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Cross-sectional evaluation of health resource use in patients with functional neurological disorders referred to a tertiary neuroscience centre

O'Mahony, BW; Nelson-Sice, R; Nielsen, G; Hunter, R; Cope, S; Agarwal, N; Edwards, MJ; Yogarajah, M (2024) Cross-sectional evaluation of health resource use in patients with functional neurological disorders referred to a tertiary neuroscience centre. BMJ NEUROLOGY OPEN, 6 (1). e000606. ISSN 2632-6140 https://doi.org/10.1136/bmjno-2023-000606
SGUL Authors: Nielsen, Glenn

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Abstract

Introduction Functional neurological disorder (FND) is a common cause of referral to neurology services. FND has been shown to lead to significant healthcare resource use and is associated with significant disability, comorbidity and distress. This leads to substantial direct, indirect and intangible costs to the patient and society. Methods We recruited consecutive patients with FND referred to a tertiary FND specialist clinic. We assessed health and social care resource use in the 6 months preceding their consultation through a modified version of the Client Service Receipt Inventory in the form of a postal questionnaire. The total cost was estimated by combining the number and frequency of health resource use with standard national unit costs. We also assessed indirect costs such as informal care and loss of income. Results We collected data on 118 subjects. Patients with comorbid anxiety or depression had higher costs in the preceding 6 months, as did patients who had a longer duration of FND symptoms. Indirect costs were higher than the already substantial direct costs and a large proportion of patients with FND were receiving government support. Conclusion This study highlights the high cost of FND to both patients and health systems. Adequate reform of the patient pathway and reorganisation of services to make diagnoses and initiate treatment more quickly would likely reduce these costs.

Item Type: Article
Additional Information: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Keywords: functional neurological disorder, conversion disorder, health economics
SGUL Research Institute / Research Centre: Academic Structure > REF 2021 user group
Journal or Publication Title: BMJ NEUROLOGY OPEN
ISSN: 2632-6140
Dates:
DateEvent
22 May 2024Published
13 March 2024Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
MR/V037676/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
Web of Science ID: WOS:001229583700002
URI: https://openaccess.sgul.ac.uk/id/eprint/116562
Publisher's version: https://doi.org/10.1136/bmjno-2023-000606

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