title: Multiple sclerosis in the UK: service use, costs, quality of life and disability.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a chronic condition that affects quality of life (QOL), leads to disability and requires ongoing care inputs. Few studies have examined the impact of QOL, disability and demographic characteristics on treatment costs.
  
  
  OBJECTIVE
  To investigate the links between service use, costs, QOL and disability for people with MS.
  
  
  METHODS
  A cross-sectional study was conducted in people with MS who were members of the Multiple Sclerosis Society of Great Britain and Northern Ireland. A questionnaire, consisting of sociodemographic questions, the Client Service Receipt Inventory, EQ-5D and Guy's Neurological Disability Scale (GNDS), was sent to 4000 members of the Society. Service and lost employment costs were calculated. Regression models were developed to identify the participant characteristics that were associated with costs, QOL and disability. All costs are presented in year 2006-7 values.
  
  
  RESULTS
  Questionnaires were returned by 1942 members (48.9%). The mean (SD) EQ-5D QOL score was 0.41 (0.34), whilst the GNDS disability score was 20.8 (8.9). The mean (SD) service cost over the preceding 6 months was pound8397 ( pound10,404), and most of this (71.6%) was due to informal care. Only a small amount of cost (8.1%) was due to the use of disease-modifying drugs and drugs for spasticity. Lost employment costs amounted to a mean of pound4240. Higher costs were associated with higher levels of disability and lower levels of health-related QOL.
  
  
  CONCLUSIONS
  This study showed that MS participants had high levels of service use, and that QOL was low in comparison with other conditions. There were significant associations between costs, QOL and disability.
authors.affiliation: Institute of Psychiatry, King's College London, London, UK. p.mccrone@iop.kcl.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: McCrone
authors.forename: Margaret
authors.initials: M
authors.lastname: Heslin
authors.forename: Martin
authors.initials: M
authors.lastname: Knapp
authors.forename: Paul
authors.initials: P
authors.lastname: Bull
authors.forename: Alan
authors.initials: A
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
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