This study aimed to evaluate the factors associated with care modality among older adults with chronic disease and disability in rural China. We hypothesised that marital status, family structure, duration of disability and the number of chronic diseases would be significantly associated with care modality. This was a cross-sectional observational study using survey data to identify demographic and health-related factors associated with care modality. The study was conducted in a rural mid-sized county in China and focused on older adults with chronic disease and disability. A total of 608 older adults aged ≥60 years with chronic disease and disability residing in Qinghe County, Hebei Province, China, completed the survey. Eligible participants had at least one chronic disease and partial or complete loss of self-care ability. The primary outcome was care modality (home-based care vs institutional care). Secondary outcomes included specific chronic disease care needs. Of the participants, 18.59% received institutional care. Divorced, widowed or unmarried participants had higher odds of institutional care use (OR=3.113, 95% CI 2.01 to 4.82, p<0.0001), as did those with one child (OR=5.55, 95% CI 1.647 to 18.696, p=0.0057). Participants with a disability lasting 3 or more years had significantly lower odds of institutional care use (OR=0.353, 95% CI 0.186 to 0.667, p=0.0014). Individuals with three chronic diseases (OR=0.486, 95% CI 0.242 to 0.977, p=0.0429) or four or more (OR=0.412, 95% CI 0.183 to 0.928, p=0.0324) also had lower odds of institutional care use. The highest-priority chronic disease care needs were regular physical examinations, rehabilitation guidance, medication guidance, chronic disease management guidance and nutritional guidance. Participants receiving institutional care reported higher needs for digitally supported services such as online referral, medical record information sharing and remote data transmission. Marital status, number of children, duration of disability and number of chronic diseases were significantly associated with care modality in this population. These findings highlight the need to improve institutional care quality and availability and to better address the chronic disease management needs of this population. Future research should focus on longitudinal studies to explore the evolving care needs of this growing demographic.

The glymphatic system, a key fluid clearance pathway in the central nervous system, is emerging as a potential therapeutic target for synucleinopathies. Dysregulation of this system may contribute to spinocerebellar ataxia type 3 (SCA3) pathogenesis, in which the accumulation of misfolded proteins acts as a central driver. The goal was to investigate glymphatic system function in SCA3 patients and evaluate its relationship with brain damage and clinical disability. Ninety-two SCA3 patients (14 with premanifest SCA3 and 78 with manifest SCA3) and 98 healthy controls underwent clinical evaluation and magnetic resonance imaging (MRI) scans. MRI parameters, including the diffusion along the perivascular space (DTI-ALPS) index (a proxy for glymphatic function); cerebral, cerebellar, and subcortical gray matter volumes; and whole-brain microstructural properties of white matter, were calculated. Patients with premanifest and manifest SCA3 had lower ALPS indices compared with healthy controls, and patients with manifest SCA3 had a lower ALPS index compared with premanifest SCA3. In SCA3 patients, lower ALPS index was associated with more severe disability and longer disease duration. A negative correlation between ALPS and disease duration emerged after 3 years, with no significant association observed before the 3-year cutoff. Moreover, lower ALPS index was correlated with more pronounced cortical and subcortical gray matter atrophy, decreased fractional anisotropy, and elevated mean diffusivity in white matter. Our findings demonstrate that glymphatic function is impaired, particularly in the presymptomatic stage of SCA3, and this impairment is associated with disability, neurodegeneration, and demyelination. Therefore, glymphatic dysfunction may contribute to the pathogenesis of SCA3. © 2026 International Parkinson and Movement Disorder Society.

Adults with paralysis often experience restricted community participation, yet less is known about participation enfranchisement, including perceived control and importance. This study aimed to describe patterns of participation enfranchisement and examine associations with demographic and functional factors among adults with mobility impairments. Thirty adults with paralysis using mobility aids completed the Community Participation Indicators (CPI) at an adaptive fitness center. Social and recreational activities were most frequently performed, whereas employment, volunteering, and civic activities were least frequently performed. Adjusted CPI ratios indicated higher meaningful participation in social and household activities (≥.60) and lower meaningful participation in employment, volunteering, and civic roles (≤.36). Independent driving (τb = -.490, p =.002) and independent living (τb =.409, p =.009) were associated with greater perceived control. Longer disability duration (rs = -.573, p <.001) and earlier onset (rs =.481, p =.007) were associated with lower perceived importance. Findings highlight barriers and opportunities for occupational therapy to enhance participation enfranchisement.

