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Dimitriou N, Bakirtzis C, Nteli E, Nousia A, Siokas V, Malefaki S, Messinis L, El-Wahsh S, Virvidaki IE, Grigoriadis P, Dardiotis E, Nasios G. Adaptation and validation of the Greek version of the Speech Pathology-Specific Questionnaire for Persons with Multiple Sclerosis (SMS). INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 26:59-67. [PMID: 37539484 DOI: 10.1080/17549507.2023.2180094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
PURPOSE The aim of the present study was to adapt and validate the Speech Pathology-Specific Questionnaire for Persons with Multiple Sclerosis (SMS) into the Greek language. METHOD The study sample consisted of 124 people with multiple sclerosis (PwMS) and 50 healthy controls (HCs). All PwMS underwent cognitive assessment using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Both PwMS and HCs completed the SMS, the Eating Assessment tool (EAT-10), the Voice Handicap Index (VHI), and the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39). RESULT Significant difference was found between PwMS and HCs for the EAT-10, SAQOL-39, the total SMS, and the SMS subscales. Discriminant validity analyses revealed a statistically significant difference between PwMS and HCs for the total and subscales SMS. Convergent validity analyses between the total SMS and the SMS subscales, and scores on the BICAMS, EAT-10, SAQOL-39, and VHI in PwMS were significantly correlated, with exception of the SMS Speech/Voice with the Symbol Digit Modalities Test (SDMT) and the Greek Verbal Learning Test-II (GVLT-II). Scores on the EAT-10, SAQOL-39, and VHI in PwMS were also correlated with the total SMS and the SMS subscales in PwMS, HCs, and the total sample. Construct validity analyses revealed that the total SMS and the SMS subscales were significantly correlated with the Expanded Disability Status Scale (EDSS) and years of education, while no associations were found with regards to age, MS subtype (relapsing-remitting MS [RRMS] vs progressive MS [PMS]), disease duration, or sex. The internal consistency of all items was excellent in PwMS and the total sample (Cronbach's alpha was >0.7 after deletion of one item), with the exception of two items, which still fell within the acceptable range (>0.6) for PwMS and the total sample. CONCLUSION The Greek version of the SMS is a reliable and valid patient-reported outcome measure to assess speech-language and swallowing pathology related symptoms in PwMS, and can be used for research and clinical purposes.
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Affiliation(s)
- Nefeli Dimitriou
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Christos Bakirtzis
- B' Department of Neurology, Multiple Sclerosis Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elli Nteli
- B' Department of Neurology, Multiple Sclerosis Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Nousia
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Sonia Malefaki
- Department of Mechanical Engineering and Aeronautics, University of Patras, Patras, Greece
| | - Lambros Messinis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Sarah El-Wahsh
- Communication Sciences and Disorders, School of Health Sciences, The University of Sydney, Australia, and
| | - Ioanna-Eleni Virvidaki
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Aarts J, Saddal SRD, Bosmans JE, de Groot V, de Jong BA, Klein M, Ruitenberg MFL, Schaafsma FG, Schippers ECF, Schoonheim MM, Uitdehaag BMJ, van der Veen S, Waskowiak PT, Widdershoven GAM, van der Hiele K, Hulst HE. Don't be late! Postponing cognitive decline and preventing early unemployment in people with multiple sclerosis: a study protocol. BMC Neurol 2024; 24:28. [PMID: 38225561 PMCID: PMC10789039 DOI: 10.1186/s12883-023-03513-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Up to 65% of people with multiple sclerosis (PwMS) develop cognitive deficits, which hampers their ability to work, participating in day-to-day life and ultimately reducing quality of life (QoL). Early cognitive symptoms are often less tangible to PwMS and their direct environment and are noticed only when symptoms and work functioning problems become more advanced, i.e., when (brain) damage is already advanced. Treatment of symptoms at a late stage can lead to cognitive impairment and unemployment, highlighting the need for preventative interventions in PwMS. AIMS This study aims to evaluate the (cost-) effectiveness of two innovative preventative interventions, aimed at postponing cognitive decline and work functioning problems, compared to enhanced usual care in improving health-related QoL (HRQoL). METHODS Randomised controlled trial including 270 PwMS with mild cognitive impairment, who have paid employment ≥ 12 h per week and are able to participate in physical exercise (Expanded Disability Status Scale < 6.0). Participants are randomised across three study arms: 1) 'strengthening the brain' - a lifestyle intervention combining personal fitness, mental coaching, dietary advice, and cognitive training; 2) 'strengthening the mind' - a work-focused intervention combining the capability approach and the participatory approach in one-on-one coaching by trained work coaches who have MS themselves; 3) Control group-receiving general information about cognitive impairment in MS and receiving care as usual. Intervention duration is four months, with short-term and long-term follow-up measurements at 10 and 16 months, respectively. The primary outcome measure of the Don't be late! intervention study will be HRQoL as measured with the 36-item Short Form. Secondary outcomes include cognition, work related outcomes, physical functioning, structural and functional brain changes, psychological functioning, and societal costs. Semi-structured interviews and focus groups with stakeholders will be organised to qualitatively reflect on the process and outcome of the interventions. DISCUSSION This study seeks to prevent (further) cognitive decline and job loss due to MS by introducing tailor-made interventions at an early stage of cognitive symptoms, thereby maintaining or improving HRQoL. Qualitative analyses will be performed to allow successful implementation into clinical practice. TRIAL REGISTRATION Retrospectively registered at ClinicalTrials.gov with reference number NCT06068582 on 10 October 2023.
