The Impact Of Disability On Activities Of Daily Living, Productivity And Independency In Patients With Multiple Sclerosis-Findings From A 2016 Study In Europe And The United States

Multiple sclerosis (MS) is a chronic disease of the central nervous system, and a leading cause of disability in young adults of working age. The main objective of this study is to compare MS patients’ productivity, ability to perform daily self-care activities and independency by level of disability progression. This study used data from the patient record form of the 2016 Adelphi Multiple Sclerosis Disease Specific Program, a cross-sectional study collecting data from 487 neurologists and 5402 patients in France, Germany, Italy, Spain, United Kingdom, and United States between November 2015 and March 2016. Patients with current EDSS score <3, 3-5.5, and >5.5 were categorized as with mild, moderate, and severe disability, respectively. Outcomes of interest, including activities of daily living (ADL) and instrumental activities of daily living (IADL) were compared across groups. Productivity and independency were examined by whether a patient was able to work full time and whether he/she had a caregiver, respectively. A total of 2,695, 1,568, and 871 MS patients were identified for the mild, moderate, and severe group, respectively. Among these groups, differences were observed in mean age (37.2, 46.0, and 51.7, p<0.0001) and percent of females (68.2%, 57.5%, and 54.8%, p<0.0001). As disability varied from mild, moderate to severe, fewer patients are being treated on a disease modifying treatment (79.4%, 69.3% vs. 48.7%, p<0.0001), a higher proportion of patients needed assistance with ADL (3.3%, 26.9%, 63.9%, p<0.001) and IADL. (12.6%, 44.1%, 72.0%, p<0.001), less likely to work full time (57.1%, 28.5%, 7.6%, p<0.001), and have a higher reliance on a professional caregiver (1.0%, 7.4%, 26.6%, p<0.001) and a family caregiver (14.7%, 39.2%, 59.7%, p<0.001). These findings highlight the increasing burden associated with disability progression in MS patients, which limit their ability to perform self-care activities, work full time, and live independently.