title: Self-reported severity among patients with multiple sclerosis in the U.S. and its association with health outcomes.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors: Health Outcomes Practice, Kantar Health, 1 Independence Way, Suite 220, Princeton, NJ 08540, USA. Electronic address: shaloo.gupta@kantarhealth.com.
authors: Shaloo
authors: S
authors: Gupta
authors: Health Outcomes Practice, Kantar Health, 11 Madison Avenue, 12th Floor, New York, NY 10010, USA. Electronic address: amir.goren@kantarhealth.com.
authors: Amir
authors: A
authors: Goren
authors: Health Outcomes & Market Access, EMD Serono Inc., One Technology Place, Rockland, MA 02370, USA. Electronic address: Amy.Phillips@emdserono.com.
authors: Amy L
authors: AL
authors: Phillips
authors: US Medical Affairs, Neurodegenerative Diseases, EMD Serono Inc., One Technology Place, Rockland, MA 02370, USA. Electronic address: fernando.dangond@emdserono.com.
authors: Fernando
authors: F
authors: Dangond
authors: Specialty Care Medicines Development Group, Pfizer Inc., 445 Eastern Point Road, MS 8260-2514, Groton, CT 06340, USA. Electronic address: michelle.stewart@pfizer.com.
authors: Michelle
authors: M
authors: Stewart
keywords: Disease severity; Multiple sclerosis; Quality of life; Resource use; Self-report; Work productivity