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Wasem J, Heer Y, Karamasioti E, Muros-Le Rouzic E, Marcelli G, Di Maio D, Braune S, Kobelt G, Dillon P. Cost and Quality of Life of Disability Progression in Multiple Sclerosis Beyond EDSS: Impact of Cognition, Fatigue, and Limb Impairment. PHARMACOECONOMICS - OPEN 2024; 8:665-678. [PMID: 38949748 PMCID: PMC11362420 DOI: 10.1007/s41669-024-00501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND AND OBJECTIVE Understanding the socioeconomic burden of multiple sclerosis (MS) is essential to inform policymakers and payers. Real-world studies have associated increasing costs and worsening quality of life (QoL) with disability progression. This study aims to further evaluate the impact of cognition, fatigue, upper and lower limb function (ULF, LLF) impairments, and disease progression per Expanded Disability Status Scale (EDSS) level, on costs and QoL. METHODS This was a cross-sectional cohort study including 20,988 patients from the German NeuroTransData MS registry from 2009 to 2019. QoL analyses were based on EQ-5D-5L. Cost analyses included indirect/direct medical and non-medical costs. Eight subgroups, ranging from 439 to 1812 patients were created based on presence of measures for disease progression (EDSS), cognition (Symbol Digit Modalities Test [SDMT]), fatigue (Modified Fatigue Impact 5-Item Scale [MFIS-5]), ULF (Nine-Hole Peg Test [9HPT]), and LLF (Timed 25-Foot Walk [T25FW]). Multivariable linear regression assessed the independent effect of each test's score on QoL and costs, while adjusting for EDSS and 12 other confounders. RESULTS Lower QoL was associated with decreasing cognition (p < 0.001), worsening ULF (p = 0.025), and increasing fatigue (p < 0.0001); however, the negative impact of LLF worsening on QoL was not statistically significant (p = 0.54). Higher costs were associated with decreasing cognition (p < 0.001), worsening of ULF (p = 0.0058) and LLF (p = 0.049), and increasing fatigue (p < 0.0001). Each 1-scale-step worsening function of SDMT, MFIS-5, 9HPT, and T25FW scores resulted in €170, €790, €330, and €520 higher costs, respectively. Modeling disability progression based on SDMT, MFIS-5, 9HPT, and T25FW scores as an interaction with EDSS strata found associations with lower QoL and higher costs at variable EDSS ranges. CONCLUSIONS Disease progression in MS measured by 9HPT, SDMT, and MFIS-5 had a significant negative impact on QoL and broad socioeconomic costs independent of EDSS. T25FW had a significant negative association with costs. Cognition, fatigue, ULF, and LLF have stronger impact on costs and QoL in patients with higher EDSS scores. Additional determinants of MS disability status, including SDMT, MFIS-5, 9HPT, and T25FW, should be considered for assessing cost effectiveness of novel therapeutics for MS.
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Affiliation(s)
- Jürgen Wasem
- Faculty of Economics, University of Duisburg-Essen, Essen, Germany
| | - Yanic Heer
- PricewaterhouseCoopers (PwC), Zurich, Switzerland
| | | | | | | | | | | | - Gisela Kobelt
- EHE International, St Moritz, Switzerland
- European Health Economics, Mulhouse, France
| | - Paul Dillon
- F. Hoffmann-La Roche Ltd., Basel, Switzerland
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Dahham J, Hiligsmann M, Kremer I, Khoury SJ, Darwish H, Hosseini H, Hallit S, Evers S, Rizk R. Health-related quality of life and utilities among Lebanese patients with Multiple Sclerosis: A cross-sectional study. Mult Scler Relat Disord 2024; 86:105635. [PMID: 38640585 DOI: 10.1016/j.msard.2024.105635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/29/2024] [Accepted: 04/15/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE This study assessed the Health-Related Quality of Life (HRQoL) and utilities of Multiple Sclerosis (MS) patients in Lebanon using generic and MS-specific QoL instruments, categorized by disease severity, and explored factors associated with HRQoL. METHODS This was a cross-sectional, retrospective HRQoL study collecting data through face-to-face interviews using the EQ-5D-5 L and the Multiple Sclerosis International Quality of Life (MusiQoL) questionnaires. We enrolled Lebanese patients aged ≥18 years, diagnosed with MS for >6 months. Patients were categorized by disease severity using the expanded disability status scale (EDSS) scores: 0-3 (mild MS), 4-6.5 (moderate MS), and 7-9 (severe MS). Bivariate and linear regression analyses were performed to study factors associated with HRQoL. RESULTS A total of 210 patients (mean age: 43.3 years; 65.7 % females) were included. The mean EQ-5D-5 L utility score was 0.74. This score decreased significantly with disease severity (p < 0.001 for the trend): 0.93, 0.60, and 0.32 for mild, moderate, and severe MS, respectively. The mean MusiQoL global index score was 71.33 and was significantly lower for severe MS (58.68), than for moderate (65.23) and mild (77.80), (p < 0.001 for the trend). Higher educational level, lower EDSS scores, and longer disease duration were associated significantly with a higher EQ-5D-5 L utility (R2 = 0.67), while employment, lower EDSS scores, and decrease in cognitive difficulties were associated with better MusiQoL utility (R2 = 0.46). CONCLUSIONS This study reveals a significant and gradual deterioration in HRQoL as MS progresses, resulting in low utility scores for patients with severe MS.
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Affiliation(s)
- Jalal Dahham
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.
| | - Mickaël Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Ingrid Kremer
- Project Manager Value-Based Health Care at Maastro, Maastricht, the Netherlands
| | - Samia J Khoury
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon; Abu-Haidar Neuroscience Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hala Darwish
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon; Hariri School of Nursing, American University of Beirut, Beirut, Lebanon; University of Michigan, Ann Arbor, Michigan, United States
| | - Hassan Hosseini
- Service de Neurologie, Hôpital Henri Mondor, Créteil, France
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O box 446, Jounieh, Lebanon; Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Silvia Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Centre for Economic Evaluations and Machine Learning, Trimbos Institute, Utrecht, the Netherlands
| | - Rana Rizk
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon; Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
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Roheger M, Grothe L, Hasselberg L, Grothe M, Meinzer M. A systematic review and meta-analysis of socio-cognitive impairments in multiple sclerosis. Sci Rep 2024; 14:7096. [PMID: 38528009 PMCID: PMC10963773 DOI: 10.1038/s41598-024-53750-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 02/05/2024] [Indexed: 03/27/2024] Open
Abstract
Socio-cognitive impairment is frequent in multiple sclerosis (MS). However, little is known about the relationship between other potentially relevant clinical symptoms (i.e., cognition, depression, fatigue) and the degree of socio-cognitive impairment, and neural mechanisms underlying socio-cognitive deficits in MS. Therefore, we meta-analytically quantified socio-cognitive impairment in MS. A systematic literature search in MEDLINE Ovid, Web of Science Core Collection, CENTRAL, and PsycInfo was conducted until December 2022. Studies investigating affective or cognitive theory of mind (a/cToM), visual perspective taking (VPT) and social decision making (SDM) in MS patients relative to healthy controls were included. Risk-of-bias (RoB) was assessed using the CLARITY group "Tool for Assessing RoB in Cohort Studies". Mediation analysis investigated the contribution of clinical symptoms to socio-cognitive impairment. In total, n = 8534 studies were screened, 58 were included in the systematic review, 27 in the meta-analyses. Most studies were rated with a moderate RoB. Meta-analyses confirmed impairment of both aToM and cToM in MS patients, with larger effect sizes for aToM. Mediation analysis demonstrated that higher levels of fatigue selectively predicted the degree of cToM impairment. There was insufficient data available to quantify impairment in other socio-cognitive domains. Fourteen structural and functional imaging studies were identified and characterized by substantial heterogeneity. Summarized, this study confirmed substantial socio-cognitive impairment in MS and highlights the potential exacerbating role of comorbid clinical symptoms. We identify several evidence gaps that need to be addressed in future large-scale studies using comprehensive and coordinated assessments of socio-cognitive parameters, potential mediators, and neural correlates.Trial registration: The pre-registered review protocol can be assessed at www.crd.york.ac.uk/PROSPERO/ (ID: CRD42020206225).
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Affiliation(s)
- Mandy Roheger
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
- Ambulatory Assessment in Psychology, Department of Psychology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Lydia Grothe
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
| | - Laura Hasselberg
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
| | - Matthias Grothe
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany.
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
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Foong YC, Merlo D, Gresle M, Zhu C, Buzzard K, Lechner‐Scott J, Barnett M, Taylor B, Kalincik T, Kilpatrick T, Darby D, Dobay P, van Beek J, Hyde R, Butzkueven H, van der Walt A. The Patient-Determined Disease Steps scale is not interchangeable with the Expanded Disease Status Scale in mild to moderate multiple sclerosis. Eur J Neurol 2024; 31:e16046. [PMID: 37584176 PMCID: PMC11235637 DOI: 10.1111/ene.16046] [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: 05/08/2023] [Revised: 07/21/2023] [Accepted: 08/09/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND AND PURPOSE The validity, reliability, and longitudinal performance of the Patient-Determined Disease Steps (PDDS) scale is unknown in people with multiple sclerosis (MS) with mild to moderate disability. We aimed to examine the psychometric properties and longitudinal performance of the PDDS. METHODS We included relapsing-remitting MS patients with an Expanded Disability Status Scale (EDSS) score of less than 4. Validity and test-retest reliability was examined. Longitudinal data were analysed with mixed-effect modelling and Cohen's kappa for concordance in confirmed disability progression (CDP). RESULTS We recruited a total of 1093 participants, of whom 904 had complete baseline data. The baseline correlation between PDDS and EDSS was weak (ρ = 0.45, p < 0.001). PDDS had stronger correlations with patient-reported outcomes (PROs). Conversely, EDSS had stronger correlations with age, disease duration, Kurtzke's functional systems and processing speed test. PDDS test-retest reliability was good to excellent (concordance correlation coefficient = 0.73-0.89). Longitudinally, PDDS was associated with EDSS, age and depression. A higher EDSS score was associated with greater PDSS progression. The magnitude of these associations was small. There was no concordance in CDP as assessed by PDDS and EDSS. CONCLUSION The PDDS has greater correlation with other PROs but less correlation with other MS-related outcome measures compared to the EDSS. There was little correlation between PDDS and EDSS longitudinally. Our findings suggest that the PDDS scale is not interchangeable with the EDSS.
