The impact of multiple sclerosis on social determinants of health: Results from the SocialMS study.
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Ponzano Marta, Signori Alessio, Schiavetti Irene, Landi Doriana, Bellavia Andrea, Lavorgna Luigi, Fantozzi Roberta, Buttari Fabio, Di Sapio Alessia, Quartana Davide, Marinelli Fabiana, Tartaglia Matteo, Callari Graziella, Cavalla Paola, Frau Jessica, Grasso Maria Grazia, Tsantes Elena, Buscarinu Maria Chiara, Marfia Girolama Alessandra, Zuliani Luigi, Cordioli Cinzia, Sibilia Grazia, Immovilli Paolo, Lorefice Lorena, Lugaresi Alessandra, Lanzillo Roberta, Panzera Ivan, Stromillo Maria Laura, Mori Laura, Laroni Alice, Battaglia Mario Alberto, Sormani Maria Pia, SocialMS study group
Аннотация
METHODS: SocialMS is a cross-sectional Italian questionnaire-based study including adults with MS. The number of SDH affected by MS was the primary endpoint and risk factors were identified using Poisson regression.
RESULTS: We included 1039 participants (mean age: 43.82 years (sd: 11.53); 68.82% females; 86.53% relapsing remitting; median Patient Determined Disease Steps (PDDS): 1 (iqr: 0-3)). Median number of SDH affected by MS was 1 (iqr: 0-3), with social life (51.20%) and work (48.22%) most impacted; high interrelationships among domains were observed. Relevant risk factors included socioeconomic factors (education incomplete at diagnosis: incidence-rate ratio (IRR)=1.19 [95% CI: 1.06; 1.35]; non-working or early retired: IRR=1.18 [1.05; 1.34]; economic strain: IRR=1.47, [1.31; 1.64]), comorbidities (IRR=1.23 [1.11; 1.37]) and PDDS (IRR=1.17 [1.13; 1.20]). Almost 90% received tangible (64.29%) or intangible (85.18%) social support, and number of SDH impacted by MS was positively associated with both (p < 0.05).
CONCLUSION: MS substantially affects multiple SDH, with greater burden among individuals with socioeconomic and health-related vulnerabilities.