BACKGROUND: Lower urinary tract dysfunction is one of the leading clinical manifestations of multiple sclerosis, occurring in 50%–90% of the patients. One of the most common urinary disorders in patients with multiple sclerosis is overactive bladder. Antimuscarinic agents remain the cornerstone of drug cotherapy for neurogenic overactive bladder; however, their often limited efficacy and suboptimal tolerability highlight the need for search of new pharmacotherapeutic approaches. AIM: This study aimed to evaluate the efficacy and safety of the beta3-adrenergic receptor agonist mirabegron in the treatment of overactive bladder in patients with multiple sclerosis. METHODS: A prospective cohort study included 52 patients with multiple sclerosis and overactive bladder (mean age: 44.7 ± 12.4 years). All patients received mirabegron 50 mg once daily for 3 months. Treatment efficacy was assessed using 3-day voiding diaries and questionnaires (Patient Global Impression of Severity, Indevus Urgency Severity Scale, and Neurogenic Bladder Symptom Score), completed by patients before and after therapy. Postvoid residual volume was measured at the same time points. RESULTS: At the end of treatment, there was a significant reduction compared with baseline in the number of micturitions and urgency episodes, as well as a decrease in the proportion of patients with urgency urinary incontinence from 37 (71.2%) to 22 (42.3%) (p 0.05). A substantial decrease in mean scores on the Patient Global Impression of Severity and Indevus Urgency Severity Scale questionnaires was observed, along with a trend toward reduction in the total Neurogenic Bladder Symptom Score. Mirabegron therapy was not associated with deterioration of bladder voiding function, as evidenced by the absence of an increase in postvoid residual volume. No differences in treatment efficacy were observed according to patient age, Expanded Disability Status Scale score, clinical course or duration of multiple sclerosis, or duration of overactive bladder symptoms. Mirabegron was well tolerated. Adverse events, mainly dyspeptic symptoms, were reported in 11 (21.2%) patients. CONCLUSION: The beta3-adrenergic receptor agonist mirabegron is an effective and well-tolerated treatment option for overactive bladder in patients with multiple sclerosis, with a favorable safety profile.

ABSTRACT Background Approximately 12% of U.S. adults have mobility limitations, a group that may be at increased risk for poor bone health. Despite the importance of bone mineral density (BMD) as an indicator of skeletal health, recent syntheses of how BMD has been examined in this population are lacking. Purpose To examine the literature regarding BMD among people with specific mobility limitations including spinal cord injuries (SCIs). Methods MEDLINE, PubMed, and CINAHL were searched for studies published between 2014 and 2025. Twenty-five studies met the inclusion criteria. Results Studies consistently reported lower BMD in people with mobility limitations compared to those without mobility limitations. People with higher severity and duration of disability had lower BMD. Physical activity exerted a positive influence on BMD. Limitations of studies examined included small sample sizes and underrepresentation of female participants. Discussion Evidence indicates consistently reduced BMD and elevated osteoporosis burden among adults with mobility limitations, with low BMD risk enhanced by severity and duration of disability and modifiable behaviors. Translation to Health Education Practice Findings support targeted screening, tailored physical activity promotion, nutrition and risk factor counseling, and advocacy for research and programs that adequately represent women and incorporate sex-specific assessment of bone health needs.

Epidemiological burden of Alzheimer's and Parkinson's diseases in East Asia: A comparative review of global burden of disease estimates and national registry data.