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Affiliation(s)
- Yi Chao Foong
- Department of NeuroscienceCentral Clinical School, Monash UniversityMelbourneVictoriaAustralia
- Alfred HealthMelbourneVictoriaAustralia
- Eastern HealthMelbourneVictoriaAustralia
- Royal Hobart HospitalHobartTasmaniaAustralia
| | - Daniel Merlo
- Department of NeuroscienceCentral Clinical School, Monash UniversityMelbourneVictoriaAustralia
- Eastern HealthMelbourneVictoriaAustralia
| | - Melissa Gresle
- Department of NeuroscienceCentral Clinical School, Monash UniversityMelbourneVictoriaAustralia
- Alfred HealthMelbourneVictoriaAustralia
- Melbourne HealthMelbourneVictoriaAustralia
| | - Chao Zhu
- Department of NeuroscienceCentral Clinical School, Monash UniversityMelbourneVictoriaAustralia
| | - Katherine Buzzard
- Eastern HealthMelbourneVictoriaAustralia
- Melbourne HealthMelbourneVictoriaAustralia
| | - Jeannette Lechner‐Scott
- The University of NewcastleNewcastleNew South WalesAustralia
- Hunter New England HealthNewcastleNew South WalesAustralia
| | - Michael Barnett
- Brain and Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Sydney Neuroimaging Analysis CentreCamperdownNew South WalesAustralia
| | - Bruce Taylor
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Tomas Kalincik
- Department of Medicine, COReUniversity of MelbourneMelbourneVictoriaAustralia
- Department of NeurologyNeuroimmunology Centre, Royal Melbourne HospitalMelbourneVictoriaAustralia
| | - Trevor Kilpatrick
- Department of NeurologyNeuroimmunology Centre, Royal Melbourne HospitalMelbourneVictoriaAustralia
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - David Darby
- Department of NeuroscienceCentral Clinical School, Monash UniversityMelbourneVictoriaAustralia
- Alfred HealthMelbourneVictoriaAustralia
- Eastern HealthMelbourneVictoriaAustralia
| | | | | | | | - Helmut Butzkueven
- Department of NeuroscienceCentral Clinical School, Monash UniversityMelbourneVictoriaAustralia
- Alfred HealthMelbourneVictoriaAustralia
| | - Anneke van der Walt
- Department of NeuroscienceCentral Clinical School, Monash UniversityMelbourneVictoriaAustralia
- Alfred HealthMelbourneVictoriaAustralia
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Sharifi N, Kohpeima Jahromi V, Zahedi R, Aram S, Ahmadi M. Social stigma and its relationship with quality of life in multiple sclerosis patients. BMC Neurol 2023; 23:408. [PMID: 37978455 PMCID: PMC10655432 DOI: 10.1186/s12883-023-03395-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 09/17/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is the most prevalent disease of the central nervous system that affects the behavioral characteristics and lifestyle of patients. This study aimed to determine the social stigma and its relationship with quality of life in people with MS referring to the Jahrom MS Association. METHOD This cross-sectional study was conducted on MS patients who are members of the MS Association of Jahrom City in Fars province, southern Iran in 2022. The samples were selected by census method. The number of participants remain 223 people. The data was collected using a standard two-part demographic and Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaire and a researcher-made 20-question Social stigma questionnaire which validity and reliability were measured. Data analysis was done in a descriptive way (frequency, percentage, mean and standard deviation), univariate regression and multivariable linear regression. Data analysis was done using SPSS version 17 and at a significance level of less than 0.05. RESULT Based on univariate regression, marriage [B = 0.2, p-value = 0.004], physical health [B = 0.4, p-value < 0.001], emotional well-being [B = 0.4, p-value = 0.001], cognitive functioning [B = 0.4, p-value < 0.001], health distress [B = 0.5, p-value < 0.001] had a positive and significant relationship with patients' quality of life. Duration of disease [B=-0.2, p-value < 0.001], physical role limitations [B=-0.4, p-value < 0.001], emotional role limitations [B=-0.5, p-value < 0.001], pain [B=-0.4, p-value < 0.001], energy [B=-0.3, p-value = 0.02], health perception [B=-0.3, p-value = 0.001], social functioning [B=-0.4, p-value < 0.001], sexual function [B=-0.3, p-value < 0.001], change in health [B=-0.3, p-value < 0.001], sexual function satisfaction [B=-0.3, p-value < 0.001] and social stigma [B=-0.3, p-value < 0.001] had a negative and significant relationship with patients' quality of life (p < 0.05). CONCLUSION The study has emphasized the relationship between the extent and severity of symptoms and disorders with the quality of life of people with MS. The results of the study showed factors such as marriage, physical health and health distress have a positive relationship and factors like duration of disease, physical role limitations, and social stigma have a negative relationship with the quality of life of people with MS. The quality of life of people with MS is more influenced by mental and psychological factors than the physical limitations of these patients.
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Affiliation(s)
- Nader Sharifi
- Department of Public Health, Khomein University of Medical Sciences, Khomein, Iran
| | - Vahid Kohpeima Jahromi
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Razieh Zahedi
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Shabnam Aram
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Maryam Ahmadi
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
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Karpuz Seren B, Acikgoz M, Piri Cinar B, Aciman Demirel E, Celebi U, Atasoy HT. The relationship between alexithymia, reading the mind in the eyes and cognition in patients with multiple sclerosis. Mult Scler Relat Disord 2022; 68:104196. [PMID: 36223703 DOI: 10.1016/j.msard.2022.104196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 08/29/2022] [Accepted: 09/25/2022] [Indexed: 12/15/2022]
Abstract
AIM The purpose of this study was to determine the frequency of alexithymia, difficulty in recognizing one's own and others' emotions, to determine the ability to read the mind in the eyes that evaluates the emotions of others, and to assess the relationship between these parameters and demographic characteristics, cognition, anxiety and depression in people with multiple sclerosis (PwMS). MATERIAL AND METHOD Seventy patients presenting to the neurology clinic and diagnosed with MS and 70 healthy volunteers with similar demographic characteristics were included in the study. The California Verbal Learning Test II (CVLT II), Symbol Digit Modalities Test (SDMT), Revised Brief Visuospatial Memory Test (BVMT-R), and Trail-Making Test (TMT) were applied to determine all participants' cognitive status. All participants were also administered Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Toronto Alexithymia Scale-20 (TAS-20), Reading the Mind in the Eyes Test (RMET), Fatigue Impact Scale (FIS) and Short Form 36 Health Survey (SF-36) for quality of life. RESULTS Alexithymia levels were higher in the PwMS than in the control group, 24.2% of the PwMS and 4.2% of the control group being alexithymic. The PwMS group exhibited poorer performance on all cognitive tests and in BDI, BAI, FIS and SF-36 scale scores than the control group. No difference was determined between the groups' RMET scores. Depression and anxiety levels increased in line with alexithymia levels in the PwMS group, while RMET scores decreased. No association was determined between alexithymia levels and age, sex, duration of disease, degree of disability, cognition, or fatigue. RMET scores were not affected by age, sex, duration of disease, degree of disability, anxiety, or fatigue, but were lower among individuals with poor cognition and in depressive patients. CONCLUSION Neuropsychiatric symptoms have been the subject of considerable research in MS in recent years and these clinical characteristics in patients have begun being closely monitored. PwMS are capable of experiencing difficulty in identifying emotions in themselves and others, and their social lives can be affected. In addition, the fact that this exhibits an association with cognition based on RMET is particularly noteworthy.
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Affiliation(s)
- Burcu Karpuz Seren
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
| | - Mustafa Acikgoz
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey.
| | - Bilge Piri Cinar
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
| | - Esra Aciman Demirel
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
| | - Ulufer Celebi
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
| | - Hüseyin Tugrul Atasoy
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
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Eshaghzadeh S, Abbaspour S, Sarboozi-hoseinabadi T, Eshaghzadeh M, Tatari M, Ramezani Nezhad M, Saravani H, Hamidi R, Aghabeigi A, Rahimi S, Sarmadi M. Quality of Life and Cognitive Emotion Regulation Strategies in Multiple Sclerosis Patients. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022. [DOI: 10.1007/s10942-022-00474-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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8
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Vitturi BK, Rahmani A, Dini G, Montecucco A, Debarbieri N, Bandiera P, Battaglia MA, Manacorda T, Persechino B, Buresti G, Ponzio M, Inglese M, Durando P. Spatial and temporal distribution of the prevalence of unemployment and early retirement in people with multiple sclerosis: A systematic review with meta-analysis. PLoS One 2022; 17:e0272156. [PMID: 35901070 PMCID: PMC9333213 DOI: 10.1371/journal.pone.0272156] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background We aimed to summarise the prevalence of unemployment and early retirement among people with MS and analyze data according to a spatio-temporal perspective. Methods We undertook a systematic search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect, and Web of Science. We included any peer-reviewed original article reporting the prevalence of unemployment and early retirement in the working-age population with MS. We excluded articles off-topic, with other study designs, whose study sample were unlikely to be representative of the MS population and in case of unavailability of the full text or essential information. A random-effects meta-analysis was used to measure overall prevalence estimates of unemployment and early retirement. We used meta-regression and subgroup analysis to evaluate potential moderators of prevalence estimates and the leave-one-out method for sensitivity analyses. Results Our research identified 153 studies across 29 countries encompassing 188436 subjects with MS. The pooled overall effect size for unemployment and early retirement was 35.6% (95% CI 32.8–38.4; I2 = 99.31) and 17.2% (95% CI 14.6–20.2; I2 = 99.13), respectively. The prevalence of unemployment varied according to the year of publication (p < 0.001) and there was a statistically significant decrease in the prevalence of unemployment over time (p = 0.042). Regarding early retirement, only seven (31.8%) estimates obtained from studies that were published before 2010 were below the overall effect size in comparison to 27 (60.0%) estimates extracted from data published between 2010 and 2021 (p = 0.039). There was a significant difference in prevalence according to countries (p < 0.001). Psychiatric illness was an important clinical feature responsible for patients leaving the workforce in regions with a high MS prevalence. Conclusions Unemployment and early retirement due to MS remain highly prevalent, despite a slight decline in the last decade. The prevalence of unemployment and early retirement varies globally.
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Affiliation(s)
| | - Alborz Rahmani
- Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy
| | - Guglielmo Dini
- Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy
| | - Alfredo Montecucco
- Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy
| | - Nicoletta Debarbieri
- IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy
| | - Paolo Bandiera
- Italian Multiple Sclerosis Association (AISM), Genoa, Italy
| | - Mario Alberto Battaglia
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
- Department of Life Science, University of Siena, Siena, Italy
| | - Tommaso Manacorda
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | | | | | - Michela Ponzio
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Matilde Inglese
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy
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9
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Papeix C, Castelnovo G, Leray E, Coustans M, Levy P, Visy JM, Kobelt G, Lamy F, Allaf B, Heintzmann F, Chouette I, Raponi E, Durand B, Grevat E, Kamar D, Debouverie M, Lebrun-Frenay C. Long-Term Effectiveness, Safety and Tolerability of Fingolimod in Patients with Multiple Sclerosis in Real-World Treatment Settings in France: The VIRGILE Study. Neurol Ther 2022; 11:633-658. [PMID: 35147904 PMCID: PMC9095796 DOI: 10.1007/s40120-022-00334-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 01/28/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction It is important to confirm the effectiveness and tolerability of disease-modifying treatments for relapsing–remitting multiple sclerosis (RRMS) in real-world treatment settings. This prospective observational cohort study (VIRGILE) was performed at the request of the French health authorities. The primary objective was to evaluate the effectiveness of fingolimod 0.5 mg in reducing the annualised relapse rate (ARR) in patients with RRMS. Methods Participating neurologists enrolled all adult patients with RRMS starting fingolimod treatment between 2014 and 2016, who were followed for 3 years. Follow-up consultations took place at the investigator’s discretion. The primary outcome measure was the change in ARR at month 24 after fingolimod initiation. Relapses and adverse events were documented at each consultation; disability assessment (EDSS) and magnetic resonance imagery were performed at the investigator’s discretion. Results Of 1055 eligible patients, 633 patients were assessable at month 36; 405 (64.0%) were treated continuously with fingolimod for 3 years. The ARR decreased from 0.92 ± 0.92 at inclusion to 0.31 ± 0.51 at month 24, a significant reduction of 0.58 [95% CI − 0.51 to − 0.65] relapses/year (p < 0.001). Since starting fingolimod, 461 patients (60.9%) remained relapse-free at month 24 and 366 patients (55.5%) at month 36. In multivariate analysis, no previous disease-modifying treatment, number of relapses in the previous year and lower EDSS score at inclusion were associated with a greater on-treatment reduction in ARR. The mean EDSS score remained stable over the course of the study. Sixty-one out of 289 (21.1%) patients presented new radiological signs of disease activity. Treatment-related serious adverse events were lymphopenia (N = 21), bradycardia (N = 19), elevated transaminases (N = 9) and macular oedema (N = 9). Conclusions The effectiveness and tolerability of fingolimod in everyday clinical practice are consistent with findings of previous phase III studies. Our study highlights the utility of fingolimod for the long-term management of patients with multiple sclerosis. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-022-00334-y.