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Affiliation(s)
- Jip Aarts
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands.
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
| | - Shalina R D Saddal
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
- MS Center Amsterdam, Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Vincent de Groot
- MS Center Amsterdam, Rehabilitation Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Brigit A de Jong
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Martin Klein
- Medical Psychology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Marit F L Ruitenberg
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Frederieke G Schaafsma
- MS Center Amsterdam, Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Esther C F Schippers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
| | - Menno M Schoonheim
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Bernard M J Uitdehaag
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Sabina van der Veen
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
| | - Pauline T Waskowiak
- Medical Psychology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Guy A M Widdershoven
- Ethics, Law & Medical Humanities, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Karin van der Hiele
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Hanneke E Hulst
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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van Egmond EEA, van der Hiele K, van Gorp DAM, Jongen PJ, van der Klink JJL, Reneman MF, Beenakker EAC, van Eijk JJJ, Frequin STFM, de Gans K, van Geel BM, Gerlach OHH, Hengstman GJD, Mostert JP, Verhagen WIM, Middelkoop HAM, Visser LH. Work difficulties in people with multiple sclerosis: The role of anxiety, depression and coping. Mult Scler J Exp Transl Clin 2022; 8:20552173221116282. [PMID: 36081414 PMCID: PMC9445483 DOI: 10.1177/20552173221116282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 07/08/2022] [Indexed: 11/28/2022] Open
Abstract
Background Symptoms of anxiety and depression affect the daily life of people with multiple sclerosis (MS). This study examined work difficulties and their relationship with anxiety, depression and coping style in people with MS. Methods 219 employed people with MS (median age = 43 years, 79% female) completed questionnaires on anxiety, depression, coping style, demographics and work difficulties, and underwent a neurological examination. Two regression analyses were performed with work difficulties as the dependent variable and either anxiety or depression as continuous independent variables. Coping style, age, gender, educational level, MS-related disability and disease duration were added as additional predictors, as well as interaction terms between coping style and either symptoms of depression or anxiety. Results A significant model was found (F(10,205) = 13.14, p < 0.001, R2 = 0.39) in which anxiety, emotion- and avoidance-oriented coping and MS-related disability were positively related to work difficulties. The analysis of depression resulted in a significant model (F(10,205) = 14.98, p < 0.001, R2 = 0.42) in which depression, emotion- and avoidance-oriented coping and MS-related disability were positively related to work difficulties. None of the interaction effects were significant. Conclusions Work difficulties were positively related to anxiety, depression, emotion- and avoidance-oriented coping and MS-related disability in workers with MS.
