Highlights
- •This study found that patients with Multiple Sclerosis (MS) have lower physical and mental Health-Related Quality of Life (HRQoL) than their non-MS counterparts.
- •MS patients were more likely to seek help for help for Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) than non-MS adults.
Abstract
Background
Multiple sclerosis (MS) is a progressive autoimmune disease of the central nervous
system. Both the physical and mental burden of MS affect patients’ health-related
quality of life (HRQoL). However, there is limited research at the national level
evaluating the humanistic burden among MS patients.
Objectives
This study evaluated the HRQoL and functional limitations among MS patients using
ten years of national survey data.
Methods
Guided by the conceptual framework of the Wilson and Cleary model, this study compared
HRQoL between adults diagnosed with MS (Clinical Classification Code= “080″) and non-MS
adults using the 2006–2015 Medical Expenditure Panel Survey (MEPS) data. The humanistic
burden included HRQoL and functional limitations. The HRQoL was evaluated using physical
component summary (PCS) and mental component summary (MCS) based on the Short Form
Health Survey (SF-12). The study applied the multivariable Generalized Linear Models
(GLM) to estimate the marginal differences in PCS and MCS based on the SF-12. In addition,
seeking help for activities of daily living (ADL) and instrumental activities of daily
living (IADL) were modeled with multivariable logistic regression.
Results
According to the MEPS, the estimated annual prevalence of MS was 0.52 million (95%
Confidence Interval [CI]: 0.42–0.60). MS patients were mainly female (71.90%), middle
aged (50–64 years, 40.21%), non-Hispanic whites (78.29%), and enrolled in private
insurance plans (68.93%). The average PCS scores in MS and non-MS groups were 35.70
and 49.48, respectively. The average MCS scores were 45.58 and 51.25 for MS and non-MS
groups, respectively. In addition, 18.26% of MS patients sought help for ADL, and
27.08% sought help for IADL. After adjusting for individual, biological, and environmental
characteristics, the multivariable GLM with Poisson distribution indicated that the
marginal difference of PCS score was 11.10 (95% CI: 9.50–12.61) units lower, and the
MCS score was 4.89 (95% CI: 3.44–6.30) units lower among MS patients. In addition,
MS patients were 17.32 (95% CI: 11.61–25.84) and 14.43 (95% CI: 10.09–20.65) times
more likely to request assistance for ADL and IADL, respectively.
Conclusions
MS was associated with lower physical and mental HRQoL than their non-MS counterparts
and MS patients were more likely to request help for ADL and IADL. More work is needed
to evaluate the effect of treatment strategies on improving the HRQoL and functional
limitations in MS.
Keywords
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Article info
Publication history
Published online: July 05, 2022
Accepted:
July 1,
2022
Received in revised form:
June 22,
2022
Received:
March 22,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