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Affiliation(s)
- Caroline Papeix
- Département de Neurologie, Hôpital de la Pitié Salpêtrière, APHP 6, 83 Boulevard de l'Hôpital, 75013, Paris, France.
| | | | | | - Marc Coustans
- Service de Neurologie, Hôpital Laënnec, Quimper, France
| | - Pierre Levy
- LEDa, LEGOS, Université Paris-Dauphine, PSL Research University, Paris, France
| | | | | | | | | | | | | | - Eric Raponi
- Novartis Pharma S.A.S., Rueil-Malmaison, France
| | | | | | - Driss Kamar
- Ividata Life Science, Levallois-Perret, France
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10
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Faraclas E, Lynn J, Lau JD, Merlo A. Health-Related Quality of Life in people with Multiple Sclerosis: How does this Population Compare to Population-based Norms in Different Health Domains? J Patient Rep Outcomes 2022; 6:12. [PMID: 35107657 PMCID: PMC8810961 DOI: 10.1186/s41687-022-00415-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 01/14/2022] [Indexed: 01/22/2023] Open
Abstract
PURPOSE The purposes of this investigation were to (1) identify the domains of health-related quality of life most impacted in people with RRMS, (2) compare the health-related QOL in people with RRMS to general population norms, and (3) to describe subgroups within the RRMS population that have similar health and wellness needs. METHODS This was a cross-sectional QOL investigation of adults with RRMS. The SF-36v2 survey and demographic information were collected electronically via Qualtrics. Participants (n = 120) were recruited through social media and the National Multiple Sclerosis Society of the United States. One-sample Z-tests were completed for all subscales, and component mean scores to determine if a difference between the sample and population norms existed. RESULTS All values of z were statistically significant, p < .01, for all subscale and composite scores. Social function, physical function, and the mental health component scores had the lowest subscale means. A first stage depression screen revealed that 49% of the surveyed population were at risk for depression, compared to 18% in the general population. Further dividing the sample into years since MS diagnosis, the recently diagnosed group had 61% at risk for depression. CONCLUSIONS Challenges related to the mental health of individuals with RRMS are influencing overall health-related QOL. Early on in the disease course (0-3 years), mental health affected QOL more than physical health. More attention must be given to the nonphysical domains of health to advance the QOL for people with RRMS.
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Affiliation(s)
- Erin Faraclas
- Doctor of Philosophy in Health Sciences Program, Rocky Mountain University of Health Professions, Provo, UT, USA.
- Doctor of Physical Therapy Program, Massachusetts College of Pharmacy and Health Sciences, Worcester, MA, USA.
| | - Jeff Lynn
- Slippery Rocky University, Slippery Rock, PA, USA
| | - Jeffery D Lau
- Doctor of Physical Therapy Program, Rocky Mountain University of Health Professions, Provo, UT, USA
| | - Angela Merlo
- Department of Physical Therapy, Eastern Washington University, Spokane, WA, USA
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11
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Kane A, Thompson NR, Sullivan AB. Assessment of Computer Assisted Rehabilitation Environment (CAREN) System Use and Mood in Patients with Multiple Sclerosis. Int J MS Care 2021; 24:63-66. [DOI: 10.7224/1537-2073.2020-131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
Background: Depression is a common comorbidity in patients with multiple sclerosis (MS) and is associated with decreased quality of life. Identifying treatments that aid psychological and physical rehabilitation in patients with MS provides valuable information for interdisciplinary teams.
Methods: Seventy-five adults with MS who completed the Patient Health Questionnaire-9 (PHQ-9) and Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health scale during routine physical therapy appointments where the (CAREN) system was used were studied. Data were retrospective and collected via patient-reported outcomes. Group comparisons used two-sample t tests or Mann-Whitney U tests for continuous variables and Fisher exact tests for categorical variables. To examine self-reported depression, mean ± SD baseline scores were computed and stratified by number of CAREN sessions.
Results: Patients with five or more sessions seemed to have lower baseline PHQ-9 and PROMIS Mental Health scores; however, no significant differences were found at the univariate level. There were no statistically significant differences in follow-up scores for the outcome measures.
Conclusions: Current research evaluating the rehabilitation of patients with MS using the CAREN system is scarce. This pilot study is important to inform prospective studies exploring use of the CAREN system for psychological rehabilitation. Patients with five or more CAREN sessions had lower baseline PHQ-9 scores, which may suggest that mood plays a role in the selection of patients for CAREN system use. This study shows that mood is not affected by the CAREN system. More specific research needs to be completed with a more robust sample.
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Affiliation(s)
- Alexa Kane
- From the Mellen Center for Multiple Sclerosis (AK, ABS), Department of Qualitative Health Sciences (NRT), and Neurological Institute Center for Outcomes Research and Evaluation (NRT), Cleveland Clinic, Cleveland, OH, USA
| | - Nicolas R. Thompson
- From the Mellen Center for Multiple Sclerosis (AK, ABS), Department of Qualitative Health Sciences (NRT), and Neurological Institute Center for Outcomes Research and Evaluation (NRT), Cleveland Clinic, Cleveland, OH, USA
| | - Amy B. Sullivan
- From the Mellen Center for Multiple Sclerosis (AK, ABS), Department of Qualitative Health Sciences (NRT), and Neurological Institute Center for Outcomes Research and Evaluation (NRT), Cleveland Clinic, Cleveland, OH, USA
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12
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Abdulla FA, Albagmi FM, Al-Khamis FA. Factors that influence quality of life in patients with multiple sclerosis in Saudi Arabia. Disabil Rehabil 2021; 44:4775-4783. [PMID: 33966564 DOI: 10.1080/09638288.2021.1919929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To study the factors which may contribute to quality of life (QOL) in patients with multiple sclerosis (pwMS) in Saudi Arabia. METHODS 175 pwMS and 71 age-, gender-, and BMI-matched healthy subjects participated in this cross-sectional study. QOL was studied by the multiple sclerosis quality of life-54 (MSQOL-54) while depression, disability, and fatigue were measured by the beck depression inventory-II (BDI-II), the expanded disability status scale (EDSS), and the modified fatigue impact scale (MFIS), respectively. The effects of demographic and clinical characteristics on MSQOL-54 were studied. RESULTS QOL was worse in pwMS. A better QOL in pwMS was linked to being male, having relapsing-remitting MS, having lower BMI, being employed, having a low disability, having no or minimal depression, and not fatigued. Age, disease duration, marital status, living status, and level of education did not affect the QOL. QOL showed a moderate to strong correlation with depression and fatigue and a weak correlation with EDSS. Depression and fatigue were the strongest predictors of QOL. Other predictors included gender and BMI but not EDSS. CONCLUSIONS Many of the factors which seem to influence QOL in pwMS are modifiable. Evaluation and management of such factors may improve QOL in pwMS.Implications for rehabilitationAssessment of QOL (using a proper tool) should be part of every pwMS evaluation.Depression and fatigue are the main predictors of QOL in pwMs, therefore, attention should be paid for their evaluation and management.Sexual dysfunction and pain should be assessed and managed early in the course of the disease.
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Affiliation(s)
- Fuad A Abdulla
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Department of Neuroscience, Institute for Research and Medical Consultation, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal M Albagmi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahd A Al-Khamis
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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13
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Özkeskin M, Özden F, Bakırhan S, Yüceyar N. Cross-cultural adaptation, reliability, and validity of the Turkish version of the SymptoMScreen. Mult Scler Relat Disord 2021; 50:102803. [DOI: https:/doi.org/10.1016/j.msard.2021.102803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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14
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Silveira SL, Cederberg KLJ, Jeng B, Sikes EM, Sandroff BM, Jones CD, Motl RW. Symptom clusters and quality of life in persons with multiple sclerosis across the lifespan. Qual Life Res 2021; 30:1061-1071. [PMID: 33155152 PMCID: PMC8005422 DOI: 10.1007/s11136-020-02689-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE To describe symptom clusters based on severity of co-occurring symptoms among adults with multiple sclerosis (MS) by age groups and to further examine symptom clusters as a correlate of quality of life (QOL) by age groups. METHODS This cross-sectional study enrolled persons with MS between 20 and 79 years of age who completed measures of fatigue, depression, anxiety, sleep quality, and QOL using the 36-Item Short Form Health Survey. Bivariate correlation and partial correlation analyses examined associations among symptoms, QOL, and MS characteristics. K-means cluster analyses determined symptom clusters among the full sample and pre-determined age groups (i.e., 20-39, 40-59, and 60-79). One-way ANOVAs examined differences in QOL among clusters for the overall sample and by age groups. RESULTS Among the overall sample of 205 participants, symptoms were significantly correlated with QOL and three distinct clusters were identified and differentiated by the magnitude of symptom experience (i.e., mild, moderate, and severe). Results were consistent among young and middle-aged adults; however, among older adults two severe sleep problem clusters were identified that were distinguished by moderate versus severe fatigue, depression, and anxiety. ANOVAs among the overall sample indicated that the three symptom clusters varied significantly for both physical component scores, F(2, 202) = 12.03, p < .001, η2 = .10, and mental component scores, F(2, 202) = 137.92, p < .001, η2 = .58; severe symptom cluster was associated with worse QOL. Patterns in the age subgroup ANOVAs were consistent. CONCLUSIONS Given the strong association between severity of symptom clusters and QOL, approaches for targeting co-occurring symptoms are critically needed.
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Affiliation(s)
- Stephanie L Silveira
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA.
| | - Katie L J Cederberg
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - Brenda Jeng
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - E Morghen Sikes
- Department of Occupational Therapy, Shenandoah University, Winchester, VA, USA
| | - Brian M Sandroff
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - Catherine D Jones
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
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David Ruban S, Christina Hilt C, Petersen T. Quality of life in multiple sclerosis: The differential impact of motor and cognitive fatigue. Mult Scler J Exp Transl Clin 2021; 7:2055217321996040. [PMID: 33708414 PMCID: PMC7907948 DOI: 10.1177/2055217321996040] [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: 11/04/2020] [Revised: 01/07/2021] [Accepted: 01/30/2021] [Indexed: 01/22/2023] Open
Abstract
Background Multiple sclerosis is a chronic disease leading to reduced quality of
life. Objectives To investigate whether motor and cognitive fatigue impact differently on
aspects of quality of life among patients with multiple sclerosis,
independently from bodily disability. Methods 79 patients with multiple sclerosis from Aalborg University Hospital, Denmark
were included in an observational, cross-sectional study. Each subject
completed two separate questionnaires regarding fatigue (Fatigue Scale for
Motor and Cognitive Functions and Modified Fatigue Impact Scale) and one
regarding quality of life (Short Form 36). Disability was measured with the
Expanded Disability Status Scale (EDSS)-scores obtained from patient
records. Results All fatigue scores were significantly correlated to all areas of quality of
life (p < 0,05). This remained significant after adjustment for age,
disease duration and EDSS-score. When looking at each type of fatigue
separately, cognitive fatigue correlated mainly with mental health aspects
of quality of life and motor fatigue with physical health areas of quality
of life. Conclusion Increased motor and cognitive fatigue lead to a differential reduction in
physical and mental quality of life, independently of bodily disability.
This underlines the importance of proper assessment and treatment of fatigue
among patients with multiple sclerosis.
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Affiliation(s)
- Sabina David Ruban
- Department of Neurology, Aalborg University Hospital, Aalborg, Denmark.,Faculty of Health, Aarhus University, Aarhus, Denmark
| | | | - Thor Petersen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
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Özkeskin M, Özden F, Bakırhan S, Yüceyar N. Cross-cultural adaptation, reliability, and validity of the Turkish version of the SymptoMScreen. Mult Scler Relat Disord 2021; 50:102803. [PMID: 33561665 DOI: 10.1016/j.msard.2021.102803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The study aimed to translate and cross-culturally adapt the SymptoMScreen into Turkish and evaluate its reliability and validity. METHODS One hundred nine MS patients were included in the study. SymptoMScreen was translated into Turkish according to the standardized guidelines and cross-culturally adapted. For construct validity, SymptoMScreen was compared with the Expanded Disability Status Scale (EDSS), Multiple Sclerosis-Related Symptom Checklist (MS-RS), and Beck Depression Scale (BDS) by Spearman's correlation coefficient. Thirty patients refilled SymptoMScreen one week later, and the test-retest reliability was analyzed by the Intraclass Correlation Coefficient (ICC). Internal consistency was evaluated with Cronbach's alpha coefficient. The standard error of measurement (SEM95) and the minimum detectable change (MDC95) were calculated. RESULTS Test-retest reliability and internal consistency of the SymptoMScreen were excellent (ICC = 0.925, α = 0.914). SEM95 and MDC95 were 3.28 and 9.29, respectively. There was a strong correlation between the SymptoMScreen with the MS-RS and EDSS (r1= 0.908, p < 0.00; r2= 0.511, p < 0.001). Besides, the SymptoMScreen was moderately correlated with BDS (r = 0.584, p < 0.001). CONCLUSION The Turkish version of the SymptoMScreen is a reliable and valid questionnaire for multiple sclerosis patients.
