(Abstract) Burden of illness of MS: Quality of life

 
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agate
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PostPosted: Fri Jun 09, 2006 3:27 pm    Post subject: (Abstract) Burden of illness of MS: Quality of life Reply with quote

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Can J Neurol Sci. 1998 Feb;25(1):31-8.

Burden of illness of multiple sclerosis: Part II: Quality of life. The Canadian Burden of Illness Study Group

[No authors listed]

OBJECTIVE: To measure the quality of life (QoL) of multiple sclerosis (MS) patients in Canada using a generic QoL instrument, the SF-36.

METHODS
: QoL was assessed in 198 MS patients, recruited from 14 MS Clinics in Canada, and stratified into three levels of disease severity, based on their Expanded Disability Status Scale (EDSS) score. Statistical tests were used to compare QoL scores between severity groups and to identify possible relationships between QoL and patient sociodemographic, clinical and economic parameters.

RESULTS
: QoL scores for all eight scales of the SF-36 were substantially reduced early in the disease. Compared to the normal population, QoL scores for patients with mild MS were on average 30% lower for all SF-36 scales. With EDSS progression a statistically significant decrease in three of the SF-36 domains (physical function, role-physical, and social function) was observed. There were no significant correlations between patient parameters considered and QoL scores.

CONCLUSIONS
: QoL of MS patients collapses early in the disease. With EDSS progression, physical functioning scales show further decreases in QoL. The absence of further changes in the mental SF-36 scales may be a reflection of patient adaptation to the disease and/or effective support care. However, the SF-36 instrument may be insensitive to some of the QoL changes in MS and a disease-specific instrument may provide additional information on QoL, particularly at later stages of the disease. This study provides a basis for future research aimed at improving management of MS.




Jun 6 2006 06:32:22
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Snoopy



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PostPosted: Fri Jun 09, 2006 5:42 pm    Post subject: Reply with quote

My understanding is the damage from MS is done early on in the course of the disease and that is what this study also indicates.

Please correct me if I am misunderstanding...it wouldn't be the first time geek

BTW...thank you Agate I do like reading the atricles.
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agate
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PostPosted: Fri Jun 09, 2006 5:58 pm    Post subject: Reply with quote

LeeAnn, you wrote:

Quote:
My understanding is the damage from MS is done early on in the course of the disease and that is what this study also indicates.

Please correct me if I am misunderstanding...it wouldn't be the first time


The study indicates that damage to quality of life happens early in the course of the disease, if I understand it right. Then it worsens if the EDSS worsens. (That kinda figures, doesn't it?)

This is Part II of a study, and I don't know if Part I would offer any more information.

I'd like to know what is meant here by "quality of life." Seems like it would be hard to evaluate because it's subjective.
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agate
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PostPosted: Fri Jun 09, 2006 6:18 pm    Post subject: Reply with quote

Here's the abstract for Part I of the study. It makes grim reading though:

Quote:


Canadian J Neurol Sci. 1998 Feb;25(1):23-30.

Burden of illness of multiple sclerosis: Part I: Cost of illness. The Canadian Burden of Illness Study Group.

[No authors listed]

BACKGROUND: Multiple sclerosis (MS) is a common neurologic disease in young and middle-aged adults affecting approximately 35,000 Canadians. The objectives of this study were to estimate the annual and lifetime costs of MS from the Canadian societal perspective.

METHODS: Patients were consecutively recruited by neurologists in 14 MS outpatient clinics across Canada. They were classified according to the Expanded Disability Status Scale (EDSS) into three groups: mild (EDSS < or = 2.5), moderate (EDSS = 3.0-6.0) and severe (EDSS > or = 6.5). Sociodemographic, clinical and resource utilization data were collected retrospectively for the three months prior to patient inclusion.

Costing of resources was performed from Ministry of Health, private third party payers, patient and societal perspectives. Average Canadian costs ($CDN 1995) were valued from available provincial data.

RESULTS: A total of 198 patients were included in the analysis (mild: n = 62, moderate: n = 68 and severe: n = 68). Costs increased with increasing EDSS scores, from all perspectives. The annualized societal costs per patient were $CDN14,523, $CDN21,698 and $CDN37,024 for the mild, moderate and severe groups, respectively.

In all severity groups, most of the financial burden is borne by patients, from 74% to 88%. Indirect costs, namely lost daily activity/leisure time and lost productivity, were the major societal cost drivers.

The lifetime cost of MS, including patient institutionalization, was estimated to be $CDN1,608,000 per patient.

CONCLUSIONS: In Canada, MS is associated with enormous direct and indirect costs. Patients carry most of the economic burden of this disease. The results of this burden of illness study provide a basis for cost-effectiveness analyses of new therapeutic interventions for MS.




Jun 6 2006 06:32:22
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