• Simon M Collin, Esther Crawley, Margaret T May, Jonathan A C Sterne, William Hollingworth, and UK CFS/ME National Outcomes Database.
• School of Social & Community Medicine, Centre for Child & Adolescent Health, University of Bristol, Oakfield House, Oakfield Grove, BS8 2BN, UK.
• Bmc Health Serv Res. 2011 Sep 15; 11: 217.

BackgroundFew studies have investigated factors associated with discontinuation of employment in patients with CFS/ME or quantified its impact on productivity.MethodsWe used patient-level data from five NHS CFS/ME services during the period 01/04/2006-31/03/2010 collated in the UK CFS/ME National Outcomes Database. We used logistic regression to identify factors associated with discontinuation of employment. We estimated UK-wide productivity costs using patient-level data on duration of illness before assessment by a CFS/ME service, duration of unemployment, age, sex and numbers of patients, in conjunction with Office for National Statistics income and population data.ResultsData were available for 2,170 patients, of whom 1,669 (76.9%) were women. Current employment status was recorded for 1,991 patients (91.8%), of whom 811 patients (40.7%) were currently employed and 998 (50.1%) had discontinued their employment "because of fatigue-related symptoms". Older age, male sex, disability, fatigue, pain, and duration of illness were associated with cessation of employment. In a multivariable model, age, male sex, and disability remained as independent predictors. Total productivity costs among the 2,170 patients due to discontinuation of employment in the years preceding assessment by a specialist CFS/ME service (median duration of illness=36 months) were £49.2 million. Our sample was equivalent to 4,424 UK adults accessing specialist services each year, representing productivity costs to the UK economy of £102.2 million. Sensitivity analyses suggested a range between £75.5-£128.9 million.ConclusionsCFS/ME incurs huge productivity costs amongst the small fraction of adults with CFS/ME who access specialist services.

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