Improving the convenience of home-based interferon beta-1a therapy for multiple sclerosis.

Subcutaneous interferon beta-1a (Rebif) therapy has been recognized as a significant advance in the treatment of relapsing-remitting multiple sclerosis (MS). The drug is supplied as a solution in a ready-to-use prefilled syringe. Given the chronic nature of the disease, a convenient and simple drug delivery for self-administration improves patient management. Home-based therapy requires comprehensive knowledge of multiple sclerosis and a training and support program to ensure maximum convenience and independence for the patient. These result in high compliance with therapy and optimum response to treatment.

Evaluation of long-term functional status in first-ever stroke patients in a defined population.

Medical, social and ADL variables were registered within 48 hours of stroke onset and 6 and 12 months later in 346 first-ever stroke patients. One year after stroke onset 27% of the patients were dead. 78% of the surviving patients were living in their own homes, 10.6% in old people's homes with no medical facilities and 9.5% in nursing homes. A health index was used for ADL evaluation and the quality of life was estimated according to Nottingham Health Profile (NHP). 16% of the patients had domestic social service assistance before stroke onset. The help given by relatives and friends far exceeded that given by the society before as well as after stroke onset. Right hemispheric stroke patients had a worse outcome than left-sided with respect to ADL and life satisfaction.

Direct costs of stroke for a Swedish population.

Direct costs were estimated for the treatment, rehabilitation, and nursing of 125 patients with first stroke in the Lund and Orup health districts (population of 200,191). Patients were followed from the onset of stroke in 1983 until October 31, 1985. The data were used to calculate the present value of the expected lifetime direct costs for an individual contracting his or her first stroke at various ages. For example, at the age of 72, these costs were estimated at SEK 283,000 for a man and SEK 561,000 for a woman. Hospital care was the major cost component (75% for males and 89% for females) at this age of onset. The results could be used to estimate the economic benefits of preventing new strokes, hence, forming part of a cost-effectiveness or cost-utility analysis. Together with prognoses of the expected developments in the incidence of stroke, they could also serve as the basis of forecasts of future costs of the health care and social service sectors.