Objective. To evaluate structural retinal changes in patients with relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS) over time and to analyze their association with the progression of neurological impairment. Material and methods . Clinical data (EDSS, T25FW, 9-HPT, SDMT) and optical coherence tomography (OCT) results (average thickness of the ganglion cell and inner plexiform layer [avgGCL+IPL]; average thickness of the peripapillary retinal nerve fiber layer [avgRNFL]) were analyzed in patients with RRMS and SPMS (42 women, 19 men; age 46.20 ± 9.49 years) over a follow-up period of 12.87 ± 1.25 months. Comparisons were performed between groups stratified by disability level (Group 1: EDSS 0–2.0, Group 2: EDSS 2.5–3.5, Group 3: EDSS≥4.0), as well as by the presence of at least one sign of progression (increase in EDSS by 0.5–1.0, ≥20 % worsening in T25FW/9HPT, or ≥4-point/10 % decrease in SDMT). Results and discussion . EDSS did not change significantly during follow-up (p = 0.451); however, 45.2 % of patients demonstrated signs of progression according to T25FW/9HPT/sDMT. T25FW performance worsened more markedly in Groups 2 and 3 (p &lt; 0.001), while no significant differences were observed between groups in other measures. Statistically significant differences in avgGCL+IPL and avgRNFL were found between Groups 1 and 3 (p = 0.007 and p = 0.016, respectively). Annual avgGCL+IPL change was −0.58 [−1.00; −0.17] μm in Group 1 vs. −3.00 [−3.33; −1.25] μm in Group 3; annual avgRNFL change was −0.62 [−1.75; 0.75] μm in Group 1 vs. −2.38 [−3.25; −1.88] μm in Group 3. Moreover, annual reductions in avgGCL+IPL and avgRNFL were greater in patients with progression (−1.54 [−3.00; −0.46] and −2.31 [−4.69; −1.25] μm, respectively) compared with stable patients (−0.83 [−1.50; −0.25] and −0.75 [−1.88; 0.50] μm, respectively), with statistically significant differences (p = 0.018 and p = 0.003, respectively). Progression was predicted by avgGCL+IPL loss &gt;1.17 μm/year (sensitivity 64.3%; specificity 66.7 %) and avgRNFL loss &gt;1.125 μm/year (78.6 and 63.6 %, respectively). Conclusions. Accumulation of neurological deficits occurs even in the absence of EDSS changes, while the neurodegenerative process is more active in patients with greater disability and longer disease duration. Annual thinning of avgGCL+IPL and avgRNFL on OCT may serve as a predictor of MS progression.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disorder with suspected neuroinflammatory pathophysiology. However, previous diffusion tensor imaging (DTI) studies have reported inconsistent white matter abnormalities in ME/CFS, and specific white matter inflammatory changes remain poorly characterised. This study employed an advanced diffusion-based neuroinflammation imaging (NII) model to investigate white matter neuroinflammation in ME/CFS. Diffusion MRI data from 67 ME/CFS patients (median age, 38; and 54 women) and 67 rigorously matched healthy controls (HCs) (median age 38; and 52 women) were analysed. Seven NII-derived metrics were computed: hindered water ratio (NII-HR), restricted fraction (NII-RF), fibre fraction (NII-FF), axial diffusivity (NII-AD), radial diffusivity (NII-RD), mean diffusivity (NII-MD) and fractional anisotropy (NII-FA). Conventional DTI metrics were also calculated. Tract-based spatial statistics were used to perform voxel-wise group comparisons, and multiple regression analysis was conducted to examine the relationship between NII/DTI metrics and clinical measures of mental health, physical health, sleep quality, disability, disease severity and disease duration. Compared to HCs, ME/CFS patients exhibited widespread white matter abnormalities, including significantly lower NII-HR and NII-RF, and significantly higher NII-FF, NII-AD, NII-MD and NII-FA across association, commissural and projection fibres. Additionally, some regions showed decreased NII-AD and NII-MD in ME/CFS. Lower NII-RF, NII-AD and NII-MD in ME/CFS were significantly associated with worse mental health, while lower NII-RF was also associated with a higher level of disability. Among ME/CFS patients, higher NII-FF was associated with lower disease severity. Conventional DTI showed minimal group differences and no significant clinical associations. This study provides invivo evidence of white matter neuroinflammation in ME/CFS, characterised by cerebral edema (reduced NII-HR), cellular infiltration (reduced NII-RF) and axonal reorganisation (increased NII-FF). This suggests NII-derived indices may serve as sensitive biomarkers for neuroinflammation in ME/CFS.