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Affiliation(s)
- Mehmet Özkeskin
- Ege University, Faculty of Health Sciences, Physical Therapy and Rehabilitation Department, İzmir, Turkey
| | - Fatih Özden
- Muğla Sıtkı Koçman University, Köyceğiz Vocational School of Health Services, Elderly Care Department, Muğla, Turkey
| | - Serkan Bakırhan
- Ege University, Faculty of Health Sciences, Physical Therapy and Rehabilitation Department, İzmir, Turkey
| | - Nur Yüceyar
- Ege University, Faculty of Medicine, Department of Neurology, İzmir, Turkey.
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Boyko OV, Choroshilova II, Petrov SV, Melnikov MV, Boyko AN. [Changes in the quality of life in patients with multiple sclerosis treated with ocrelizumab]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 119:120-127. [PMID: 31934997 DOI: 10.17116/jnevro201911910120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIM To study the quality of life (QoL) in patients with multiple sclerosis (MS) treated with ocrelizumab for at least 12 months. MATERIAL AND METHODS Thirty-eight patients were observed, including 13 with primary progressive MS (PPMS), 15 with highly active relapsing-remitting MS (HAMS) and 10 with secondary progressive MS (SPMS) with relapses. QoL was studied using unspecific SF-36 and MS-specific MusiQoL questionnaires. Depression and fatigue were assessed with the Beck Depression Scale (BDS) and the Modified Fatigue Impact Scale (MFIS). RESULTS AND CONCLUSION Basic characteristics of QoL indexes of the patients were similar to those previously reported for these MS variants. After 6 and 12 months, a significant increase in the indexes of the majority of SF-36 and MusiQoL scales was identified that shows a significant improvement in both physical and psychological domains of QoL. The significant and rapid decrease in depression severity after 6-month treatment with ocrelizumab may at least in part be associated with improvement of indexes of vitality, general health, social relations and the total QoL score.
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Affiliation(s)
- O V Boyko
- Pirogov's Russian Science Research Medical University, Moscow, Russia; Yusupov Hospital, 'Neuro-Clinica', Moscow, Russia; Federal Center of Cerebrovascular Pathology and Stoke, Moscow, Russia
| | | | - S V Petrov
- Yusupov Hospital, 'Neuro-Clinica', Moscow, Russia
| | - M V Melnikov
- Pirogov's Russian Science Research Medical University, Moscow, Russia; Federal Center of Cerebrovascular Pathology and Stoke, Moscow, Russia
| | - A N Boyko
- Pirogov's Russian Science Research Medical University, Moscow, Russia; Yusupov Hospital, 'Neuro-Clinica', Moscow, Russia; Federal Center of Cerebrovascular Pathology and Stoke, Moscow, Russia
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18
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Farran N, Safieddine BR, Bayram M, Abi Hanna T, Massouh J, AlKhawaja M, Tamim H, Darwish H. Factors affecting MS patients' health-related quality of life and measurement challenges in Lebanon and the MENA region. Mult Scler J Exp Transl Clin 2020; 6:2055217319848467. [PMID: 31976081 PMCID: PMC6956607 DOI: 10.1177/2055217319848467] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/01/2019] [Accepted: 04/07/2019] [Indexed: 11/17/2022] Open
Abstract
Background In the Middle East and North Africa (MENA) region, few studies explored the quality of life of multiple sclerosis patients and the factors affecting it. Objective The objective of this study was to explore studies on multiple sclerosis quality of life in the MENA area through a comprehensive literature review. To validate the Multiple sclerosis international Quality of Life (MusiQoL) and Modified Fatigue Impact Scale (MFIS) in Arabic, and investigate the impact of sociodemographic and clinical variables of Lebanese multiple sclerosis patients on quality of life. Methods As part of an ongoing observational prospective research study, data from 663 stable multiple sclerosis patients were analysed. Results In Lebanese multiple sclerosis patients, the Arabic MusiQoL and MFIS seem to be accurate and valid tools with high reliability coefficients and confirmatory factor analytic indices. Variables such as age and disease type predicted multiple sclerosis quality of life, yet were significantly affected by psychosocial fatigue. The influence of sociodemographic and clinical variables on quality of life dimensions varied. Being a woman with multiple sclerosis, receiving medications and experiencing physical fatigue worsens the psychological wellbeing quality of life dimension. Conclusion Several sociodemographic and clinical variables predicted the health-related quality of life dimensions of multiple sclerosis patients in MENA. Further in-depth investigation to guide more targeted clinical management is recommended. We encourage using validated multidimensional tools to measure quality of life in MENA such as the Arabic MusiQoL.
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Affiliation(s)
| | | | - Mariam Bayram
- Hariri School of Nursing, American University of Beirut, Lebanon
| | | | - Joelle Massouh
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Lebanon
| | - Mona AlKhawaja
- Neurology Department, King Faisal Specialist Hospital and Research Center, Saudi Arabia
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Center, Lebanon
| | - Hala Darwish
- Hariri School of Nursing, American University of Beirut, Lebanon
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19
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Health-related quality of life in multiple sclerosis: Links to acceptance, coping strategies and disease severity. Disabil Health J 2019; 12:608-614. [DOI: 10.1016/j.dhjo.2019.06.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/04/2019] [Accepted: 06/06/2019] [Indexed: 12/30/2022]
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20
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Malygin VL, Boyko AN, Konovalova OE, Iskandirova AS, Dumbrova EV, Boyko OV, Malygin YV. [Influence of psychopathological factors and personality traits on the results of the study of quality of life in patients with multiple sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:42-48. [PMID: 31156240 DOI: 10.17116/jnevro20191192242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To study the influence of psychopathological factors and personality traits on the results of the study of quality of life (QoL) in patients with multiple sclerosis (MS). MATERIAL AND METHODS Forty-three patients with relapsing MS were included in the study (74.4% female; mean age 33.1 years). SF-36 was used to evaluate QoL. Effects of psychopathological factors, cognitive regulation of emotions and personality traits on QoL were studied. Statistical analysis was performed using multiple linear model. RESULTS AND DISCUSSION A wide number of strategies of cognitive regulation of emotions has conflicting effects on the physical component of QoL; subscales of anhedonic depression and anxious arousal (MASQ), which probably represent depressive and anxiety disorders, decrease the physical component of QoL. The key factors of the mental component of QoL include psychopathological factors (mostly obsessive-compulsive symptoms) and personality traits (the more intense they are the lower is QoL). Strategies of cognitive regulation of emotions have low impact on the mental component of QoL.
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Affiliation(s)
- V L Malygin
- Evdokimov Moscow State University of Medical Dentistry, Moscow, Russia
| | - A N Boyko
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - O E Konovalova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A S Iskandirova
- Evdokimov Moscow State University of Medical Dentistry, Moscow, Russia
| | - E V Dumbrova
- Evdokimov Moscow State University of Medical Dentistry, Moscow, Russia
| | - O V Boyko
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Ya V Malygin
- Pirogov Russian National Research Medical University, Moscow, Russia
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Costa JM, Matos D, Arroja B, Gon�alves R, Soares JB. The main determinants of disability in IBD and its relationship to optimism. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2019; 111:579-585. [DOI: 10.17235/reed.2019.6033/2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Law L, Beckman Rehnman J, Deminger A, Klingberg E, Jacobsson LTH, Forsblad-d'Elia H. Factors related to health-related quality of life in ankylosing spondylitis, overall and stratified by sex. Arthritis Res Ther 2018; 20:284. [PMID: 30587228 PMCID: PMC6307231 DOI: 10.1186/s13075-018-1784-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 12/03/2018] [Indexed: 11/30/2022] Open
Abstract
Background Ankylosing spondylitis (AS) begins early in life and often leads to reduced physical function, but less is known about the impacts it has on health-related quality of life (HRQoL). The aims of this study were to assess HRQoL using the Short Form-36 (SF-36) in a cohort of patients with AS compared with controls and to examine associations between SF-36 scores and spinal radiographic changes, physical function, disease activity and demographic data overall and stratified by sex. Methods A cohort of patients with AS from Western Sweden were assessed using the Modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with spinal radiographs, clinical examination and questionnaires, including the Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP), Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Patient Global (BASG) and SF-36. Each patient’s SF-36 results were compared with those of five age-matched and sex-matched persons (n = 1055) from the SF-36 Swedish normative population database. Associations between SF-36 physical component summary (PCS) and mental component summary (MCS) scores and disease-related and demographic factors were investigated using univariate and multivariable ogistic regression analyses with PCS and MCS below/above their respective median values as dependent variables. Results A total of 210 patients, age (median, IQR) 49.0 (21.2) years, symptom duration 24.0 (21.0) years, men 57.6% and HLAB27 87.1% were included. Patients with AS scored significantly lower (p < 0.001) compared to controls in all SF-36 domains and component summaries; PCS 42.4 (14.5) in AS versus 52.4 (11.8) in controls and MCS 47.9 (20.0) in AS versus 54.1 (10.1) in controls. Both men and women scored significantly lower in PCS compared with MCS. Multivariable logistic regression analyses revealed that living without a partner (OR 2.38, 95% CI 1.00–5.67), long symptom duration (year in decade OR 1.66, 95% CI 1.16–2.37), higher BASFI (OR 1.98, 95% CI 1.46–2.70) and ASDAS ≥ 2.1 (OR 3.32, 95% CI 1.45–7.62) were associated with worse PCS, while living without a partner (OR 3.04, 95% CI 1.34–6.91), fatigue (visual analogue scale for global fatigue greater than the median (OR 6.36, 95% CI 3.06–13.19) and ASDAS ≥ 2.1 (OR 2.97, 95% CI 1.41–6.25) with worse MCS. Some differences between sexes were observed in the results. Conclusions The patients with AS had significantly lower HRQoL compared with controls. PCS was more affected compared to MCS in both sexes. Both disease-related and demographic factors were associated with HRQoL, partly overlapping for PCS and MCS. Factors associated with HRQoL showed some differences between sexes. By modifying factors, such as ASDAS-CRP and fatigue, HRQoL may potentially be improved. Trial registration ClinicalTrials.gov, NCT00858819. Registered on 9 March 2009. Last updated on 28 May 2015. Electronic supplementary material The online version of this article (10.1186/s13075-018-1784-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lucy Law
- Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, 901 87, Umeå, Sweden
| | - Jeanette Beckman Rehnman
- Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, 901 87, Umeå, Sweden
| | - Anna Deminger
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
| | - Eva Klingberg
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
| | - Lennart T H Jacobsson
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
| | - Helena Forsblad-d'Elia
- Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, 901 87, Umeå, Sweden. .,Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden.
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Sex differences in predictors of illness intrusiveness in persons with multiple sclerosis. Qual Life Res 2018; 28:389-397. [DOI: 10.1007/s11136-018-2023-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2018] [Indexed: 12/14/2022]
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O’Mahony J, Marrie RA, Laporte A, Bar-Or A, Yeh EA, Brown A, Dilenge ME, Banwell B. Pediatric-onset multiple sclerosis is associated with reduced parental health–related quality of life and family functioning. Mult Scler 2018; 25:1661-1672. [DOI: 10.1177/1352458518796676] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Diagnosis of multiple sclerosis (MS) during childhood has the potential to impact the affected child’s self-perception and the health-related quality of life (HRQoL) of the family. Objective: To evaluate the impact of chronic disease, in children ascertained as having MS and their families, when compared to those with monophasic acquired demyelinating syndrome (monoADS). Methods: In a national prospective cohort study of pediatric acquired demyelinating syndromes (ADS), the HRQoL of children and their families was captured using the Pediatric Quality of Life Inventory (PedsQL™) Modules. Results: Participants (58 MS; 178 monoADS) provided cross-sectional HRQoL data a median (interquartile range (IQR)) of 4.1 (2.0–6.0) years after disease onset. The HRQoL of parents of children with MS and their family functioning was lower when compared to that of parents and families of children with monoADS (both p < 0.001); parents of children with MS reported greater emotional dysfunction, worry, worse communication, and lower family functioning irrespective of clinical disease activity. Self-reports of the MS and monoADS participants did not suggest a difference in overall HRQoL or fatigue after adjusting for age of the child at the time of assessment. Conclusion: While children with MS did not self-report lower HRQoL compared to children who experienced monoADS, the diagnosis of MS during childhood was negatively associated with parental HRQoL and family functioning.
