Chen, J and Ahmad, H and Taylor, B and Palmer, AJ and van der Mei, I, Impact of remoteness on patient outcomes for people with multiple sclerosis in Australia, Multiple Sclerosis and Related Disorders, 55 Article 103208. ISSN 2211-0348 (2021) [Refereed Article]
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Background: Little is known about whether living in remote areas is associated with worse health outcomes in Australians with MS.
Objectives: To evaluate whether living in remote areas was associated with worse health outcomes, employment outcomes and different disease modifying therapy (DMTs) utilisation among Australians with MS.
Methods: We included 1,611 participants from the Australian MS Longitudinal Study. Level of remoteness (major cities, inner regional, outer regional, remote, and very remote Australia) was determined using postcode. Data were analysed using linear, log-binomial, log-multinomial and negative binomial regression.
Results: Living in more remote areas was not associated with substantial worse health/employment outcomes. There was a consistent pattern of those living in inner regional areas having worse outcomes, but the effect sizes were relatively small with no clear dose-response relationships with increasing remoteness. Those living in more remote areas were less likely to use high efficacy DMTs. Adjusting for age, disease duration, and education level only marginally reduced the associations.
Conclusions: There is no large inequity in health outcomes in the Australian MS population due to remoteness. However, modest and consistent differences in health outcomes and DMTs treatment are likely to have a substantial cumulative impact at an individual level.
|Item Type:||Refereed Article|
|Keywords:||disease modifying therapy; multiple sclerosis; quality of life; remoteness; symptoms|
|Research Division:||Biomedical and Clinical Sciences|
|Research Field:||Neurology and neuromuscular diseases|
|Objective Group:||Evaluation of health and support services|
|Objective Field:||Determinants of health|
|UTAS Author:||Ahmad, H (Dr Hasnat Ahmad)|
|UTAS Author:||Taylor, B (Professor Bruce Taylor)|
|UTAS Author:||Palmer, AJ (Professor Andrew Palmer)|
|UTAS Author:||van der Mei, I (Professor Ingrid van der Mei)|
|Web of Science® Times Cited:||1|
|Deposited By:||Menzies Institute for Medical Research|
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