Tuesday, 25 September 2012

Research: the costs of walking and mobility problems

BACKGROUND: Multiple sclerosis (MS) is a chronic progressive neurological disease and the majority of patients will experience some degree of impaired mobility. We evaluated the prevalence, severity and burden of walking and mobility problems (WMPs) in 5 European countries.
METHODS: This was a cross-sectional, patient record-based study involving 340 neurologists who completed detailed patient record forms (PRF) for patients (>18 years) attending their clinic with MS. Patients were also invited to complete a questionnaire (PSC). Information collected included demographics, disease characteristics, work productivity, quality of life (QoL; EuroQol-5D and Hamburg Quality of Life Questionnaire Multiple Sclerosis [HAQUAMS]) and mobility (subjective patient-reported and objectively measured using the timed 25 foot walk test [T25FW]). Relationships between WMPs and disease and other characteristics were examined using Chi square tests. Analysis of variance was used to examine relationships between mobility measures and work productivity.
RESULTS: Records were available for 3572 patients of whom 2171 also completed a PSC. WMPs were regarded as the most bothersome symptom by almost half of patients who responded (43%; 291/683). There was a clear, independent and strong directional relationship between severity of WMPs (subjective and objective) and healthcare resource utilisation. Patients with longer T25FW times (indicating greater walking impairment) were significantly more likely to require additional caregiver support (p < 0.0001), visit a variety of healthcare professionals including their primary care physicians (p = 0.0044) and require more long-term non-disease modifying drugs (p = 0.0001). A similar pattern was observed when subjective reporting of the severity of WMPs was considered. Work productivity was also markedly impacted by the presence of WMPs with fewer patients working full time and a reduction in weekly working hours as T25FW times and the subjective severity of WMPs increased.
CONCLUSIONS: In Europe, WMPs in MS represent a considerable personal and social burden both financially and in terms of quality of life. Interventions to improve mobility could have significant benefits for patients and society as a whole.
Walking and mobility problems are a common bothersome symptom in about 45% of MSers and the more problem there were the more health care, drugs etc. where required which obviously carries greater costs.  This was also associated with loss of employment and social costs


  1. It's common sense, really, isn't it? But good to have it measured and labelled if that will help with funding and with research

  2. These studies that look at disability and progression confuse me a little. Does the study reflect a "snapshot" in time. That is, at any given time 45% of MSers have reached a point in their disease where they have difficulty walking? Or does it reflect that over a lifetime, 45% of MSers will ever have walking difficulty?

  3. The person who left the comment above sums up what life with MS consists of: Worry.

    There is a constant thought of will my disease get worse because the statistics are troubling.

    Take it one day at a time. Whatever is meant to be will be. Go with God.


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