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Affiliation(s)
- Julia O’Mahony
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada/The Hospital for Sick Children, Toronto, ON, Canada/Canadian Centre for Health Economics, Toronto, ON, Canada
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Audrey Laporte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada/Canadian Centre for Health Economics, Toronto, ON, Canada
| | - Amit Bar-Or
- Center for Neuroinflammation and Experimental Therapeutics and Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - E Ann Yeh
- Department of Pediatrics, University of Toronto, Canada; Division of Neurology, The Hospital for Sick Children, Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada
| | - Adalsteinn Brown
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Brenda Banwell
- Division of Child Neurology, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Barin L, Salmen A, Disanto G, Babačić H, Calabrese P, Chan A, Kamm CP, Kesselring J, Kuhle J, Gobbi C, Pot C, Puhan MA, von Wyl V. The disease burden of Multiple Sclerosis from the individual and population perspective: Which symptoms matter most? Mult Scler Relat Disord 2018; 25:112-121. [PMID: 30059895 DOI: 10.1016/j.msard.2018.07.013] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/22/2018] [Accepted: 07/08/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND MS symptoms affect many functional domains. Knowing the specific impact of symptoms on health-related quality of life (HRQoL) is vital for successful disease and symptom management in MS. We aimed at investigating how specific MS symptoms contribute to the disease burden in individuals and from a population perspective. METHODS We included 855 Swiss Multiple Sclerosis Registry participants with a relapsing-remitting form (RRMS) or a progressive form (PMS). HRQoL was measured with the EuroQol 5-Dimension EQ-5D-index and EQ-Visual Analogue Scale (EQ-VAS) on 0-100% scales. Their associations with 20 symptoms, socio-demographic and clinical information were explored in median regression models, stratified by RRMS and PMS. RESULTS We included 611 participants with RRMS and 244 with PMS. In RRMS, gait (-6.5%) and balance problems (-5.1%) had the largest EQ-5D-index reductions, and were also important at the population level (frequencies 45% and 52%). Fatigue, depression, and spasticity (frequencies 74.1%, 31%, 38%) also contributed to the population disease burden. In PMS, spasticity, paralysis, and bowel problems had the largest impact on EQ-5D-index, both at the individual and population levels. The largest impact on EQ-VAS at population level was associated in RRMS with balance problems, depression, dizziness, and spasticity, while in PMS with weakness, pain, and paralysis. CONCLUSIONS While HRQoL at population level is most affected by balance problems, spasticity, and depression in RRMS, the biggest HRQoL losses in PMS are caused by spasticity, paralysis, weakness, and pain. Many symptoms with the largest effects in individuals substantially contribute to the population disease burden.
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Affiliation(s)
- Laura Barin
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - Anke Salmen
- Department of Neurology, University Hospital Bern and University of Bern, Bern, Switzerland.
| | - Giulio Disanto
- Neurocenter of southern Switzerland, Ospedale regionale di Lugano, Lugano, Switzerland; Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
| | - Haris Babačić
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Pasquale Calabrese
- Neuropsychology and Behavioral Neurology Unit, Division of Molecular and Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland.
| | - Andrew Chan
- Department of Neurology, University Hospital Bern and University of Bern, Bern, Switzerland.
| | - Christian P Kamm
- Department of Neurology, University Hospital Bern and University of Bern, Bern, Switzerland; Neurology and Neurorehabilitation Centre, Luzerner Kantonsspital, Lucerne, Switzerland.
| | - Jürg Kesselring
- Department of Neurology & Neurorehabilitation, Rehabilitation Centre Kliniken Valens, Valens, Switzerland.
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
| | - Claudio Gobbi
- Neurocenter of southern Switzerland, Ospedale regionale di Lugano, Lugano, Switzerland.
| | - Caroline Pot
- Laboratories of Neuroimmunology, Division of Neurology and Neuroscience Research Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland.
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - Viktor von Wyl
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
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Ozakbas S, Turkoglu R, Tamam Y, Terzi M, Taskapilioglu O, Yucesan C, Baser HL, Gencer M, Akil E, Sen S, Turan OF, Sorgun MH, Yigit P, Turkes N. Prevalence of and risk factors for cognitive impairment in patients with relapsing-remitting multiple sclerosis: Multi-center, controlled trial. Mult Scler Relat Disord 2018; 22:70-76. [DOI: 10.1016/j.msard.2018.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
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Nickel S, von dem Knesebeck O, Kofahl C. Self-assessments and determinants of HRQoL in a German MS population. Acta Neurol Scand 2018; 137:174-180. [PMID: 28975610 DOI: 10.1111/ane.12854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The importance of health-related quality of life (HRQoL) in multiple sclerosis (MS) is widely acknowledged. In 2015, a multicenter study was launched to assess the HRQoL and coping styles of chronically ill persons in Germany. The aims of this paper were (i) to describe how persons affected by MS assess their HRQoL and (ii) find out sociodemographic and disease-specific determinants of HRQoL. MATERIALS AND METHODS A quantitative survey (optionally per paper-pencil or online) was conducted between March and October 2015 in Germany. Recruitment ways were as follows: Associations of the German Multiple Sclerosis Society (DMSG), medical practices specialized in neurology/MS, hospitals, public events, social networks, and self-help clearinghouses. To measure HRQoL, the Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire and the short form of the Fear of Progression Questionnaire (FoP-Q) were used. RESULTS A total of 1220 individuals with MS participated in the study. Frequent problems reported were related to activities of daily living as well as sentimental and sexual life. Multiple regression analyses identified disease severity and comorbidity-in different directions (positive and negative)-as the strongest factors in predicting activities of daily living, symptoms, sentimental and sexual life, and reject. The demographic variables sex, age, education, and employment status also have different impact on the HRQoL. CONCLUSIONS Using HRQoL measures can be feasible outcomes in addition to clinical assessments of MS and other chronic diseases and can help better managing the care. Some challenges have to be taken into account involving patients and the limitations of our empirical study.
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Affiliation(s)
- S. Nickel
- Institute of Medical Sociology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - O. von dem Knesebeck
- Institute of Medical Sociology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - C. Kofahl
- Institute of Medical Sociology University Medical Center Hamburg‐Eppendorf Hamburg Germany
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Michel P, Baumstarck K, Loundou A, Ghattas B, Auquier P, Boyer L. Computerized adaptive testing with decision regression trees: an alternative to item response theory for quality of life measurement in multiple sclerosis. Patient Prefer Adherence 2018; 12:1043-1053. [PMID: 29950817 PMCID: PMC6016264 DOI: 10.2147/ppa.s162206] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The aim of this study was to propose an alternative approach to item response theory (IRT) in the development of computerized adaptive testing (CAT) in quality of life (QoL) for patients with multiple sclerosis (MS). This approach relied on decision regression trees (DRTs). A comparison with IRT was undertaken based on precision and validity properties. MATERIALS AND METHODS DRT- and IRT-based CATs were applied on items from a unidi-mensional item bank measuring QoL related to mental health in MS. The DRT-based approach consisted of CAT simulations based on a minsplit parameter that defines the minimal size of nodes in a tree. The IRT-based approach consisted of CAT simulations based on a specified level of measurement precision. The best CAT simulation showed the lowest number of items and the best levels of precision. Validity of the CAT was examined using sociodemographic, clinical and QoL data. RESULTS CAT simulations were performed using the responses of 1,992 MS patients. The DRT-based CAT algorithm with minsplit = 10 was the most satisfactory model, superior to the best IRT-based CAT algorithm. This CAT administered an average of nine items and showed satisfactory precision indicators (R = 0.98, root mean square error [RMSE] = 0.18). The DRT-based CAT showed convergent validity as its score correlated significantly with other QoL scores and showed satisfactory discriminant validity. CONCLUSION We presented a new adaptive testing algorithm based on DRT, which has equivalent level of performance to IRT-based approach. The use of DRT is a natural and intuitive way to develop CAT, and this approach may be an alternative to IRT.
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Affiliation(s)
- Pierre Michel
- Aix-Marseille Univ, School of Medicine, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
- Mathematics Institute of Marseille, Aix-Marseille University, Marseille, France
| | - Karine Baumstarck
- Aix-Marseille Univ, School of Medicine, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Anderson Loundou
- Aix-Marseille Univ, School of Medicine, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Badih Ghattas
- Mathematics Institute of Marseille, Aix-Marseille University, Marseille, France
| | - Pascal Auquier
- Aix-Marseille Univ, School of Medicine, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Laurent Boyer
- Aix-Marseille Univ, School of Medicine, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
- Correspondence: Laurent Boyer, Aix-Marseille Univ, School of, MEDICINE - La Timone Medical, Campus, EA 3279: CEReSS – Health, Service Research and Quality of Life, Center, 27 Boulevard Jean Moulin, 13005 Marseille, France, Tel +33 6 8693 6276, Email
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Vlasov YV, Churakov MV, Kurapov MA, Gromova TN, Popova EV, Boyko OV, Spirin NN, Sivertseva SA, Belskaya GN, Malkova NA, Habirov FA, Haybullin TI, Kotov SV, Greshnova IV, Ivashinenkova EI, Bakalova MA, Yampolskaya-gosteva IA, Boyko AN. Primary-progressive multiple sclerosis in Russia: a medical-sociological study involving patients and neurologists. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:40-46. [DOI: 10.17116/jnevro201811808240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Short-Term and Long-Term Effects of an Exercise-Based Patient Education Programme in People with Multiple Sclerosis: A Pilot Study. Mult Scler Int 2017; 2017:2826532. [PMID: 28900546 PMCID: PMC5576429 DOI: 10.1155/2017/2826532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 07/07/2017] [Accepted: 07/16/2017] [Indexed: 11/21/2022] Open
Abstract
Background. Although people with Multiple Sclerosis (pwMS) benefit from physical exercise, they still show reduced physical activity and exercise behaviour. This study aimed to investigate short- and long-term effects of an exercise-based patient education programme (ePEP) that focuses on empowering pwMS to a sustainable and self-regulated exercise training management. Methods. Fourteen pwMS were randomly assigned to immediate experimental group (EG-I: n = 8) and waitlist-control group (EG-W: n = 6) and attended biweekly in a six-week ePEP. All participants were measured for walking ability, quality of life, fatigue, and self-efficacy towards physical exercise before and after the ePEP, after 12 weeks, and one year after baseline. Short-term effects were analysed in a randomised control trial and long-term effects of all ePEP participants (EG-I + EG-W = EG-all) in a quasi-experimental design. Results. Only functional gait significantly improved in EG-I compared to EG-W (p = 0.008, r = −0.67). Moderate to large effects were found in EG-all for walking ability. Not significant, however, relevant changes were detected for quality of life and fatigue. Self-efficacy showed no changes. Conclusion. The ePEP seems to be a feasible option to empower pwMS to a self-regulated and sustainable exercise training management shown in long-term walking improvements.