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Affiliation(s)
- EEA van Egmond
- Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
- National Multiple Sclerosis Foundation, Rotterdam, the Netherlands
- Department of Care Ethics, University of Humanistic Studies, Utrecht, the Netherlands
| | - K van der Hiele
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
| | - DAM van Gorp
- Department of Care Ethics, University of Humanistic Studies, Utrecht, the Netherlands
| | - PJ Jongen
- MS4 Research Institute, Nijmegen, the Netherlands
- Department of Community & Occupational Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - JJL van der Klink
- Tilburg School of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, Tilburg University, Tilburg, the Netherlands
- Optentia, North West University of South Africa, Vanderbijlspark, South Africa
| | - MF Reneman
- Department of Rehabilitation Medicine, Centre for Rehabilitation, University of Groningen, University Medical Centre Groningen, Haren, the Netherlands
| | - EAC Beenakker
- Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
| | - JJJ van Eijk
- Department of Neurology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, the Netherlands
| | - STFM Frequin
- Department of Neurology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - K de Gans
- Department of Neurology, Groene Hart Hospital, the Netherlands
| | - BM van Geel
- Department of Neurology, NoordWest Ziekenhuisgroep, the Netherlands
| | - OHH Gerlach
- Department of Neurology, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
- Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Neurology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | | | - JP Mostert
- Department of Neurology, Rijnstate Hospital, the Netherlands
| | - WIM Verhagen
- Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
| | - HAM Middelkoop
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
- Department of Neurology & Neuropsychology, Leiden University Medical Centre, Leiden, the Netherlands
| | - LH Visser
- Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
- Department of Care Ethics, University of Humanistic Studies, Utrecht, the Netherlands
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Huygens S, Versteegh M. Modeling the Cost-Utility of Treatment Sequences for Multiple Sclerosis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1612-1619. [PMID: 34711361 DOI: 10.1016/j.jval.2021.05.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/06/2021] [Accepted: 05/14/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Most patients with multiple sclerosis (MS) switch between disease-modifying therapies (DMTs) during their lifetime. Our aim was to develop an MS cost-utility model that takes treatment switching into account to provide a more realistic estimate of treatment benefit than previous models that assume lifetime use of 1 DMT. METHODS A treatment sequence model using a microsimulation framework with a lifetime time horizon and a societal perspective was developed in R. Clinical plausibility and decision rules for switching were defined in consultation with Dutch MS neurologists. The ability of DMTs to prevent relapses and delay disease progression was modeled by applying DMT-specific estimates derived from a network meta-analysis of randomized controlled trials to natural history data. A total of 2 treatment strategies were compared: a first-line DMT sequence (peginterferon-glatiramer-teriflunomide-interferon-beta-dimethyl fumarate) and an escalation DMT sequence (peginterferon-glatiramer-ocrelizumab-natalizumab-alemtuzumab). Scenario analyses explored impact of alternative sources of natural history data, societal versus healthcare perspective, and condition-specific versus generic utilities. Predicted short-term switches (<5 years) were externally validated with Dutch claims data on DMT use. RESULTS Short-term switches predicted by the model compared well with Dutch claims data. Transition from relapsing-remitting MS to secondary progressive MS was delayed by the escalation sequence (24.7 vs 20.3 years on first-line sequence). Model results were sensitive to utility values and medical resource consumption was a large driver of uncertainty. CONCLUSIONS This microsimulation model overcomes the limitation of previous models by modeling treatment sequences. Because it better reflects clinical reality, it facilitates incorporating cost-utility information in clinical guidelines.
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Affiliation(s)
- Simone Huygens
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Matthijs Versteegh
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
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A Greek Validation Study of the Multiple Sclerosis Work Difficulties Questionnaire-23. Healthcare (Basel) 2021; 9:healthcare9070897. [PMID: 34356274 PMCID: PMC8306802 DOI: 10.3390/healthcare9070897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022] Open
Abstract
The Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) is a self-report instrument developed to assess barriers faced by People with Multiple Sclerosis (PwMS) in the workplace. The aim of this study was to explore the psychometric properties of the Greek version of the MSWDQ-23. The study sample consisted of 196 PwMS, all currently working in part- or full-time jobs. Participants underwent clinical examination and cognitive screening with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and completed self-report measures of fatigue, psychological functioning, and quality of life, along with the MSWDQ-23 questionnaire. Confirmatory Factor Analysis (CFA) was performed, and goodness-of-fit measures were used to evaluate construct validity. Convergent validity was checked by correlating MSWDQ-23 scores with study measures. Cronbach's alpha value was produced to assess internal consistency. CFA yielded a model with a fair fit confirming the three-factor structure of the instrument. Higher work difficulties were associated with higher Expanded Disability Status Scale (EDSS) scores, poorer cognitive function, more fatigue, stress, anxiety, and depression, and poorer health status, supporting the convergent validity of MSWDQ-23. Internal consistency (Cronbach's alpha = 0.94) and test-retest reliability (ICC = 0.996, 95%, CI = 0.990-0.998) were excellent. The Greek MSWDQ-23 can be considered a valid patient-reported outcome measure and can be used in interventions aiming to improve the vocational status of PwMS.
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