Highlights
- •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.
Abstract
Purpose
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.
Methods
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%).
Results
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.
Conclusion
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.
Abbreviations:
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)Keywords
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Article info
Publication history
Published online: July 01, 2013
Accepted:
June 2,
2013
Received in revised form:
May 7,
2013
Received:
October 29,
2012
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