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31
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The Relationship between Psychosocial Factors and Cognition in Multiple Sclerosis. Behav Neurol 2017; 2017:6847070. [PMID: 28584406 PMCID: PMC5451874 DOI: 10.1155/2017/6847070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/06/2017] [Accepted: 04/12/2017] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is a common disorder in some regions of the world, with over 2.3 million people diagnosed worldwide. Cognitive impairment is one of the earliest symptoms to present in the course of the disease and can cause significant morbidity. We proposed a study to explore the psychosocial predictors of cognitive impairment in MS patients in Saudi Arabia, a previously unexplored patient population. METHODS Demographic data, depression scale (PHQ9), symptom burden (PHQ15), anxiety (GAD7), disease duration, and Montreal Cognitive Assessment (MOCA) scores were collected from 195 patients in a neurology clinic in Ryiadh, Saudi Arabia. Univariate and multiple regression analyses were conducted to identify variables that are significantly associated with cognitive impairment. RESULTS Variables that were identified to be significantly associated with cognition, p < 0.05, were education level, disease duration, and family history. DISCUSSION Both education level and disease duration were variables identified in previous studies. We showed family history to be a significant variable, and no association was found with depression or anxiety, which is unique to our study population. CONCLUSIONS We identified several psychosocial predictors that are associated with cognition in our patient population. It was also noted that a difference exists between patient populations, highlighting the need for further studies in specific geographical regions.
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Gower-Rousseau C, Sarter H, Savoye G, Tavernier N, Fumery M, Sandborn WJ, Feagan BG, Duhamel A, Guillon-Dellac N, Colombel JF, Peyrin-Biroulet L. Validation of the Inflammatory Bowel Disease Disability Index in a population-based cohort. Gut 2017; 66:588-596. [PMID: 26646934 DOI: 10.1136/gutjnl-2015-310151] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/07/2015] [Accepted: 11/09/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND IBDs are chronic destructive disorders that negatively affect the functional status of patients. Recently, the Inflammatory Bowel Disease Disability Index (IBD-DI) was developed according to standard WHO processes. The aims of the current study were to validate the IBD-DI in an independent patient cohort, to develop an index-specific scoring system and to describe the disability status of a well-defined population-based cohort of French patients with IBD. METHODS From February 2012 to March 2014, the IBD-DI questionnaire was administered to a random sample of adult patients with an established diagnosis of IBD issued from a French population-based registry. The IBD-DI consists of 28 items that evaluate the four domains of body functions, activity participation, body structures and environmental factors. Validation included item reduction and data structure, construct validity, internal consistency, interobserver and intraobserver reliability evaluations. RESULTS 150 patients with Crohn's disease (CD) and 50 patients with UC completed the IBD-DI validation phase. The intraclass correlation coefficient for interobserver reliability was 0.91 and 0.54 for intraobserver reliability. Cronbach's α of internal consistency was 0.86. IBD-DI scores varied from 0 to 100 with a mean of 35.3 (Q1=19.6; Q3=51.8). IBD-DI scores were highly correlated with Inflammatory Bowel Disease Questionnaire (-0.82; p<0.001) and SF-36 (-0.61; p<0.05) scores. Female gender (p<0.001), clinical disease activity (p<0.0001) and disease duration (p=0.02) were associated with higher IBD-DI scores. CONCLUSIONS The IBD-DI has been validated for use in clinical trials and epidemiological studies. The IBD-DI showed high internal consistency, interobserver reliability and construct validity, and a moderate intraobserver reliability. It comprises 14 questions and ranges from 0 to 100. The mean IBD-DI score was 35.3 and was associated with gender, clinical disease activity and disease duration. Further research is needed to confirm the structural validity and to assess the responsiveness of IBD-DI. TRIAL REGISTRATION NUMBER 2011-A00877-34.
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Affiliation(s)
- Corinne Gower-Rousseau
- Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille Cedex, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm/Université Lille 2/CHRU de Lille; Equipe «IBD and environmental factors: epidemiology and functional analyses, Lille University, France
| | - Hélène Sarter
- Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille Cedex, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm/Université Lille 2/CHRU de Lille; Equipe «IBD and environmental factors: epidemiology and functional analyses, Lille University, France
| | - Guillaume Savoye
- Gastroenterology Unit, Epimad Registry, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France
| | - Noémie Tavernier
- Gastroenterology Unit, Hôpital Huriez, Lille University Hospital, France
| | - Mathurin Fumery
- Gastroenterology Unit, Epimad Registry, CHU Amiens Sud, Avenue Laennec- Salouel, Amiens University Hospital, France
| | - William J Sandborn
- Division of Gastroenterology, University of California San Diego, La Jolla, California, USA
| | | | - Alain Duhamel
- Univ. Lille, CHU Lille, EA 2694-Santé publique : épidémiologie et qualité des soins, Lille, France
| | - Nathalie Guillon-Dellac
- Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille Cedex, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm/Université Lille 2/CHRU de Lille; Equipe «IBD and environmental factors: epidemiology and functional analyses, Lille University, France
| | | | - Laurent Peyrin-Biroulet
- Gastroenterology Department and Inserm U954, Nancy University Hospital, Université de Lorraine, Nancy, France
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Krüger T, Behrens JR, Grobelny A, Otte K, Mansow-Model S, Kayser B, Bellmann-Strobl J, Brandt AU, Paul F, Schmitz-Hübsch T. Subjective and objective assessment of physical activity in multiple sclerosis and their relation to health-related quality of life. BMC Neurol 2017; 17:10. [PMID: 28086828 PMCID: PMC5237144 DOI: 10.1186/s12883-016-0783-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/09/2016] [Indexed: 12/02/2022] Open
Abstract
Background Physical activity (PA) is frequently restricted in people with multiple sclerosis (PwMS) and aiming to enhance PA is considered beneficial in this population. We here aimed to explore two standard methods (subjective plus objective) to assess PA reduction in PwMS and to describe the relation of PA to health-related quality of life (hrQoL). Methods PA was objectively measured over a 7-day period in 26 PwMS (EDSS 1.5–6.0) and 30 matched healthy controls (HC) using SenseWear mini® armband (SWAmini) and reported as step count, mean total and activity related energy expenditure (EE) as well as time spent in PA of different intensities. Measures of EE were also derived from self-assessment with IPAQ (International Physical Activity Questionnaire) long version, which additionally yielded information on the context of PA and a classification into subjects’ PA levels. To explore the convergence between both types of assessment, IPAQ categories (low, moderate, high) were related to selected PA parameters from objective assessment using ANOVA. Group differences and associated effect sizes for all PA parameters as well as their relation to clinical and hrQoL measures were determined. Results Both, SWAmini and IPAQ assessment, captured differences in PA between PwMS and HC. IPAQ categories fit well with common cut-offs for step count (p = 0.002) and mean METs (p = 0.004) to determine PA levels with objective devices. Correlations between specifically matched pairs of IPAQ and SWAmini parameters ranged between r .288 and r .507. Concerning hrQoL, the lower limb mobility subscore was related to four PA measures, while a relation with patients’ report of general contentment was only seen for one. Conclusions Both methods of assessment seem applicable in PwMS and able to describe reductions in daily PA at group level. Whether they can be used to track individual effects of interventions to enhance PA levels needs further exploration. The relation of PA measures with hrQoL seen with lower limb mobility suggests lower limb function not only as a major target for intervention to increase PA but also as a possible surrogate for PA changes. Electronic supplementary material The online version of this article (doi:10.1186/s12883-016-0783-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Theresa Krüger
- NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Janina R Behrens
- NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Anuschka Grobelny
- NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Karen Otte
- Motognosis UG, Schönhauser Allee 177, 10119, Berlin, Germany
| | | | - Bastian Kayser
- Motognosis UG, Schönhauser Allee 177, 10119, Berlin, Germany
| | - Judith Bellmann-Strobl
- NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Alexander U Brandt
- NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany
| | - Tanja Schmitz-Hübsch
- NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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Krops LA, Jaarsma EA, Dijkstra PU, Geertzen JHB, Dekker R. Health Related Quality of Life in a Dutch Rehabilitation Population: Reference Values and the Effect of Physical Activity. PLoS One 2017; 12:e0169169. [PMID: 28060949 PMCID: PMC5217970 DOI: 10.1371/journal.pone.0169169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 12/13/2016] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To establish reference values for Health Related Quality of Life (HRQoL) in a Dutch rehabilitation population, and to study effects of patient characteristics, diagnosis and physical activity on HRQoL in this population. METHOD Former rehabilitation patients (3169) were asked to fill in a questionnaire including the Dutch version of the RAND-36. Differences between our rehabilitation patients and Dutch reference values were analyzed (t-tests). Effects of patient characteristics, diagnosis and movement intensity on scores on the subscales of the RAND-36 were analyzed using block wise multiple regression analyses. RESULTS In total 1223 patients (39%) returned the questionnaire. HRQoL was significantly poorer in the rehabilitation patients compared to Dutch reference values on all subscales (p<0.001) except for health change (p = 0.197). Longer time between questionnaire and last treatment was associated with a smaller health change (p = 0.035). Higher age negatively affected physical functioning (p<0.001), social functioning (p = 0.004) and health change (p = 0.001). Diagnosis affected outcomes on all subscales except role limitations physical, and mental health (p ranged <0.001 to 0.643). Higher movement intensity was associated with better outcomes on all subscales except for mental health (p ranged <0.001 to 0.190). CONCLUSIONS HRQoL is poorer in rehabilitation patients compared to Dutch reference values. Physical components of HRQoL are affected by diagnosis. In rehabilitation patients an association between movement intensity and HRQoL was found. For clinical purposes, results of this study can be used as reference values for HRQoL in a rehabilitation setting.
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Affiliation(s)
- Leonie A. Krops
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- * E-mail:
| | - Eva A. Jaarsma
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Pieter U. Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands
| | - Jan H. B. Geertzen
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Center for Sports Medicine, Groningen, The Netherlands
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Defining Quality of Life Levels to Enhance Clinical Interpretation in Multiple Sclerosis. Med Care 2017; 55:e1-e8. [DOI: 10.1097/mlr.0000000000000117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rilo O, Peña J, Ojeda N, Rodríguez-Antigüedad A, Mendibe-Bilbao M, Gómez-Gastiasoro A, DeLuca J, Chiaravalloti N, Ibarretxe-Bilbao N. Integrative group-based cognitive rehabilitation efficacy in multiple sclerosis: a randomized clinical trial. Disabil Rehabil 2016; 40:208-216. [PMID: 27927036 DOI: 10.1080/09638288.2016.1250168] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Oiane Rilo
- Department of Methods and Experimental Psychology, University of Deusto, Bilbao, Spain
| | - Javier Peña
- Department of Methods and Experimental Psychology, University of Deusto, Bilbao, Spain
| | - Natalia Ojeda
- Department of Methods and Experimental Psychology, University of Deusto, Bilbao, Spain
| | | | | | | | - John DeLuca
- Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Nancy Chiaravalloti
- Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
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Nejati S, Rajezi Esfahani S, Rahmani S, Afrookhteh G, Hoveida S. The Effect of Group Mindfulness-based Stress Reduction and Consciousness Yoga Program on Quality of Life and Fatigue Severity in Patients with MS. J Caring Sci 2016; 5:325-335. [PMID: 28032077 PMCID: PMC5187553 DOI: 10.15171/jcs.2016.034] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 05/27/2016] [Indexed: 12/12/2022] Open
Abstract
Introduction: The chronic nature of Multiple Sclerosis (MS),
have can leave devastating effects on quality of life and fatigue. The present research
aimed to study the effect of group Mindfulness-based Stress Reduction (MBSR) and conscious
yoga program on the quality of life and fatigue severity among patients with MS. Methods: This study was quasi-experimental with intervention
and control groups. The statistical population included all members to MS Society of
Tehran Province, 24 of whom diagnosed with MS were selected as the sample based on the
inclusion criteria. The subjects were randomly assigned into the test group (12 patients)
and the control group (12 patients). MS Quality of Life-54 (MSQOL-54) and Fatigue Severity
Scale (FSS) were used for data collection. Subjects in the test group underwent a MBSR and
conscious yoga program in 8 two-hour sessions. The data were analyzed using the SPSS
ver.13 software. Results: The study findings showed that there was a
significant difference between subjects in the experimental and control groups in terms of
mean score of some subscales of quality of life including physical health, role
limitations due to physical and emotional problems, energy, emotional well-being, health
distress, health perception, and satisfaction with sexual function, overall quality of
life, and fatigue severity. Conclusion: The results show that the program is effective
in reduction of fatigue severity and improving some subscales of quality of life in MS
patients. Hence, this supportive method can be used as an effective way for improving
quality of life and relieving fatigue in MS patients.
