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document
Home based management in multiple sclerosis : results of a randomised controlled trial . BACKGROUND Home based medical care is a popular alternative to standard hospital care but there is uncertainty about its cost-effectiveness . OBJECTIVES To compare the effectiveness and the costs of multidisciplinary home based care in multiple sclerosis with hospital care in a prospective randomised controlled trial with a one year follow up . METHODS 201 patients with clinically definite multiple sclerosis were studied . They were randomised in a ratio 2:1 to an intervention group ( 133 ) or a control group ( 68 ) . They were assessed at baseline and one year after randomisation with validated measures of physical and psychological impairment and quality of life ( SF-36 health survey ) . The costs to the National Health Service over the one year follow up were calculated by a cost minimisation analysis . RESULTS There were no differences in functional status between the home based care group and the hospital group . There was a significant difference between the two groups favouring home based management in four SF-36 health dimensions-general health , bodily pain , role-emotional , and social functioning ( all p < or = 0.001 ) . The cost of home based care was slightly less ( 822 euros/patient/year ) than hospital care , mainly as a result of a reduction in hospital admissions . CONCLUSIONS Comprehensive planning of home based intervention implemented by an interdisciplinary team and designed specifically for people with multiple sclerosis may provide a cost-effective approach to management and improve the quality of life .
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Intervention_Educational
Home based management
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Intervention_Educational
Home based medical care
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Intervention_Educational
multidisciplinary home based care
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Intervention_Educational
Comprehensive planning of home based intervention
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Outcome_Other
cost-effectiveness .
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Outcome_Other
effectiveness and the costs
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Outcome_Mental
validated measures of physical and psychological impairment and quality of life ( SF-36 health survey ) .
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Outcome_Other
costs to the National Health Service over the one year follow up
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Outcome_Mental
functional status
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Outcome_Physical
four SF-36 health dimensions-general health , bodily pain , role-emotional , and social functioning
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Outcome_Other
cost
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Outcome_Other
cost-effective
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Outcome_Other
quality of life
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Participant_Condition
multiple sclerosis
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Participant_Sample-size
201