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Use of health services in people with multiple sclerosis with and without fatigue

Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden sverker.johansson{at}ki.se

C Ytterberg

Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

K Gottberg

Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

L Widén Holmqvist

Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

L von Koch

Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

Objective

To explore and compare the use of health services in people with multiple sclerosis (MS) with and without fatigue.

Methods

Over a period of 30 months, the use of health services in 48 MS outpatients with persistent fatigue and 36 without fatigue was studied. Data were collected from a computerized register and by interviews, and analyzed with regard to disease severity categorized as mild or moderate/severe MS.

Results

Fatigued people with mild MS used more hospital outpatient care and primary care including rehabilitation, and a higher proportion had transportation service, compared with non-fatigued people with mild MS. In moderate/severe MS, the differences were that non-fatigued people used more occupational therapy in primary care and a higher proportion had salaried service. Regardless of MS severity, informal care was more common among fatigued people.

Conclusions

Overall, fatigued people with mild MS have more contacts with outpatient health care compared with non-fatigued people. There are few such differences in people with moderate/severe MS. The reasons for the differences in use between fatigued and non-fatigued people are not understood and need further exploration. Fatigued people more often receive informal care, thus support to caregivers are of particular importance if fatigue is present.

Key Words: fatigue • health services • multiple sclerosis • resource utilization

This version was published on January 1, 2009

Multiple Sclerosis, Vol. 15, No. 1, 88-95 (2009)
DOI: 10.1177/1352458508095730


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