Change in disability profile and quality of life in multiple sclerosis patients: a five-year longitudinal study using the Multiple Sclerosis Impact Profile (MSIP) (original) (raw)

Comparison of Health-Related Quality of Life in Patients With Various Types of Multiple Sclerosis

Purpose: Chronic diseases affect patients' Quality of Life (QoL) and even their caregivers. By evaluating the QoL of patients with multiple sclerosis, the undiagnosed problems of the patients can be detected and the appropriate treatment objectives can be determined. This study was conducted to evaluate the QoL in patients with different types of MS. Methods: A total of 314 patients with Multiple Sclerosis (MS) referred to " Society for the support of MS patients " , " Raad Charity and Education complex " , and an outpatient clinic in Tehran during fall and winter 2014-2015 were recruited. All patients completed the 36-Item Short Form questionnaire (SF-36) and Dartmouth Coop Functional Health Assessment/World Organization of National Colleges, Academies and Academic Association of General Practitioners (COOP/ WONCA) functional health assessment charts as self-report. Results: To investigate the research hypothesis and analyzing the results of the two questionnaires, 1-way analysis of variance (ANOVA) was used. The results of the analysis showed a significant difference between the three types of MS (relapsing-remitting, secondary progressive and primary progressive) in the scores of all SF-36 questionnaire subscales. A significant difference was also found between the three types of MS regarding the scores of all charts of COOP/WONCA, except for social support. Then with the use of LSD post hoc test, scores of both questionnaires subscales in these three types of MS were pair-wisely compared. Conclusion: The results showed that the type of MS disease can affect the patients' QoL. Patients with relapsing-remitting MS had the best level of QoL among all others. The COOP/WONCA charts were more sensitive in measuring the differences between the secondary-progressive MS and primary-progressive MS.

Quality of Life in Multiple Sclerosis

Archives of Neurology, 1992

An overall aim of treatment in multiple sclerosis is to lower the negative impact of the disease on functioning and quality of life of patients. Therefore, a measurement of functioning and quality of life should be included in the evaluation of the effectiveness of treatment. The most commonly used quality of life questionnaires, either generic or specific, were presented in this paper,. Information about clinical and functional status is useful in the interpretation of the quality of life assessment results. Because of that, instruments for the assessment of depression, cognitive functions, functional ability and fatigue in multiple sclerosis were also described. Key words: ame li or at ion , di sa bi l it y, f ati gue , M ul ti ple S c ler o si s , Q ua li ty of Life, rehabilitation. Quality of Life in MS patients Quality of Life (QoL) is a multi-dimensional construct which consists of at least three broad domains: physical, mental and social. In the field of medicine researchers and physicians have often used healthrelated quality of life concept which specifically focuses on the impact of an illness and/or treatment on patients' perception of their status of health and on subjective wellbeing or satisfaction with life (Jaracz 2003)[1]. We have described the Quality of Life of post-stroke patients and their caregivers in our first report (JMed&Life 2010;3(3):216-220)[2]. The Quality of Life of patients with Multiple Sclerosis is being described in this next review report. MS can cause a variety of symptoms, including changes in sensation, visual problems, muscle weakness, depression, difficulties in coordination and speech, severe fatigue, cognitive impairment, problems with balance, overheating, and pain. MS will cause impaired mobility and disability in more severe cases. Multiple sclerosis may take several different forms, with new symptoms either occurring in discrete attacks or slowly accruing over time. Between attacks, symptoms may resolve completely, but permanent neurologic problems often persist, especially as the disease advances. Currently, MS does not have a cure, though several treatments are available, that may slow the appearance of new symptoms. MS primarily affects adults, with an age of onset typically between 20 and 40 years old, and is more common in women than in men. The course of MS is difficult to predict, and the disease may, at times, either lie dormant or progress steadily. Several subtypes or patterns of progression, have been described. Subtypes use the past course of the disease in an attempt to predict the future course. Subtypes are important not only for prognosis but also for therapeutic decisions. Individuals with progressive subtypes of MS, particularly the primary progressive subtype, have a more rapid decline in function. In the primary progressive subtype, supportive equipment (such as a wheelchair or standing frame) is often needed after six to seven years. However, when the initial disease course is the relapsingremitting subtype, the average time until such equipment is needed is twenty years. This means that many individuals with MS will never need a wheelchair. There is also a more cognitive impairment in the progressive forms than in the relapsing-remitting MS. The earlier in life MS occurs, the slower disability progresses. Individuals who are older than fifty when diagnosed are more likely to experience a chronic progressive course, with a more rapid progression of disability. Those diagnosed before the age of 35 years old have the best prognosis. Females generally have a better prognosis than males. However, their Patient-Reported

The impact of disease characteristics on multiple sclerosis patients’ quality of life

Epidemiology and Health, 2017

METHODS: This was a crosssectional study, in which 171 patients were enrolled. Healthrelated QoL was assessed using the Persian version of the Multiple Sclerosis Quality of Life54 questionnaire. To measure patients' disability status, we used the Ex panded Disability Status Scale. Other variables included in the study were disease course and relapses of the disease. RESULTS: The average scores for patients' physical and mental QoL were 60.9±22.3 and 59.5±21.4, respectively. In a bivariate analysis, disease course, severity of the disease, and relapses were significantly associated with the physical and mental health composite scores. In a hierarchal regression analysis, disease course, severity of the disease, and relapses were responsible for 38 and 16% of the variance in physical and mental QoL, respectively. It was also observed that relapses were a strong predictor of both physical and mental QoL. CONCLUSIONS: Our results showed that disease characteristics significantly affected both dimensions of QoL. It is therefore suggested that health care providers should be aware of these characteristics of MS to more successfully improve MS patients' QoL.

