Research Article| Volume 3, ISSUE 1, P78-88, January 2014

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Self-reported severity among patients with multiple sclerosis in the U.S. and its association with health outcomes


      • MS can impair quality of life and work productivity and increase resource use.
      • Increasing perceived severity of MS can contribute to these impairments.
      • Yet, the mild-to-moderate-to-severe transition may be nonlinear.
      • Greater health outcomes impairments may occur with mild-to-moderate shifts in disability.
      • Findings show increasing disease severity is associated with worse health outcomes.



      Individuals with multiple sclerosis (MS) experience diminished health outcomes. However, little is known about how these outcomes differ according to disease severity. The aim of this study is to compare health-related quality of life (HRQoL), work productivity, activity impairment, and resource use between MS patients and controls, as well as across MS patients with varying self-reported disease severity.


      Data were analyzed from respondents reporting an MS diagnosis (n=536) and controls (n=74,451) in the U.S. 2009 National Health and Wellness Survey (administered online to a nationally representative adult population). Differences were assessed between those with and without MS, and across three MS severity groups: mild (38.4%), moderate (50%), and severe (11.6%).


      MS patients vs. controls experienced significantly more activity impairment, decreased work productivity, increased healthcare utilization, and lower HRQoL (all p<0.001). Increasing MS severity was associated with greater activity impairment, lower work productivity, increased healthcare utilization, and lower HRQoL. More significant impairments emerged between individuals who perceived their disease severity as mild vs. moderate than moderate vs. severe.


      MS patients reported greater impairment than controls, and impairment increased with disease severity (especially from mild to moderate). These findings show that increasing MS disease severity is associated with worse health outcomes.


      BMI (Body Mass Index), CCI (Charlson Comorbidity Index), DMD (Disease Modifying Drug), EDSS (Expanded Disability Status Scale), ER (Emergency Room), NHWS (National Health and Wellness Survey), HRQoL (Health-Related Quality of Life), MCS (Mental Component Summary), MS (Multiple Sclerosis), PCS (Physical Component Summary), PROs (Patient-Reported Outcomes), SF-6D (Short Form 6D), SF-12v2 (The Medical Outcomes Study 12-Item Short Form Survey Instrument), U.S. (United States), WPAI (Work Productivity and Activity Impairment Questionnaire)


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