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成人多发性硬化症日间项目与多发性硬化症患者及非正式照料者的健康相关生活质量

Multiple Sclerosis Adult Day Programs and Health-Related Quality of Life of Persons with Multiple Sclerosis and Informal Caregivers.

作者信息

Gasper Joseph M, Lewis Megan, Kroeger Anne, Muz Ben, LaRocca Nicholas, Frankel Debra

出版信息

Int J MS Care. 2020 Jul-Aug;22(4):187-192. doi: 10.7224/1537-2073.2019-020. Epub 2020 Jan 9.

Abstract

BACKGROUND

Multiple sclerosis adult day programs (MSADPs) offer life-enhancing services for individuals and informal caregivers affected by multiple sclerosis (MS), including medical care, rehabilitation therapies, nutrition therapy, cognitive training, tailored education, exercise programs, and social interaction. The purpose of this study was to examine the effects of MSADPs on health-related quality of life (HRQOL) and health care utilization of persons with MS and HRQOL and well-being of informal caregivers.

METHODS

Using a quasi-experimental design, outcomes between baseline and 1-year follow-up in persons with MS and informal caregivers who used MSADP services and a comparison group of similar persons with MS and caregivers who did not use MSADP services were compared. For persons with MS, outcomes included standardized measures of physical and mental HRQOL and health care utilization. For caregivers, outcomes included physical and mental HRQOL and well-being. Changes in outcomes between baseline and follow-up were examined using propensity score-weighted difference-in-differences regression analysis.

RESULTS

For persons with MS, MSADP use had a significant positive effect on 12-Item Short Form Health Survey physical component scores, although the difference was not clinically meaningful. Use of MSADPs did not have effects on any other outcomes for persons with MS or caregivers.

CONCLUSIONS

Use of MSADPs did not show a clinically meaningful effect on HRQOL for persons with MS or informal caregivers. The MSADPs do not seem to offer sustained benefits to persons with MS or caregivers, but the possibility of initial short-term benefits cannot be ruled out.

摘要

背景

成人多发性硬化症日间项目(MSADP)为受多发性硬化症(MS)影响的个人和非正式照料者提供改善生活的服务,包括医疗护理、康复治疗、营养治疗、认知训练、定制教育、锻炼项目和社交互动。本研究的目的是检验MSADP对MS患者的健康相关生活质量(HRQOL)和医疗保健利用情况以及非正式照料者的HRQOL和幸福感的影响。

方法

采用准实验设计,比较使用MSADP服务的MS患者和非正式照料者在基线和1年随访之间的结果,以及未使用MSADP服务的类似MS患者和照料者的对照组的结果。对于MS患者,结果包括身体和心理HRQOL的标准化测量以及医疗保健利用情况。对于照料者,结果包括身体和心理HRQOL以及幸福感。使用倾向得分加权差分回归分析来检验基线和随访之间结果的变化。

结果

对于MS患者,使用MSADP对12项简短健康调查问卷身体成分得分有显著的积极影响,尽管差异在临床上无意义。使用MSADP对MS患者或照料者的任何其他结果均无影响。

结论

使用MSADP对MS患者或非正式照料者的HRQOL未显示出临床上有意义的影响。MSADP似乎并未为MS患者或照料者带来持续的益处,但不能排除最初短期益处的可能性。

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