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Background: Health-related quality of life (HRQoL) has not been assessed in Australians with multiple sclerosis (MS) using a preferentially sensitive multi-attribute utility instrument.

Objectives: To assess HRQoL and to quantify the impact of disability on health state utility values (HSUVs), and the physical and psychosocial health of people with MS using the Assessment of Quality of Life-8-Dimension (AQoL-8D) instrument.

Methods: We estimated HSUVs and the unique composite individual and super dimensional (physical and psychosocial) scores of the AQoL-8D for a large, representative sample (n=1,577) of Australians with MS. The estimates were compared to Australian general population norms and broken down by disability severity, classified as no disability (Expanded Disability Status Scale [EDSS] level:0), mild (EDSS:1-3.5), moderate (EDSS:4-6) and severe (EDSS:6.5-9.5). A multivariable regression model adjusted the association between MS disability severity and HSUVs for age, sex, MS onset type, DMTs usage status, and MS duration. Results: Mean overall HSUV at 0.61 (95% confidence interval [CI]: 0.60-0.62) was 0.18 units lower than the Australian population norm. HSUV decreased with increasing disability severity: 0.81 (95%CI: 0.80-0.83), 0.65 (95%CI: 0.63-0.67), 0.54 (95%CI: 0.52-0.56) and 0.48 (95%CI: 0.46-0.50) for no, mild, moderate and severe disability, respectively. The mean Physical super-dimension score of 0.57 (95%CI: 56-0.58) was 0.21 units lower than the Australian norm and the Psychosocial super-dimension of 0.33(95%CI:32-0.34) was 0.16 units lower. Lower HRQoL was primarily driven by reduced scores on Independent living (-0.23), Pain (-0.15), Relationships (-0.13), Coping (-0.12), and Self-worth (-0.12).

Conclusions: MS impacts all aspects of HRQoL. Effective pain management and support to maintain independent living, relationships, and self-worth can significantly improve the HRQoL of people with MS. Early diagnosis and affordable access to effective treatments to slow or prevent disability accumulation may also be helpful.

Item Type:	Refereed Article
Keywords:	multiple sclerosis, quality of life, AQoL-8D, health state utility, economic evaluation
Research Division:	Economics
Research Group:	Applied economics
Research Field:	Health economics
Objective Division:	Economic Framework
Objective Group:	Other economic framework
Objective Field:	Other economic framework not elsewhere classified
UTAS Author:	Ahmad, H (Mr Hasnat Ahmad)
UTAS Author:	van der Mei, I (Professor Ingrid van der Mei)
UTAS Author:	Taylor, BV (Professor Bruce Taylor)
UTAS Author:	Campbell, JA (Dr Julie Campbell)
UTAS Author:	Palmer, AJ (Professor Andrew Palmer)
ID Code:	139827
Year Published:	2020
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2020-07-07
Last Modified:	2021-03-26
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