The impact of disabilities on quality of life in people with multiple sclerosis

Multiple Sclerosis, 2008

Objective People with Multiple Sclerosis (MS) experience lower levels of quality of life (QOL) than people from the general population. We examined the relative impact of MS-related disabilities on QOL. Method Data were obtained from a sample of 530 patients who completed the Multiple Sclerosis Impact Profile (MSIP), a disability measure based on the International Classification of Functioning, Disabilities and Health (ICF) and two generic health-related QOL measures, the Medical Outcome study Short Form Questionnaire (SF-36) and the World Health Organization Quality Of Life-BREF (WHOQOL-BREF). The impact of disabilities on QOL was estimated using hierarchical multiple regression analyses after controlling for the clinical course of MS.

Quality of life and impairment in patients with multiple sclerosis

Journal of Neurology, Neurosurgery & Psychiatry, 2005

Objectives: The aims of this study were to describe the quality of life in patients with multiple sclerosis (MS) given immunological treatment and in those not given immunological treatment and to investigate the relationship between impairment and quality of life. Methods: Twenty nine patients given immunological treatment were matched with the same number of patients not given such treatment. Matching variables were sex, Kurtzke's Expanded Disability Status Scale (EDSS), years since diagnosis, and age (total n = 58). The patients were interviewed using the self-reported impairment checklist and they answered two questionnaires on quality of life, the 36-Item Short-Form Health Survey (SF-36) and the Subjective Estimation of Quality of Life (SQoL). Results: The self-reported impairment checklist captured a more differentiated picture of the patients' symptoms of MS than the EDSS. Health related quality of life was markedly reduced, while the subjective quality of life was less affected. There was a stronger association between self-reported ratings of impairment and health related quality of life on the SF-36 than between impairment and global ratings of quality of life on the SQoL. Subjective quality of life on the SQoL was not directly dependent on impairment expressed in physical limitations. There were no statistically significant differences between the treated and untreated groups. A non-significant trend towards better health related quality of life was found in favour of the treated group with respect to emotional role, physical role, and social function on the SF-36. Conclusions: The self-reported impairment checklist and SF-36 proved to be valuable complements to the well established EDSS in describing the diverse symptoms of MS. Measuring both health related quality of life and subjective wellbeing provides valuable knowledge about the consequences of MS.

Quality of life in multiple sclerosis: The disability and impact profile (DIP)

Journal of Neurology, 1996

Flemish patients with definite multiple sclerosis (MS) were assessed by means of the Disability and Impact Profile (DIP), which is a 2 × 39 item, self-administered questionnaire with assesses a wide range of potentially MS-affected human activities, and also takes into account the subjective perception of disabilities.

Quality of life assessment in patients with multiple sclerosis

Vojnosanitetski pregled, 2009

Multiple sclerosis (MS) is a chronic inflammatory disease of central nervous system. The main physiopatological feature of MS is demyelination. Multiple sclerosis is one of three most common causes of severe disability in youngest people. In patients with MS, apart from complete psychophysical status and objective neurologic status, a subjective perception of symptoms and signs, known as quality of life, must be considered, too. The aim of this study was to estimate a health related quality of life (HRQoL) in patients with multiple sclerosis (MS) and to investigate the correlations between scores of HRQoL and selected demographic and clinical parameters. A cross-sectional study was performed in patients meeting following inclusion criteria: MS diagnosis (McDonald's criteria), age 18-60 years, the Expanded Disability Status Scale (EDSS) < 8, and written informed consent. Exclusion criteria were exacerbation of MS in the last month, any preexisting major chronic illness and/or psychiatric disorders and antidepressive and/or corticosteroid therapy in the last month. The quality of life was measured by a disease specific instrument, MSQoL-54 (The Multiple Sclerosis Quality of Life). The neurological impairment was assessed using the Expended Disability Status Scale (EDSS) and Mini Mental Scale (MMS). The presence and severity of depression was estimated by the Hamilton Depression Rating Scale (HDRS). The presence and severity of fatigue was assessed by the Fatigue Severity Scale (FSS). Statistical analysis included descriptive statistics and correlation analysis. The higher HRQoL score was registered for mental health (56.3 +/- 19.5) than for physical one (51.3 +/- 17.9), which means that physical disability had more important influence on quality of life deterioration comparing to mental health. The highest values of HRQoL were observed in domains of Cognitive Functioning (77.4 +/- 22.5) and Pain (75.7 +/- 25.5). The lowest scores of HRQoL were registered in domains of Role Limitations due to Physical Problems (32.5 +/- 42.0) and Role Limitations due to Emotional Problems (44.6 +/- 47.8). HRQoL scores statistically significantly correlated with natural history of MS, duration of diseases, employment and marriage status of participants. Deterioration in quality of life scores in the most of MSQoL-54 scales and subscales statistically significantly correlated with the presence and severity of physical disability, depression status and fatigue in patients with MS. This study showed that different demographic and clinical parameters had a major influence on HRQoL impairment in the sample of patients with MS.