This study systematically mapped domestic research trends on the economic activity of older persons with disabilities (OPwD) in Korea. Method: A scoping review was conducted following Arksey &amp; O’Malley (2005). We set no lower bound and searched through June 2025, comprehensively canvassing KCI, DBpia, KISS, and major institutional websites; 49 records met inclusion criteria (42 journal articles, 7 research reports). Results: Journals most often used the terms “older persons with disabilities” and “middle‑to‑older persons with disabilities.” applying age thresholds of 50, 45, and 55 years, whereas reports used “older persons with disabilities” with 50 and 40 years, Journal topics clustered around employment, life satisfaction, and job retention; reports focused on employment policy. Across studies, 207 recommendations were synthesized into 38 categories, Compared with those aging with a long‑standing disability, persons with older‑onset disability showed lower labor‑force participation and job retention and higher economic hardship and retirement probability. Conclusion : Policies should reflect early aging and heterogeneity among OPwD by providing (a) targeted employment and re-employment services, (b) individualized job‑retention supports, (c) assessment tools for work‑ability decline, (d) retirement transition and later‑life planning, (e) professional training, (f) enhanced employer supports, and (g) policy designs that differentiate by disability onset and duration.

The article presents a comprehensive classification and critical review of factors influencing return-to-work (RTW) timelines after occupational injuries, from an interdisciplinary perspective and using predictive modeling. The research relevance is driven not only by the socio-economic magnitude of the issue, but also by an increasing need for evidence-based strategies to manage work sustainability. The objective is to systematize and classify biological, psychological, organizational, and regulatory determinants shaping the duration of work disability, and to compare traditional clinical approaches with contemporary predictive analytics tools. The novelty lies in integrating the conceptual model of the Arena for Work Disability Prevention with modern machine-learning methods, thereby constructing a holistic, multi-level schema of influences that range from individual attitudes and psychophysiological resources to institutional regulators and macroeconomic conditions. The main findings demonstrate that disability duration emerges from the interaction of four circuits: personal, workplace, healthcare, and regulatory. It is shown that graded RTW programs, cognitive-behavioral and organizational interventions, and coordinated participation by the physician, employer, and insurer can shorten the average time-to-work resumption by several weeks. The article is intended for researchers in occupational medicine and rehabilitation, occupational safety professionals, healthcare managers, and developers of digital solutions for predictive monitoring of work sustainability.

The phenomenon of workplace accidents in the metalworking industry is recognized as a worrying issue for those responsible for occupational safety and health. The objective of this study was to analyze the prevalence of workplace accidents in the metalworking sector of the city of Cartagena. The methodology consisted of field research with an exploratory and mixed-methods approach. Workplace accident reports from 55 workers in a metalworking company were used, covering the period from 2018 to 2024. Results: Statistically significant differences (p=0.029871) were found by type of injury (blow, wound, contusion) and by the workers' seniority in the position, indicating that work experience can influence the occurrence of accidents resulting in injury. Sixteen upper limb injuries and seven eye injuries were identified. The average duration of disability was two days, with a significant association (p=0.0001). In conclusion, workers in the metalworking sector are highly exposed to injuries, especially to the upper extremities and eyes, primarily caused by blows, cuts, and contusions. Furthermore, it was shown that greater seniority is associated with a higher tendency to suffer more severe injuries.

Visual disabilities and depression/anxiety among adolescents: A nationwide cohort study.

Individuals with pediatric-onset spinal cord injury (SCI) represent a distinct group; management can be more complex than in adult-onset SCI. Changing medical needs, transfer of responsibility, and cognitive appraisals of disability may all impact life satisfaction in pediatric-onset SCI. Further, bladder/bowel management over many years may be time-consuming and socially disruptive. Cognitive appraisal of disability has been linked to life satisfaction and functioning in pediatric-onset SCI. This study examines associations between bladder/bowel accidents, bowel management, cognitive appraisals, and life satisfaction in pediatric-onset SCI. Part of a larger study, 180 adults who sustained SCI age ≤18 and received treatment at a pediatric rehabilitation hospital system were interviewed. Participants were 55.6% male, 83.3% White, 38.6 years at interview, and 13.1 years at injury; 66.1% had complete injury, and 51.1% had paraplegia. Participants reported demographics/medical needs via semi-structured interview. Cognitive appraisals and life satisfaction were assessed using Appraisals of DisAbility Primary and Secondary Scale-Short Form and Satisfaction with Life Scale. Pairwise correlations with all constructs of interest and multivariable linear regressions using bowel program duration and cognitive appraisals as predictors of life satisfaction were conducted. Correlations align with literature suggesting associations between bladder accident frequency/bowel program duration and negative appraisals of disability (r = .17-.22, P < .05) and bowel program duration and reduced life satisfaction (r = -.29, P < .01). Increased bowel program duration is associated with reduced growth and resilience appraisals (r = .32, P < .001). Regressions indicate that increased bowel program duration and negative appraisals (fearful despondency, overwhelming disbelief, negative perceptions) are associated with reduced life satisfaction (R 2 = .12-.24). Findings suggest interventions targeting bowel management efficiency and cognitive appraisals may improve life satisfaction in this population.