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Affiliation(s)
- Somayeh Nejati
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Rajezi Esfahani
- Clinical Psychology, Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Rahmani
- Department of Psychology and Educational Science, Semnan University, Semnan, Iran
| | - Gita Afrookhteh
- Psychological Counseling and Guidance, Azad University of Science and Research, Tehran, Iran
| | - Shahrzad Hoveida
- Health Psychology, Azad University of Science and Research, Alborz, Iran
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Borghi M, Carletto S, Ostacoli L, Scavelli F, Pia L, Pagani M, Bertolotto A, Malucchi S, Signori A, Cavallo M. Decline of Neuropsychological Abilities in a Large Sample of Patients with Multiple Sclerosis: A Two-Year Longitudinal Study. Front Hum Neurosci 2016; 10:282. [PMID: 27375468 PMCID: PMC4896920 DOI: 10.3389/fnhum.2016.00282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 05/25/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE In this longitudinal study, we monitored two large groups of multiple sclerosis (MS) patients and healthy controls (HC) for 2 years, with the aim of comparing their neuropsychological profile over time. METHOD Three hundred and twenty-two patients with MS and 303 HC were administered the Brief Repeatable Battery of Neuropsychological tests (BRB-N); neuropsychiatric measures were also administered. Two follow-ups were scheduled at 1 and 2 years, respectively. RESULTS A linear mixed model (LMM) with random intercept was run by considering participants' performance on each test of the BRB-N at the three assessment points (baseline and follow-ups) as the within-subjects variable, and group (patients and controls) as the between-subjects factor. The interaction term was statistically significant for the tests: Symbol Digit Modalities test (SDMT) (p = 0.044), Paced Auditory Serial Addition test (PASAT) (p = 0.011) and Word List Generation (WLG) (p < 0.001), whereas for the PASAT-3 approached statistical significance (p = 0.05). In addition, a LMM with random intercept was also run by identifying three groups (controls, relapsing-remitting course of MS (i.e. RR-MS), and prog-MS). The interaction term was statistically significant for: PASAT-3 (p = 0.017), PASAT-2 (p = 0.0026), and WLG (p = 0.0022). CONCLUSIONS Our results corroborate on a very large scale evidence that the abilities tapped by the tasks SDMT, PASAT and WLG are particularly sensitive to MS, and further extend this issue by showing that these abilities are likely to be more sensitive than others to the progression of the disease, as compared to HC.
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Affiliation(s)
- Martina Borghi
- Clinical Psychology and Psychosomatics Service, University Hospital San Luigi Gonzaga, University of Turin Orbassano, Italy
| | - Sara Carletto
- Clinical Psychology and Psychosomatics Service, University Hospital San Luigi Gonzaga, University of Turin Orbassano, Italy
| | - Luca Ostacoli
- Clinical Psychology and Psychosomatics Service, University Hospital San Luigi Gonzaga, University of Turin Orbassano, Italy
| | - Francesco Scavelli
- Clinical Psychology and Psychosomatics Service, University Hospital San Luigi Gonzaga, University of Turin Orbassano, Italy
| | - Lorenzo Pia
- SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, Department of Psychology, University of TurinTurin, Italy; Neuroscience Institute of Turin (NIT), University of TurinTurin, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche (CNR), Rome Italy
| | - Antonio Bertolotto
- Neurologia 2 - CRESM (Regional Reference Centre for Multiple Sclerosis), "San Luigi Gonzaga" Hospital Medical School Orbassano, Italy
| | - Simona Malucchi
- Neurologia 2 - CRESM (Regional Reference Centre for Multiple Sclerosis), "San Luigi Gonzaga" Hospital Medical School Orbassano, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genoa Genoa, Italy
| | - Marco Cavallo
- Faculty of Psychology, eCampus UniversityNovedrate, Italy; Department of Mental Health, Azienda Sanitaria Locale Torino 3Collegno, Italy
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Nakao M, Yamauchi K, Ishihara Y, Solongo B, Ichinnorov D, Breugelmans R. Validation of the Mongolian version of the SF-36v2 questionnaire for health status assessment of Mongolian adults. SPRINGERPLUS 2016; 5:607. [PMID: 27247903 PMCID: PMC4864778 DOI: 10.1186/s40064-016-2204-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/21/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Ulaanbaatar, Mongolia, is one of the world's worst air-polluted cities, but effects of this air pollution on the population health status have not yet been evaluated. Therefore, we developed a Mongolian version of the SF-36v2 questionnaire to investigate the health status of Mongolian population. METHODS Health checkups were conducted in Ulaanbaatar and the health status was measured using a Mongolian translated version of the SF-36v2 questionnaire. The reliability and validity of the Mongolian SF-36v2 questionnaire, and the relationship between health status and respiratory condition were examined. RESULTS Factor analysis of the Mongolian SF-36v2 questionnaire showed that the "Role-physical" and "Role-emotional" were classified into a single subscale. The "Mental health" and "Vitality" were each divided into two subscales. Cronbach's alpha and intraclass correlation coefficient (ICC) for reproducibility were >0.7, except for "General health perceptions" (Cronbach's alpha and ICC < 0.7), "Social functioning" (Cronbach's alpha < 0.7), and "Vitality" (ICC < 0.7). The SF-36v2 subscales and the corresponding items of the COOP/WONCA charts were correlated, and subjects with respiratory symptoms showed lower SF-36v2 scores compared to normal subjects, suggesting external validity. Subjects with respiratory symptoms showed significantly lower scores for the majority of the SF-36v2 subscales than those with normal lung function. In subjects with combined ventilatory impairment, "Physical functioning", "Role-physical", "Bodily pain", and "Vitality" scores were significantly lower than those with normal lung function. CONCLUSIONS The Mongolian version of the SF-36v2 questionnaire provides substantial reliability and validity, and is useful for evaluating the health status of Mongolian adults with ventilatory impairment. Health status measured by SF-36v2 was significantly aggravated by combined ventilatory impairment when compared with normal lung function.
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Affiliation(s)
- Motoyuki Nakao
- Department of Public Health, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011 Japan
| | - Keiko Yamauchi
- Department of Public Health, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011 Japan
| | - Yoko Ishihara
- Department of Public Health, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011 Japan
| | - Bandi Solongo
- Department of Respiratory Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Dashtseren Ichinnorov
- Department of Respiratory Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Raoul Breugelmans
- Department of Medical Education, Tokyo Medical University, Tokyo, 160-8402 Japan
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Tülek Z, Polat C, Kürtüncü M, Eraksoy M. Validity and Reliability of the Turkish Version of the Multiple Sclerosis-Related Symptom Checklist. ACTA ACUST UNITED AC 2016; 54:328-333. [PMID: 29321706 DOI: 10.5152/npa.2016.16976] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/28/2016] [Indexed: 12/13/2022]
Abstract
Introduction Multiple sclerosis (MS) is a disease that causes different symptoms in each attack and has an individual-specific course. Detailed questioning and recording of MS symptoms is important for developing a management plan for individual-specific symptoms. The present study was planned to evaluate the validity and reliability of the Turkish version of "Multiple Sclerosis-Related Symptom Checklist" (MS-RS), which has been developed for patients to personally follow-up the symptoms they experience. Methods The study was conducted in the outpatient MS clinic of the Istanbul University Istanbul Faculty of Medicine between January and October 2013 and included a sample group of 148 patients who were aged >18 years, could easily communicate, had a definite diagnosis of MS, and had no other medical problems besides MS. The data were collected using patient information forms, including sociodemographic and MS-RS forms. To assess the linguistic validity, the Likert-type scale with 26 items was first applied to a group of 30 patients. Confirmatory factor analysis was used to test the construct validity. Furthermore, the correlation of the scale with the Expanded Disability Status Scale (EDSS), Hospital Anxiety and Depression Scale (HADS), Mini-Mental Status Evaluation (MMSE) scale, and Multiple Sclerosis Quality of Life Scale-54 (MSQL-54) was evaluated. Results The scale comprised five factors with factor loading values between 0.39 and 0.86. The item-total correlation coefficients revealed values of 0.27-0.88. The Cronbach's alpha reliability coefficient for the whole scale was determined to be 0.89 and for the subscales to be 0.60-0.85. The test-retest analysis revealed no difference between the scale and its subscales in terms of invariance with time (p>0.05). Moreover, MS-RS was significantly correlated with EDSS, HADS, MMSE, and MSQL-54. Conclusion The Turkish version of MS-RS is a valid and reliable scale that can be used in the Turkish population.
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Affiliation(s)
- Zeliha Tülek
- İstanbul University Florence Nightingale Faculty of Nursing, İstanbul, Turkey
| | - Cansu Polat
- İstanbul University Florence Nightingale Faculty of Nursing, İstanbul, Turkey
| | - Murat Kürtüncü
- Department of Neurology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Mefkure Eraksoy
- Department of Neurology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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Giovannetti AM, Schiavolin S, Brenna G, Brambilla L, Confalonieri P, Cortese F, Covelli V, Frangiamore R, Leonardi M, Mantegazza R, Moscatelli M, Ponzio M, Torri Clerici V, Zaratin P, Raggi A. Cognitive function alone is a poor predictor of health-related quality of life in employed patients with MS: results from a cross-sectional study. Clin Neuropsychol 2016; 30:201-15. [PMID: 26930374 DOI: 10.1080/13854046.2016.1142614] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Depression, anxiety, disease severity, and cognitive functions impact on the quality of life of people with MS. However, the majority of studies were not based on multivariate models and did not target employed patients. The aim of this study was to investigate predictors of HRQoL in persons with MS in the workforce considering cognitive, psychological, disease severity, and disability-related variables. METHODS Cross-sectional study. Hierarchical block regression analyses were conducted to identify predictors of physical and mental components of HRQoL, measured with the MSQOL-54. Candidate predictors included cognitive functioning (a selection of Rao's BRB-NT), sample features (age, education, MS duration), depressive symptoms (BDI-II), anxiety (STAI-Y), disability (WHODAS 2.0), and MS severity (EDSS): those that correlated with PCS and MCS with p < .250 and those that correlated with other predictors with coefficients >.800 were excluded from regression analyses. RESULTS In total, 181 patients (60.8% females, mean age 39.6, median EDSS 1.5) were included. In both models, cognitive variables had a poor explicative power. The models improved significantly when psychological, as well as, disease severity and disability variables were added. R(2) of complete models was 0.732 for the physical component, 0.697 for the mental one: BDI-II, STAI-State and, some WHODAS 2.0 scales were significant predictors of HRQoL. CONCLUSIONS Monitoring anxiety, depressive symptoms, and level of disability through self-reported questionnaires may provide useful suggestions to improve the HRQoL of persons with MS in the workforce, permitting to address possible problems in the work context and plan corrective actions.
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Affiliation(s)
- Ambra Mara Giovannetti
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Silvia Schiavolin
- b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Greta Brenna
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Laura Brambilla
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Paolo Confalonieri
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Francesca Cortese
- c Scientific Directorate , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Venusia Covelli
- b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Rita Frangiamore
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Matilde Leonardi
- b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Renato Mantegazza
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Marco Moscatelli
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Michela Ponzio
- d Scientific Research Area , Italian Foundation of Multiple Sclerosis , Genoa , Italy
| | - Valentina Torri Clerici
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Paola Zaratin
- d Scientific Research Area , Italian Foundation of Multiple Sclerosis , Genoa , Italy
| | - Alberto Raggi
- b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
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Abstract
BACKGROUND Pediatric onset multiple sclerosis (MS) negatively affects cognitive function, mood and health related quality of life (HRQOL). We aimed to explore the cognitive, psychological and HRQOL impacts of pediatric MS on young adults and to explore the relationships between disability, disease duration, cognition, mood and HRQOL in this hypotheses generating study. METHODS Thirty-four young adults with pediatric onset MS at St. Michael's Hospital in Toronto were included in this cross-sectional study (mean age 21.3 years, 56% female). Participants completed assessments of physical disability (Expanded Disability Status Scale (EDSS)), cognitive function (Symbol Digit Modalities Test (SDMT)), mood (Beck Depression Inventory II (BDI-II)), and HRQOL (Short Form Health Survey (SF-36v2)). Findings were compared to age- and gender- matched normative data. RESULTS Individuals with pediatric MS performed worse on the SDMT compared to normative data, with 53% demonstrating cognitive impairment. There was no difference in BDI-II scores from normative data, but 21% showed at least mild depression. There was a non-significant impairment in physical HRQOL compared to normative data. Decreased physical HRQOL was related to disability (EDSS), while mental HRQOL was related to depression (BDI-II). CONCLUSIONS Young adults with pediatric MS have reduced cognitive function. Non-significant reductions in HRQOL may be partly attributed to physical disability and depression. These factors should be addressed in the care of adults with pediatric MS. Further studies including control groups and longitudinal design are needed to confirm these findings.
