Journal of Pain and Symptom Management
Volume 38, Issue 6 , Pages 816-826 , December 2009

Is Short-Term Palliative Care Cost-Effective in Multiple Sclerosis? A Randomized Phase II Trial

  • Irene J. Higginson, BMedSci, BMBS, PhD, FFPM, FRCP

      Affiliations

    • Department of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
    • Department of Palliative Care, King's College Hospital, London, United Kingdom
    • Corresponding Author InformationAddress correspondence to: Irene J. Higginson, BMed Sci, BMBS, PhD, FFPM, FRCP, Department of Palliative Care, Policy and Rehabilitation, King's College London School of Medicine, Weston Education Centre, Cutcombe Road, London SE5 9RJ, United Kingdom.
    • ,
  • Paul McCrone, BSc Hons, MSc, PhD

      Affiliations

    • Institute of Psychiatry, King's College London, London, United Kingdom
    • ,
  • Sam R. Hart, BA

      Affiliations

    • Department of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
    • ,
  • Rachel Burman, MA, FRCP

      Affiliations

    • Department of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
    • Department of Palliative Care, King's College Hospital, London, United Kingdom
    • ,
  • Eli Silber, MD, FCP(Neuro)SA

      Affiliations

    • Department of Neurology, King's College Hospital, London, United Kingdom
    • ,
  • Polly M. Edmonds, MBBS, MRCP, FRCP

      Affiliations

    • Department of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
    • Department of Palliative Care, King's College Hospital, London, United Kingdom

,Accepted 13 July 2009.

