (93 %) and male (65 %). The plurality were highly-educated with graduate degrees (42 %). Of the 60 participants, 23 (38 %) reported a little bit and 14 (23 %) reported somewhat or more hardship. Comprehensive financial toxicity (22.0 ± 8.7) was correlated moderately (ρ = −0.56) with the single-item summary score. High financial hardship was associated with reduced confidence in job retention (ρ = −0.43, p = 0.001) and reduced perceived workplace success (ρ = −0.352, p = 0.006). Financial hardship was also associated with poorer quality of life in five Neuro-QOL domains: lower extremity function, satisfaction with social roles and activities, depression, anxiety, and stigma (p < 0.05). Conclusion: Financial hardship was common and was associated with employment challenges and poor quality of life. Further work should explore the effects of medical and psychosocial interventions to alleviate financial and employment challenges in individuals with early PD.

AB - Introduction: Motor and nonmotor Parkinson's disease (PD) symptoms can negatively influence employment, which may contribute to financial hardship. This article explores the association between financial hardship, employment challenges, and quality of life in people with early PD. Methods: We measured financial hardship with a validated summary item (5-point scale, lower score - less hardship) and the Comprehensive Score for Financial Toxicity (0–44, lower score worse toxicity) in a cohort of 60 employed individuals with early PD (<5 years). We used Spearman's Correlations and nonparametric tests to identify associations between financial hardship, demographic characteristics, PD-related factors, employment factors, and quality of life (Neuro-QOL computer adapted measures). Results: The sample was mostly white (93 %) and male (65 %). The plurality were highly-educated with graduate degrees (42 %). Of the 60 participants, 23 (38 %) reported a little bit and 14 (23 %) reported somewhat or more hardship. Comprehensive financial toxicity (22.0 ± 8.7) was correlated moderately (ρ = −0.56) with the single-item summary score. High financial hardship was associated with reduced confidence in job retention (ρ = −0.43, p = 0.001) and reduced perceived workplace success (ρ = −0.352, p = 0.006). Financial hardship was also associated with poorer quality of life in five Neuro-QOL domains: lower extremity function, satisfaction with social roles and activities, depression, anxiety, and stigma (p < 0.05). Conclusion: Financial hardship was common and was associated with employment challenges and poor quality of life. Further work should explore the effects of medical and psychosocial interventions to alleviate financial and employment challenges in individuals with early PD.

KW - Disability

KW - Employment

KW - Financial toxicity

KW - Parkinson's disease

KW - Patient reported outcome measures

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M1 - 100225

ER -

Financial hardship is associated with employment challenges and reduced quality of life in early Parkinson's disease

Abstract

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