Project title: The impact of rehabilitation on the social cost and quality of life in the sclerosimultipla as a model of physical disability

Duration: 24 months

Client: Ministry of Health

Institutional recipient: Liguria Region

Operational units: -AISM Italian Sclerosis Association Multipla, Rome -Clin. Neurological II, Dept. of Neurosciences, Ophthalmology and Genetics, University of Genoa -Dep. Pathophysiology, Experimental Medicine and Public Health, Siena University -Foundation Laboratory for social policies – Labos, Rome

Issue addressed: MS affects 56,000 people in Italy, two third women, 1,800 new cases / year, especially between 20 and 30 years , does not reduce life expectancy and with it, with progressive disability, coexists for decades. The progressive increase in prevalence must be addressed by the NHS with the use of innovative drugs with an impact on the progression of the disease and with a qualification of the services that limit the consequences in terms of cost for the company and that at the same time direct the appropriate use of resources. MS is the second cause of neurological disability among young adults, second among neurological diseases for social cost. This motivates the evaluation of the role of the services in charge, the updated study of the social cost in Italy with the evaluation of the efficacy of the clinical-assistance and social-health interventions. Survey assumes the assessment of the quality of life of the person with MS and of the main and secondary caregivers involved with it.

Objectives of the project: To define the effects of rehabilitation on the social cost and in particular: – To demonstrate the reduction of costs consequently to the rehabilitation approach according to the European Recommendations – Demonstrate the reduction of direct and indirect tangible costs – Demonstrate the reduction of the care load of the informal caregivers-Analyze the synergistic and / or additive action of personality, social and rehabilitation variables, in the genesis of the quality of life of the person with MS and of the caregivers. Define the role of the clinical reference centers for the MS of the NHS in the rehabilitation approach and in particular: -Evaluate the elements characterizing the current role of the centers, with emphasis on the relationship with the local services, highlighting good practices and weaknesses -Proposing interdisciplinary approach models and training guidelines for the operators

Results from achieve: – Knowledge of the social cost value of MS e the same modifying factors for an appropriate choice of the services to be provided. – Knowledge of international and national Recommendations and guidelines in the field of rehabilitation by the NHS operators and decision-makers – Reduction in the long term of the social cost of illness, in particular on patients with disabilities, and reduction of the care load for caregivers with improvement of the quality of life of the person and of his caregivers-Scientific report on the psychometric tools that will be used; -Report on longitudinal research; -Presentation at national and international congresses of research findings.

Methodology: The study of the social cost of the disease is multicentric, prospective, evaluates direct and indirect tangible costs measured on the basis of resource consumption and the value calculated according to methods defined and already used in previous studies and the intangible cost measured in reduction of the quality of life. Costs are assessed in patients classified by different stages of disease and measured by the association between costs and socio-demographic and clinical variables and with reference to rehabilitation frameworks. 1000 patients and their caregivers representative of the national geographical areas will be evaluated and the patients will be recruited involving the network of reference clinical centers operating in Italy. The cost will be compared between those who benefit from rehabilitation treatments compared to those who do not use them. A detailed cost analysis will be carried out for specific rehabilitative interventions highlighted in importance in the European Recommendations for MS rehabilitation

Contact person: Anna Calvaruso