References 

  1. Emanuel EJ, Emanuel LL. The economics of dying. The illusion of cost savings at the end of life. N Engl J Med. 1994;330(8):540–544
  2. McCrone P, Allcock LM, Burn DJ. Predicting the cost of Parkinson's disease. Mov Disord. 2007;22(6):271–274
  3. The Canadian Burden of Illness Study Group. Burden of illness of multiple sclerosis: part I: cost of illness. Can J Neurol Sci. 1998;25(1):23–30
  4. Grima DT, Torrance GW, Francis G, et al. Cost and health related quality of life consequences of multiple sclerosis. Mult Scler. 2000;6(2):91–98
  5. Kobelt G, Berg J, Lindgren P, Fredrikson S, Jonsson B. Costs and quality of life of patients with multiple sclerosis in Europe. J Neurol Neurosurg Psychiatry. 2006;77(8):918–926
  6. Kristjanson LJ, Aoun SM, Oldham L. Palliative care and support for people with neurodegenerative conditions and their carers. Int J Palliat Nurs. 2006;12(8):368–377
  7. Wollin JA, Yates PM, Kristjanson LJ. Supportive and palliative care needs identified by multiple sclerosis patients and their families. Int J Palliat Nurs. 2006;12(1):20–26
  8. Taylor DH, Ostermann J, Van Houtven CH, Tulsky JA, Steinhauser K. What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program?. Soc Sci Med. 2007;65(7):1466–1478
  9. Morrison RS, Penrod JD, Cassel JB, et al. Cost savings associated with US hospital palliative care consultation programs. Arch Intern Med. 2008;168(16):1783–1790
  10. Lorenz KA, Lynn J, Dy SM, et al. Evidence for improving palliative care at the end of life: a systematic review. Ann Intern Med. 2008;148(2):147–159
  11. Higginson IJ, Finlay IG, Goodwin DM, et al. Is there evidence that palliative care teams alter end-of-life experiences of patients and their caregivers?. J Pain Symptom Manage. 2003;25(2):150–168
  12. Harding R, Higginson IJ. What is the best way to help caregivers in cancer and palliative care? A systematic literature review of interventions and their effectiveness. Palliat Med. 2003;17(1):63–74
  13. Gomez-Batiste X, Tuca A, Corrales E, et al. Resource consumption and costs of palliative care services in Spain: a multicenter prospective study. J Pain Symptom Manage. 2006;31(6):522–532
  14. Brumley R, Enguidanos S, Jamison P, et al. Increased satisfaction with care and lower costs: results of a randomized trial of in-home palliative care. J Am Geriatr Soc. 2007;55(7):993–1000
  15. Murray TJ. Diagnosis and treatment of multiple sclerosis. BMJ. 2006;332(7540):525–527
  16. MacLurg K, Reilly P, Hawkins S, et al. A primary care-based needs assessment of people with multiple sclerosis. Br J Gen Pract. 2005;55(514):378–383
  17. Edmonds P, Vivat B, Burman R, Silber E, Higginson IJ. Loss and change: experiences of people severely affected by multiple sclerosis. Palliat Med. 2007;21(2):101–107
  18. Higginson IJ, Vivat B, Silber E, et al. Study protocol: delayed intervention randomised controlled trial within the Medical Research Council (MRC) Framework to assess the effectiveness of a new palliative care service. BMC Palliat Care. 2006;5:7
  19. Higginson IJ, Hart S, Silber E, Burman R, Edmonds P. Symptom prevalence and severity in people severely affected by multiple sclerosis. J Palliat Care. 2006;22(3):158–165
  20. Higginson IJ, Hart S, Burman R, et al. Randomised controlled trial of a new palliative care service: compliance, recruitment and completeness of follow-up. BMC Palliat Care. 2008;7:7
  21. Roberts C, Torgerson D. Randomisation methods in controlled trials. BMJ. 1998;317(7168):1301
  22. Rossier P, Wade DT. The Guy's Neurological Disability Scale in patients with multiple sclerosis: a clinical evaluation of its reliability and validity. Clin Rehabil. 2002;16(1):75–95
  23. Rossier P, Wade DT. Validity and reliability comparison of 4 mobility measures in patients presenting with neurologic impairment. Arch Phys Med Rehabil. 2001;82(1):9–13
  24. Hearn J, Higginson IJ. Development and validation of a core outcome measure for palliative care: the palliative care outcome scale. Qual Health Care. 1999;8:219–227
  25. Higginson IJ, Donaldson N. Relationship between three palliative care outcome scales. Health Qual Life Outcomes. 2004;2:68–75
  26. Bedard M, Molloy DW, Squire L, et al. The Zarit Burden Interview: a new short version and screening version. Gerontologist. 2001;41(5):652–657
  27. Douglas HR, Normand CE, Higginson IJ, Goodwin DM, Myers K. Palliative day care: what does it cost to run a centre and does attendance affect use of other services?. Palliat Med. 2003;17(7):628–637
  28. Curtis L, Netten A. Unit costs of health and social care. Canterbury: Personal Social Services Research Unit, University of Kent; 2005;
  29. Ory MG, Williams TF, Emr M, et al. Families, informal supports, and Alzheimer's disease. Current research and future agendas. Res Aging. 1985;7(4):623–644
  30. Mets T, Vandewoude M, Jacquy J, et al. Patient and caregiver outcomes after 6 +/- 1.5-months of rivastigmine therapy for mild-to-moderate Alzheimer's disease: the Belgian FExT study. Curr Med Res Opin. 2007;23(10):2485–2501
  31. Harding R, Higginson IJ, Donaldson N. The relationship between patient characteristics and carer psychological status in home palliative cancer care. Support Care Cancer. 2003;11:638–643
  32. Patel A, Knapp M, Evans A, Perez I, Kalra L. Training care givers of stroke patients: economic evaluation. BMJ. 2004;328(7448):1102
  33. Weinshenker BG, Rice GP, Noseworthy JH, et al. The natural history of multiple sclerosis: a geographically based study. 3. Multivariate analysis of predictive factors and models of outcome. Brain. 1991;114(Pt 2):1045–1056
  34. Jordhoy MS, Fayers P, Saltnes T, et al. A palliative-care intervention and death at home: a cluster randomised trial. Lancet. 2000;356(9233):888–893

 This study was funded by the Multiple Sclerosis Society of Great Britain and Northern Ireland.

 Clinical Trial Registration: www.ClinicalTrials.gov, Identifier: NCT00364936.

PII: S0885-3924(09)00741-6

doi: 10.1016/j.jpainsymman.2009.07.002

Journal of Pain and Symptom Management
Volume 38, Issue 6 , Pages 816-826 , December 2009

Article Tools

* Image Usage & Resolution