ECTRIMS: Impact of Impaired Walking On Health Care Utilization

Impaired mobility and walking in patients with multiple sclerosis (MS) negatively impacts all aspects of the patients’ lives. In a new study presented at the ECTRIMS meeting, researchers investigated the association between walking speed, measured by the Timed 25-Foot Walk (T25FW) test, and direct health care resource use, walking aid use, and modifications to daily living at home and work.

The study included 490 neurologists, who completed 10 to 15 prospective records for consulting MS patients. Multivariate regressions assessed the relationship between walking speed and direct and indirect health care resource use. Covariates included were age, sex, body mass index, time since MS diagnosis, and relevant concomitant conditions.

Of 5397 patients with MS, 512 had a T25FW test result, of whom 162 reported the utilization of support services. The mean age of patients was 44.01 years and the mean time since MS diagnosis was 5.63 years. Most were

employed (47.27%) and lived with partner/ spouse (71.48%). Comorbidites included hypertension (9.77%), osteoporosis/arthritis (8.20%), and diabetes (5.08%). Increased walking speed (walking faster) was associated with a reduction in nonprofessional and professional caregiver need (P=.001). The number of emergency department

visits in the past 12 months (P=.009), hospitalizations (P=.377), and neurologist consultations (P=.808) for MS increased with reducing walking speed, although the researchers noted that the associations were not statistically significant for hospitalizations and neurologist consultations.

Increased walking speed was also associated with less need for walking aids (P=.001) and less need for home modifications (P=.003). There was a numerical but not significant relationship between increased walking speed and more ability to work, fewer MS-related hospitalizations, fewer neurologist consultations, fewer MS nurse consultations, fewer car modifications needed, and fewer workplace modifications.

“Reduced walking speed due to MS may exert additional economic burden among patients, their caregivers, and the health care system,” said the researchers. “Therapies that improve walking speed may be beneficial to reduce economic burden.”—Eileen Koutnik-Fotopoulos

This study was supported by funding from Biogen.