Piwko Charles, Desjardins Olivier B, Bereza Basil G, Machado Marcio, Jaszewski Barbara, Freedman Mark S, Einarson Thomas R, Iskedjian Michael
PharmIdeas Research and Consulting Inc, Oakville, Ontario, Canada.
Pain Res Manag. 2007 Winter;12(4):259-65. doi: 10.1155/2007/128681.
Multiple sclerosis (MS) is a neurological disease affecting approximately 50,000 Canadians. Although studies have described overall MS costs, none have focused specifically on MS-related pain.
To estimate the prevalence of MS-related pain in Canada, the proportion of patients treated and responding to treatment for MS-related pain, and the associated economic burden.
Results were captured through physician and patient surveys. Patients were recruited through MS clinics and the MS Society. Patient-reported outcomes and resource utilization over the previous six months were collected by telephone interview. Costs were measured in 2004 Canadian dollars. The economic burden was extrapolated to the population using national demographics and prevalence. Spearman's rho assessed the relationship between cost and pain severity.
Physicians estimated that 46% of their MS patients experienced MS-related pain, and that 35% received treatment for pain. Pain was reported to be relieved somewhat in 29%+/-10% of their patients, adequately in 26%+/-19% and poorly in 27%+/-13%, while 17%+/-9% received no relief. Two hundred ninety-seven participants completed the patient survey. Seventy-one per cent (211 of 297 patients) experienced MS-related pain. Eighty per cent of patients reported taking some type of medication to manage their pain, and of these, 82% reported some reduction in pain. The mean +/- SD direct cost per patient of MS-related pain was dollars 2,528+/-5,695. The mean +/- SD indirect cost per patient was dollars 669+/-875. Total costs were positively correlated with levels of self-reported pain (rho=0.291, rho<0.0001). The estimated six-month burden of pain of MS patients in Canada was dollars 79,444,888.
The prevalence of pain is high in MS patients. This condition may be underdiagnosed and undertreated, and results in a significant economic burden on society.
多发性硬化症（MS）是一种影响约50000名加拿大人的神经系统疾病。尽管已有研究描述了MS的总体费用，但尚无研究专门关注与MS相关的疼痛。
估计加拿大与MS相关疼痛的患病率、接受治疗并对与MS相关疼痛治疗有反应的患者比例以及相关的经济负担。
通过医生和患者调查获取结果。通过MS诊所和MS协会招募患者。通过电话访谈收集患者报告的过去六个月的结果和资源利用情况。费用以2004年加拿大元衡量。使用全国人口统计数据和患病率将经济负担外推至总体人群。Spearman等级相关系数评估费用与疼痛严重程度之间的关系。
医生估计，他们的MS患者中有46%经历过与MS相关的疼痛，其中35%接受了疼痛治疗。据报告，29%±10%的患者疼痛有所缓解，26%±19%的患者疼痛得到充分缓解，27%±13%的患者疼痛缓解不佳，而17%±9%的患者疼痛未得到缓解。297名参与者完成了患者调查。71%（297名患者中的211名）经历过与MS相关的疼痛。80%的患者报告服用了某种药物来控制疼痛，其中82%的患者报告疼痛有所减轻。与MS相关疼痛的每位患者的平均±标准差直接费用为2528加元±5695加元。每位患者的平均±标准差间接费用为669加元±875加元。总费用与自我报告的疼痛程度呈正相关（rho = 0.291，rho < 0.0001）。加拿大MS患者估计的六个月疼痛负担为79444888加元。
MS患者中疼痛的患病率很高。这种情况可能未得到充分诊断和治疗，并给社会带来了重大经济负担。
