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Health Qual Life Outcomes. 2013 Oct 3;11:162. doi: 10.1186/1477-7525-11-162.

Preference-based Health status in a German outpatient cohort with multiple sclerosis.

Author information

1
Department of Neurology, Philipps-University, Marburg, Germany. dodel@med.uni-marburg.de.

Abstract

BACKGROUND:

To prospectively determine health status and health utility and its predictors in patients with multiple sclerosis (MS).

METHODS:

A total of 144 MS patients (mean age: 41.0 ± 11.3 y) with different subtypes (patterns of progression) and severities of MS were recruited in an outpatient university clinic in Germany. Patients completed a questionnaire at baseline (n = 144), 6 months (n = 65) and 12 months (n = 55). Health utilities were assessed using the EuroQol instrument (EQ-5D, EQ VAS). Health status was assessed by several scales (Expanded Disability Severity Scale (EDSS), Modified Fatigue Impact Scale (M-FIS), Functional Assessment of MS (FAMS), Beck Depression Inventory (BDI-II) and Multiple Sclerosis Functional Composite (MSFC)). Additionally, demographic and socioeconomic parameters were assessed. Multivariate linear and logistic regressions were applied to reveal independent predictors of health status.

RESULTS:

Health status is substantially diminished in MS patients and the EQ VAS was considerably lower than that of the general German population. No significant change in health-status parameters was observed over a 12-months period. Multivariate analyses revealed M-FIS, BDI-II, MSFC, and EDSS to be significant predictors of reduced health status. Socioeconomic and socio-demographic parameters such as working status, family status, number of household inhabitants, age, and gender did not prove significant in multivariate analyses.

CONCLUSION:

MS considerably impairs patients' health status. Guidelines aiming to improve self-reported health status should include treatment options for depression and fatigue. Physicians should be aware of depression and fatigue as co-morbidities. Future studies should consider the minimal clinical difference when health status is a primary outcome.

PMID:
24089999
PMCID:
PMC3851447
DOI:
10.1186/1477-7525-11-162
[Indexed for MEDLINE]
Free PMC Article

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