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美国多发性硬化症患者自我报告的严重程度及其与健康结果的关联。

Self-reported severity among patients with multiple sclerosis in the U.S. and its association with health outcomes.

作者信息

Gupta Shaloo, Goren Amir, Phillips Amy L, Dangond Fernando, Stewart Michelle

机构信息

Health Outcomes Practice, Kantar Health, 1 Independence Way, Suite 220, Princeton, NJ 08540, USA.

Health Outcomes Practice, Kantar Health, 11 Madison Avenue, 12th Floor, New York, NY 10010, USA.

出版信息

Mult Scler Relat Disord. 2014 Jan;3(1):78-88. doi: 10.1016/j.msard.2013.06.002. Epub 2013 Jun 27.

DOI:10.1016/j.msard.2013.06.002
PMID:25877977
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.

摘要

目的

多发性硬化症(MS)患者的健康状况较差。然而,对于这些结果如何因疾病严重程度而异,我们知之甚少。本研究的目的是比较MS患者与对照组之间以及不同自我报告疾病严重程度的MS患者之间的健康相关生活质量(HRQoL)、工作生产力、活动障碍和资源使用情况。

方法

对2009年美国国家健康与健康调查(对全国有代表性的成年人群进行在线调查)中报告患有MS诊断的受访者(n = 536)和对照组(n = 74,451)的数据进行分析。评估有无MS者之间以及三个MS严重程度组之间的差异:轻度(38.4%)、中度(50%)和重度(11.6%)。

结果

与对照组相比,MS患者的活动障碍明显更多、工作生产力下降、医疗保健利用率增加且HRQoL更低(所有p<0.001)。MS严重程度增加与更大的活动障碍、更低的工作生产力、更高的医疗保健利用率和更低的HRQoL相关。自我感觉疾病严重程度为轻度与中度的个体之间出现的损伤比中度与重度个体之间更显著。

结论

MS患者报告的损伤比对照组更大,且损伤随疾病严重程度增加(尤其是从轻度到中度)。这些发现表明,MS疾病严重程度增加与更差的健康结果相关。

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