While cognitive functioning in multiple sclerosis has been extensively studied, the presence of social cognition deficits in persons affected by relapsing-remitting multiple sclerosis (RRMS) remains comparatively less explored. This study recruited 30 Turkish patients with RRMS and 30 healthy controls (HCs) matched for demographic characteristics and cognitive status. We tested their social cognition abilities within two main subdomains, namely, theory of mind (ToM) and emotion recognition. The combination of tests we used was novel and rather broad as ToM was evaluated in both its affective and cognitive components while emotion recognition was evaluated in two tasks requiring either naming or discriminating facial expressions. All tests required verbal responses and were scored in terms of accuracy. The results indicated that patients with RRMS exhibited significantly lower accuracy compared to the HC group across all social cognition tasks. Correlation analyses revealed a significant negative relationship between emotion discrimination performance and both level of disability and disease duration. Additionally, RRMS patients showed significant deficits in recognizing negative emotions, while no differences with the HC group were observed for positive emotion recognition. The presence of a domain-specific, selective deficit for social cognition was also confirmed after further controlling for overall cognitive functioning. Our findings capitalize on previous evidence demonstrating that social cognition impairments in RRMS have domain-specific characteristics and can be reliably detected in a new cultural context.

The results of serial casting in the treatment of proximal interphalangeal joint contractures in patients with systemic sclerosis.

The impact of spinal pain on family members' burden: a cross-sectional study.

Introduction. The reasons for tooth extraction are varied and include complications of the carious process, periodontal disease, orthodontic indications, traumatic injuries, and more. It is well established that post-extraction alveolar bone atrophy occurs in approximately 50–60% of cases within the first three months following tooth loss. Purpose. To evaluate the effect of platelet-rich fibrin (PRF) clot application on clinical healing parameters of the extraction socket. Materials and Methods. The study included 20 patients who underwent mandibular molar extraction. Participants were divided into two clinical groups of 10 patients each. In the control group, standard tooth extraction was performed without additional intervention. In the experimental group, following extraction, a PRF clot was placed into the socket and stabilized with guiding sutures. Results. In the experimental group (PRF application), patients reported only mild pain in the area of the surgical wound on the first postoperative day, and 70% of them experienced no pain by the third day. In the control group, intraoral examination revealed marginal hyperemia and edema of the oral mucosa at the extraction site in 70% of patients on the first postoperative day. These signs persisted with reduced intensity in 50% of patients by the third day, and slight hyperemia of the socket margins remained in some cases on the fifth day of observation. In contrast, among patients in the experimental group, signs of marginal hyperemia and edema were observed in only 40% of cases on the first day and had decreased to 20% by the third day. Conclusion. The use of PRF clot during standard mandibular molar extraction enhances postoperative wound healing, reduces local clinical signs of inflammation, improves patient comfort, and contributes to a shorter duration of temporary disability.

ObjectivePeriacetabular osteotomy (PAO) is an effective treatment for hip dysplasia in adults, often performed in working-age patients. This study investigates return to work after PAO, focusing on work disability duration and job changes.MethodsWe retrospectively analyzed 108 patients who underwent PAO between January 2015 and June 2017. Work-related data included preoperative occupation, work disability duration, and job changes. Occupations were classified as white-collar, blue-collar, grey-collar, or student. Radiological parameters (LCE, TA, FHEI) and functional scores (iHOT-12, SHV, HOOS Function & Daily Living) were assessed pre- and postoperatively.ResultsAfter PAO, 68.6% of patients returned to their original job, while 27.1% changed professions. The mean duration of work disability among patients who did not change jobs was 26.6 weeks (standard deviation: 34.9; range: 2–208 weeks). Patients with white-collar jobs had the shortest duration of work disability, averaging 16.4 weeks (standard deviation: 13.2; range: 2–78 weeks). Grey-collar jobs showed a mean disability duration of 36.6 weeks (standard deviation: 36.2; range: 6–130 weeks), whereas patients with blue-collar jobs had the longest work disability duration (mean: 54.8 weeks; standard deviation: 64.8; range: 16–208 weeks).Job changes often involved shifts between job categories: 42% of job changes were from blue-collar to white-collar, 33% from blue-collar to grey-collar, and 25% remained within the same category (e.g., blue-collar to blue-collar).Radiological parameters showed significant improvements (e.g., LCE: 16.2° to 29.2°, p < 0.001; FHEI: 0.23 to 0.09, p < 0.001). Pain levels significantly decreased (NRS: 7.2 to 2.2, p < 0.001). Hip-specific function also improved significantly (e.g., iHOT-12: 41.2 to 71.6 points, p < 0.001).ConclusionPAO improves hip function and facilitates work reintegration. Patients in less physically demanding jobs return to work sooner and are more likely to keep their original job. Physically demanding occupations are associated with longer disability periods and a higher likelihood of job changes, often leading to reduced physical workload. These findings help set realistic patient expectations regarding work reintegration after PAO.

