Health care worry is associated with worse outcomes in multiple sclerosis.

TitleHealth care worry is associated with worse outcomes in multiple sclerosis.
Publication TypeJournal Article
AuthorsJones SM, Amtmann D
JournalRehabil Psychol
Date Published2014 Aug

PURPOSE/OBJECTIVE: People with multiple sclerosis (MS) experience higher levels of depression and anxiety than the general population. This is the first study to examine the relationship of worry about affording health care and symptoms in MS. RESEARCH METHOD/DESIGN: People with MS (n = 405) were recruited for a needs assessment study. Participants completed a structured telephone interview measuring depression, anxiety, fatigue, sleep disturbance, pain interference, social function, and perceived cognitive functioning, and rated their worry about the following: premiums increasing, income decreasing, affording health care services, insurance dropping coverage, and affording prescriptions. Multiple regression analyses controlled for age, gender, disability status, education, income, and health insurance coverage. RESULTS: The highest rated worry was inability to afford health care services. Higher health care worry was reported by women, younger participants, participants with lower incomes, and those with only private (vs. public) insurance. Total level of health care worry was significantly related to depression, anxiety, fatigue, sleep disturbance, pain interference, social function, and perceived cognitive functioning. CONCLUSIONS/IMPLICATIONS: Health care worry was significantly related to psychological, physical, and cognitive symptoms. Future research should compare health care worry in MS with other populations (i.e., healthy adults) and should examine changes in health care worry over time. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Alternate JournalRehabil Psychol
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What is this research about?

If you’re living with a chronic condition, like multiple sclerosis (MS), an unclear future is a normal part of life.  When it comes to health care and the costs, not knowing what will happen is stressful.  We all worry about problems, but sometimes worry can get away from us and be harmful to our well-being. Health care coverage is essential for people living with chronic conditions. Before the Affordable Care Act (ACA), insurance companies were allowed to deny coverage for people living with a chronic condition. We were curious about people living with MS who worried about heath care and we were interested in learning if their health was worse.

What did the researchers do?

We called 405 people living with MS and asked many questions. Several questions asked about how much they worried about being able to afford health care. Other questions asked people about how troubled they are with secondary conditions. We also asked about social activities and family life. When we studied the answers, we first looked at differences in worry between men and women, older and younger people, and people with higher or lower incomes. Then we looked at the relationship between worry and secondary conditions, ability to do daily activities, and social life.

What did the researchers find?

People living with MS were worried about affording health care. Women were more worried than men. Younger people were more worried than older. People with lower incomes were more worried than those with higher incomes. People with private health insurance were more worried about affording health care than people with some form of public insurance (Medicaid, Medicare, etc.). People who worried about affording health care were more likely to feel sad (depressed), tired or weak (fatigued), and anxious. People who worried said they have trouble sleeping,more pain, more trouble with daily activities and take less part in social activities. This research did not find that worry about health care causes health problems, just that people who worry more report more troubles. It may be that stress causes more problems or more problems cause more worry or both.

How can you use this research?

For those living with MS, being overly worried about affording health care may take a toll on your health and life.  Are you worried about affording health care? Here’s what we recommend:

  • Talk with your doctor. Some clinics have social workers who help patients navigate the ins and outs of health insurance coverage.  Check out our factsheet, Getting the Most Out of Health Care Visits.
  • Learn more about your health care coverage options from the National MS Society. 
  • Talk to a  person who knows about health care options. The National MS Society have “MS Navigators” who are available to help with questions of any kind. Call 1-800-344-4867 or Contact them.
  • Do you need help sorting out how the ACA can help you? The National Disability Navigator is an outstanding group with many helpful factsheets. You may contact them as well with health insurance coverage questions.

What you need to know:

  • People living with MS who worry a lot about affording health care report more health problems and less well-being.
  • Reducing your secondary conditions, may reduce your stress about health care costs. Check out our factsheets on several ways to tackle problems with secondary conditions.

About the researcher(s):  Salene MW Jones is a post-doctoral fellow for Group Health Research Institute and interested in mental health needs in women with medical conditions. Dagmar Amtmann, PhD is a researcher in Rehabilitation Medicine who studies health and well-being. Dagmar is interested in how to ask the best questions about health and teaches about what and how researchers and clinicians should measure in clinics and studies. 

PubMed ID25019308

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