Purpose Research indicates that employment is beneficial for people with multiple sclerosis (MS). However, people with MS typically face reduced workforce participation compared to the general population. Using a discrete choice experiment (DCE) we explored which factors are most important in influencing employment choices of people with MS, and whether the relative importance of factors differs between subgroups. Methods Attributes and levels for the DCE were developed using a systematic literature review and public involvement techniques with people with MS. In an online survey, respondents were asked to choose between two hypothetical job scenarios described using six attributes. We used a large, national register (the UK MS Register), to recruit participants aged 18–64 years with a diagnosis of MS. Choice data were analysed using multinomial logit and latent class models. Results Analyses were based on responses from 2350 people with MS. The preferred model specification was a latent class model, with three classes of respondent. The relative importance of attributes varied between classes, with one giving the greatest weight to the impact of work on other aspects of their lives, the second to having supportive bosses and colleagues, and the third to job flexibility. The classes differed significantly in terms of age and gender, type of MS, and socio-economic status. Conclusions Significant heterogeneity was apparent among people with MS regarding the factors that influence their employment decisions. Attributes concerning the impact of work, attitudes in the workplace and job flexibility appear more influential than those concerning physical workplace adaptations.

目的研究表明，就业对多发性硬化症 (MS) 患者有益。然而，与普通人群相比，多发性硬化症患者的劳动力参与率通常较低。通过离散选择实验 (DCE)，我们探讨了哪些因素对影响多发性硬化症患者的就业选择最重要，以及这些因素的相对重要性在亚组之间是否存在差异。方法通过系统文献回顾和多发性硬化症患者的公众参与技术，制定了 DCE 的属性和级别。在一项在线调查中，受访者被要求在使用六个属性描述的两个假设工作场景之间进行选择。我们使用大型国家登记册（英国多发性硬化症登记册）来招募年龄在 18-64 岁且诊断为多发性硬化症的参与者。使用多项 Logit 和潜在类别模型对选择数据进行分析。结果分析基于 2350 名多发性硬化症患者的回答。首选模型规范是潜在类别模型，具有三类受访者。不同阶层的属性的相对重要性各不相同，一是最重视工作对生活其他方面的影响，二是拥有支持性的老板和同事，三是工作灵活性。这些班级在年龄和性别、多发性硬化症类型和社会经济地位方面存在显着差异。结论在影响多发性硬化症患者就业决策的因素方面，多发性硬化症患者存在明显的异质性。有关工作影响、工作场所态度和工作灵活性的属性似乎比有关实际工作场所适应的属性更具影响力。