To characterize psychotropic medicine utilization and identify its correlates in injured Australian workers with back and neck-related conditions following a workers' compensation claim. Psychotropic medicine utilization (antidepressants, gabapentinoids, anxiolytics, hypnotics/sedatives and antipsychotics) was examined among 22 595 injured workers with accepted claims (2010-2016) in Victoria, Australia, over three years post-claim. The defined daily dose (DDD) per 1000 workers per day was used to describe utilization and temporal trends. Zero-inflated negative binomial regression was employed to identify its determinants. The overall utilization (DDD/1000/day) of psychotropics for all-injured workers was 135.4 (CI: 128.8-142.1), highest for antidepressants (74.2, CI: 70-78.5), followed by gabapentinoids (31.6, CI: 29.7-33.5), anxiolytics (16.1, CI: 14.7-17.6), hypnotics/sedatives (10.6, CI: 9.4-11.8) and antipsychotics (2.9, CI: 2.3-3.4). Workers with longer periods of disability showed increasing utilization across each medicine group and for psychotropic medications overall. Middle age was associated with higher utilization while higher socioeconomic status and living regionally were associated with lower psychotropic utilization. Gabapentinoid utilization (more than doubled (109.2%) from 20.7 in 2010 to 43.3 in 2016. Conversely, anxiolytics and hypnotics/sedatives utilization showed a relative decrease over the study period. The utilization of psychotropics increased among injured workers across the course of their claim. Psychotropic medicine utilization in compensated Australian workers with back or neck conditions was high, particularly in those with longer disability duration. Psychotropic prescribing has changed over time, with a notable increase in gabapentinoid utilization. Furthermore, a trend indicating long-term or higher-dose use of psychotropics was observed, raising concerns of potential overuse.

The implementation of a set of rehabilitation measures in accordance with the individual rehabilitation and habilitation program (IRHP) is one of the key tasks of medical institutions and social service organizations. The effectiveness of the rehabilitation can be judged both by the results of repeated examinations and by the subjective assessment of the quality of life by the disabled in dynamics. The purpose of the work – сomparison of indicators of subjective assessment of the health of disabled people depending on the duration of disability, prescribed and received rehabilitation measures in accordance with the IHRP. Materials and methods: From January to March 2025, a retrospective analytical descriptive study was conducted. The inclusion group consisted of 324 disabled people and disabled children with socially significant diseases, who had previously taken part in a survey on satisfaction with rehabilitation measures and subjective assessment of their health and quality of life. In the framework of this study, the respondents' information on the group and terms of disability establishment, as well as the assignment of rehabilitation services based on the results of medical and social examination were analyzed by extracting from the AIS "Electronic Social Register of the Population of St. Petersburg". Results and discussion: The analysis revealed a number of indicators influencing the self-assessment of the health of people with disabilities: life expectancy with disability and refusal of preferential drug provision during the development of the IPRA. The hypotheses about the presence of an association between the patient's subjective assessment of their health and the life expectancy with disability, as well as the association between the patient's subjective assessment of their health using the visual analogue scale (EQ-VAS) and consent to receive preferential provision in the form of medications were statistically confirmed. Conclusion: It is necessary to develop organizational and managerial solutions for working with long-term disabled persons in order to prevent deterioration of the patient's condition, focusing on the need to receive and take medications for prevention further unjustified requests, prevent disability and improve the quality of life of persons with disabilities.