Social participation in patients with multiple sclerosis: correlations between disability and economic burden

Abstract

BackgroundEconomic costs related to treatment of multiple sclerosis (MS) must be justified by health state, quality of life (QOL) and social participation improvement. This study aims to describe correlations between social participation, economic costs, utility and MS-specific QOL in a sample of patients with MS (pwMS).MethodsWe interviewed 42 pwMS receiving natalizumab and collected clinical data, direct medical costs, productivity loss, utility (EQ5D-VAS), MS-specific QOL (SEP-59), social participation with the Impact on Participation and Autonomy questionnaire (IPA). We performed descriptive and correlation analyses.Results41 pwMS, with a mean Expanded Disability Status Scale (EDSS) score of 4.0, completed questionnaires. Mean annual global cost per patient was 68448 +/-33374 Euros and increased with EDSS (r = 0.644), utility (r = -0.456) and IPA (r = 0.519-0.671) worsening. Mean utility was 0.52 +/- 0.28. Correlations between IPA and QOL (EQ5D-VAS or SEP-59) were observed (r = -0.53 to -0.78). Association between QOL and EDSS was smaller (EQ5D-VAS) or absent. Productivity losses were poorly correlated to EDSS (r = 0.375).ConclusionModerate to strong correlations of social participation with clinical status (EDSS), QOL, utility and economic costs encourage exploring better these links in larger cohorts. The stronger correlation between social participation and QOL than between EDSS and QOL needs to be confirmed.

Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences

“…Indeed, increased social participation was perceived by a widevariety of persons with MS, and identified in high-quality studies. Social participation is negatively correlated with a range of clinical MS outcomes [74,75] in persons with MS, leading to decreased health and economic burdens [75]. Therefore, it is important that the most common perceived social outcome was increased social participation and this finding should fuel further study into the participatory benefits of physical activity and exercise.…”

Cognitive impairment among patients with multiple sclerosis: associations with employment and quality of life

“…Cognitive impairment has been shown to negatively impact upon QOL independent of physical disability5 and employment status has been more closely linked to QOL than EDSS 30…”

Multiple sclerosis: patient-reported quality of life in the Świętokrzyskie Region

“…Compatibility between all registries has been achieved at the cost of extensive assessment based on such important factors as the impact of depression, tiredness, sleep disorders, social support, income, and caregiver burden. The role of these factors is underlined in many publications [39,40].…”