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Factors Associated with Health-Related Quality of Life in Multiple Sclerosis

Published online by Cambridge University Press:  02 December 2014

Wilma M. Hopman ,
Helen Coo ,
Cathy M. Edgar ,
Evelyn V. McBride ,
Andrew G. Day  and
Donald G. Brunet
Wilma M. Hopman
Affiliation:
Clinical Research Centre, Kingston General Hospital
Helen Coo
Affiliation:
Department of Community Health and Epidermiology, Queen's University, Kingston, Ontario, Canada
Cathy M. Edgar
Affiliation:
Multiple Sclerosis Clinic, Kingston General Hospital
Evelyn V. McBride
Affiliation:
Multiple Sclerosis Clinic, Kingston General Hospital
Andrew G. Day
Affiliation:
Clinical Research Centre, Kingston General Hospital
Donald G. Brunet
Affiliation:
Multiple Sclerosis Clinic, Kingston General Hospital
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Abstract

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Background:

Much research has gone into the assessment of function and health-related quality of life (HRQOL) in those with multiple sclerosis (MS). The Medical Outcomes Study 36-item short form (SF-36) has been widely used in this population but current recommendations are that it be supplemented with condition-specific measures such as the MS Quality of Life Inventory (MSQLI) and the MS Functional Composite (MSFC). The goal of the baseline component of this study was the measurement of generic and condition-specific HRQOL, and the identification of factors associated with these outcomes.

Methods:

HRQOL was assessed at the baseline phase of a longitudinal study. Participants completed the assessment during their regularly scheduled clinic visit.

Results:

300 of 387 eligible patients agreed to participate, for a response rate of 77.5%. Age ranged from 22 to 77 years, while duration of MS ranged from 1 to 47 years. Mean SF-36 scores were well below age- and sex-adjusted normative data. Only 240 completed the MSFC component. Higher EDSS, use of support services, pain medications, clinical depression and antidepressant use were associated with poorer HRQOL, while higher income and education were associated with better HRQOL.

Conclusions:

There is a substantial burden of illness associated with MS when compared to normative HRQOL data. This was more pronounced in physically- than in mentally-oriented domains. Assessment of HRQOL provides a valuable complement to the EDSS by providing information about the patient perception of function and HRQOL beyond that which can be obtained by physical assessment alone.

Résumé:

RÉSUMÉ:Contexte:

L'évaluation du fonctionnement et de la qualité de vie reliée à la santé (QVRS) chez les patients atteints de sclérose en plaques (SEP) a fait l'objet de beaucoup de recherches. Le Medical Outcomes Study 36-item short form (SF-36) a été très utilisé chez ces patients. Cependant, on recommande maintenant d'y ajouter des mesures spécifiques à la maladie comme le MS Quality of Life Inventory (MSQLI) et le MS Functional Composite (MSFC). Le but du volet initial de cette étude était de mesurer la QVRS générique et spécifique à la maladie et d'identifier les facteurs associés à ses répercussions.

Méthodes :

La QVRS a été évaluée lors de la phase initiale d'une étude longitudinale. Les participants complétaient l'évaluation pendant leur visite de suivi régulier à la clinique.

Résultats :

300 des 387 patients éligibles ont accepté de participer, soit un taux de participation de 77,5%. Ils étaient âgés de 22 à 77 ans et atteints de la maladie depuis 1 à 47 ans. Les scores SF-36 moyens étaient bien en deçà des données normatives ajustées pour l'âge et le sexe. Seulement 240 patients ont complété la composante MSFC. Un score EDSS plus élevé, l'utilisation de services de soutien, une médication anti-douleur, la dépression clinique et l'utilisation d'antidépresseurs étaient associés à une moins bonne QVRS. Un revenu et un niveau de scolarité plus élevés étaient associés à une meilleure QVRS.

Conclusions :

Il existe un fardeau dû00E0; la maladie qui est substantiel chez les patients atteints de la SEP par rapport aux données normatives sur la QVRS. Ce fardeau était plus lourd dans les domaines axés sur le fonctionnement physique que sur le fonctionnement mental. L'évaluation de la QVRS est un complément précieux au EDSS en fournissant de l'information sur la perception qu'a le patient de son état fonctionnel et de sa QVRS, au-delà de ce qui peut être obtenu par l'évaluation physique seule.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue 2 , May 2007 , pp. 160 - 166
Copyright
Copyright © The Canadian Journal of Neurological 2007

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