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Castelli L, De Luca F, Marchetti MR, Sellitto G, Fanelli F, Prosperini L. The dual task-cost of standing balance affects quality of life in mildly disabled MS people. Neurol Sci 2016; 37:673-9. [PMID: 26728268 DOI: 10.1007/s10072-015-2456-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 12/16/2015] [Indexed: 11/27/2022]
Abstract
The aim of this study was to explore the correlations between the dual-task cost (DTC) of standing balance and quality of life (QoL) in mildly disabled patients with multiple sclerosis (MS). In this cross-sectional study, patients affected by MS with an expanded disability status scale (EDSS) score of 3.0 or less and without an overt balance impairment were tested by means of static posturography under eyes-opened (single-task condition) and while performing the Stroop word-color test (dual-task condition), to estimate the DTC of standing balance. The self-reported 54-item MS quality of life questionnaire (MSQoL-54) was also administered to obtain a MS-specific assessment of health-related QoL. Among the 120 screened patients, 75 (53 women, 22 men) were tested. Although there was no impact of the DTC of standing balance on the physical and mental composite scores of MSQoL-54, patients who had a greater DTC of standing balance scored worse on role limitations due to physical problems (p = 0.007) and social function (p < 0.001), irrespective of demographic and other clinical characteristics including walking performance and cognitive status. However, the EDSS step and fatigue also contributed to reduced scores in these two QoL domains (p-values < 0.01). In conclusion, the phenomenon of cognitive-motor interference, investigated as DTC of standing balance, may affect specific QoL domains even in mildly disabled patients with MS and in the absence of an overt balance dysfunction.
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Affiliation(s)
| | - Francesca De Luca
- Department of Neurology and Psychiatry, Sapienza University, Viale dell'Università, 30, 00185, Rome, Italy
| | | | | | - Fulvia Fanelli
- Department of Neurology and Psychiatry, Sapienza University, Viale dell'Università, 30, 00185, Rome, Italy
| | - Luca Prosperini
- Department of Neurology and Psychiatry, Sapienza University, Viale dell'Università, 30, 00185, Rome, Italy.
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Health-related quality of life in multiple sclerosis: role of cognitive appraisals of self, illness and treatment. Qual Life Res 2015; 25:1761-70. [DOI: 10.1007/s11136-015-1204-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2015] [Indexed: 01/05/2023]
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Antoniu SA, Petrescu E, Stanescu R, Anisie E, Boiculese L. Impact of fatigue in patients with chronic obstructive pulmonary disease: results from an exploratory study. Ther Adv Respir Dis 2015; 10:26-33. [PMID: 26596633 DOI: 10.1177/1753465815617707] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Fatigue, which is also present in the healthy population, is a common but understudied symptom in chronic obstructive pulmonary disease (COPD). We hypothesized that clinically significant fatigue is also frequent in COPD and can be associated with an increased disease burden. METHODS An exploratory analysis derived from an ongoing cross-sectional study was carried out to evaluate levels of fatigue and impact on health-related quality of life/health status in patients with COPD (COPD group; n = 20) and healthy subjects (control group; n = 5). Health-related quality of life was measured using the Short Form Health Survey 36 (SF-36), health status with the Clinical COPD Questionnaire (CCQ), and airways obstruction with postbronchodilator forced expiratory volume in 1 s (FEV1 %predicted). Fatigue was measured with the vitality score of the SF-36, its clinical significance being defined by values of 50 or less. Fatigue was also measured using the Functional Assessment of Chronic Illness Therapy scale for fatigue (FACIT-F). RESULTS Vitality scores were significantly worse in the COPD group (45.60 versus 76.25; p = 0.004). FACIT-F scores were significantly lower in the COPD group versus the control group (74.5 versus 95.0; p = 0.03). Clinically significant fatigue was detected in 60% of the COPD group, and was associated with a worse FEV1 %predicted (47.71 versus 65.82%; p = 0.016), worse symptoms burden (CCQ symptoms score 3.75 versus 2.43; p = 0.019), and worse overall health status (CCQ total score 3.30 versus 2.11; p = 0.011). Its link with systemic inflammation remains to be clarified further. CONCLUSIONS Clinically significant fatigue is common among patients with COPD and is associated with an increased disease burden. It should therefore be integrated as a measure of disease prognosis and control in patients with COPD.
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Affiliation(s)
- Sabina Antonela Antoniu
- Department of Preventive Medicine and Interdisciplinarity, Medicine-Palliative Care Nursing, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., Iasi, 700115, Romania
| | - Elena Petrescu
- Department of Morphofunctional Sciences, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Raluca Stanescu
- Department of Morphofunctional Sciences, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Ecaterina Anisie
- Laboratory of Immunology, Sf. Spiridon University Hospital, Iasi, Romania
| | - Lucian Boiculese
- Department of Preventive Medicine and Interdisciplinarity, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
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Meca-Lallana JE, Hernández-Clares R, Carreón-Guarnizo E. Spasticity in multiple sclerosis and role of glatiramer acetate treatment. Brain Behav 2015; 5:e00367. [PMID: 26445705 PMCID: PMC4589813 DOI: 10.1002/brb3.367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/28/2015] [Accepted: 06/07/2015] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Spasticity is one of the most disabling and difficult-to-treat symptoms shown by patients with multiple sclerosis, who often show a suboptimal and unsatisfactory response to classic treatment and new available nonpharmacological alternatives. Due to the progressive nature of this condition, the early management should be essential to improve long-term outcomes. METHODS We performed a narrative literature review of the contribution of spasticity to the burden of multiple sclerosis and the potential role of classic disease-modifying drugs. RESULTS Added to the underlying pathophysiology of spasticity, certain external factors and drugs such as interferon may exacerbate the existing condition, hence their awareness is crucial as part of an effective management of spasticity. Furthermore, the evidence for the effectiveness of glatiramer acetate in preventing spasticity in naïve patients and in those switching from interferon should not be ignored. CONCLUSIONS This literature review proposes the examination of spasticity and the influence of classic disease-modifying agents on the level of existing condition among the variables to be considered when deciding on therapy for multiple sclerosis in clinical practice.
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Affiliation(s)
- Jose Eustasio Meca-Lallana
- Department of Neurology, Multiple Sclerosis Unit, Hospital Clínico Universitario Virgen de la Arrixaca Carretera Madrid-Cartagena s/n, 30120, Murcia, Spain ; Cátedra de Neuroinmunología Clínica y Esclerosis Múltiple, UCAM Universidad Católica San Antonio de Murcia Campus de los Jerónimos, Guadalupe, 30107, Murcia, Spain
| | - Rocío Hernández-Clares
- Department of Neurology, Multiple Sclerosis Unit, Hospital Clínico Universitario Virgen de la Arrixaca Carretera Madrid-Cartagena s/n, 30120, Murcia, Spain ; Cátedra de Neuroinmunología Clínica y Esclerosis Múltiple, UCAM Universidad Católica San Antonio de Murcia Campus de los Jerónimos, Guadalupe, 30107, Murcia, Spain
| | - Ester Carreón-Guarnizo
- Department of Neurology, Multiple Sclerosis Unit, Hospital Clínico Universitario Virgen de la Arrixaca Carretera Madrid-Cartagena s/n, 30120, Murcia, Spain ; Cátedra de Neuroinmunología Clínica y Esclerosis Múltiple, UCAM Universidad Católica San Antonio de Murcia Campus de los Jerónimos, Guadalupe, 30107, Murcia, Spain
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Leary A, Quinn D, Bowen A. Impact of Proactive Case Management by Multiple Sclerosis Specialist Nurses on Use of Unscheduled Care and Emergency Presentation in Multiple Sclerosis: A Case Study. Int J MS Care 2015; 17:159-63. [PMID: 26300701 DOI: 10.7224/1537-2073.2014-011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) affects approximately 100,000 people in the United Kingdom, with rising emergency admissions to the hospital. The multiple sclerosis specialist nurse plays a pivotal role in managing MS care in the United Kingdom, and there is anecdotal evidence that this role can help avoid emergency presentations and unnecessary hospital admissions. METHODS A retrospective service evaluation took place in one established MS nursing service. The impact of the introduction of proactive nurse-led management and a rapid response service on rates of emergency presentation, hospital admission, and bed use was examined. The primary intervention was the introduction of extra nursing hours (6 hours per week) and the reallocation of some routine administrative duties, which allowed the service to move to a proactive management model aimed at avoiding the need for unplanned care. In addition, a care pathway was implemented in the emergency department for patients with MS who did present. RESULTS Reduction in utilization was from a mean of 2700 bed-days per year (2002-2006) to a mean of 198 bed-days per year (2007-2013). CONCLUSIONS During a 10-year period, moving from reactive management to proactive management demonstrated an increase in complex specialist nursing interventions and led to a decrease in emergency presentation and bed use at the local acute-care center.
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Leary A, Mynors G, Bowen A. Modelling the complex activity of multiple sclerosis specialist nurses in England. ACTA ACUST UNITED AC 2015. [DOI: 10.12968/bjnn.2015.11.4.170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Alison Leary
- Professor, Healthcare and Workforce Modelling, London Southbank University
| | - Geraldine Mynors
- Independent Healthcare Consultant, Director, Mynors Supphiah Ltd, GEMSS Programme Facilitator for the Multiple Sclerosis Trust (MST)
| | - Amy Bowen
- Director of Service Development, MST, UK
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Joustra ML, Janssens KAM, Bültmann U, Rosmalen JGM. Functional limitations in functional somatic syndromes and well-defined medical diseases. Results from the general population cohort LifeLines. J Psychosom Res 2015; 79:94-9. [PMID: 26026696 DOI: 10.1016/j.jpsychores.2015.05.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 05/08/2015] [Accepted: 05/10/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Functional somatic syndromes (FSS), defined as physical syndromes without known underlying organic pathology, are sometimes regarded as less serious conditions than well-defined medical diseases (MD). The aims of this study were to evaluate functional limitations in FSS, and to compare the results to MD patients with the same core symptoms. METHODS This study was performed in 89,585 participants (age: 44.4±12.4 years, 58.5% female) of the general-population cohort LifeLines. Quality of Life (QoL) and work participation were examined as indicators of functional limitations. QoL was assessed with two summary scales of the RAND-36: the physical component summary (PCS) and the mental component summary (MCS). Work participation was assessed with a self-reported questionnaire. QoL and work participation were compared between FSS and MD patients, using Chi-squared tests and ANCOVA-analyses, adjusted for age, sex, educational level, and mental disorders. RESULTS Of the participants, 11.0% (n=9861) reported a FSS, and 2.7% (n=2395) reported a MD. Total QoL, PCS and MCS were significantly lower in all separate FSS and MD compared to controls (P≤.001). Clinically relevant differences in QoL were found between chronic fatigue syndrome and multiple sclerosis patients, and between fibromyalgia syndrome and rheumatoid arthritis patients. Compared to controls, FSS and MD patients reported a comparably reduced working percentage, increased sick absence, early retirement due to health-related reasons, and disability percentage (P≤.001). CONCLUSION Functional limitations in FSS patients are common, and as severe as those in patients with MD when looking at QoL and work participation, emphasizing that FSS are serious health conditions.
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Affiliation(s)
- Monica L Joustra
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, The Netherlands
| | - Karin A M Janssens
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, The Netherlands.
| | - Ute Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, The Netherlands
| | - Judith G M Rosmalen
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, The Netherlands
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Rieckmann P, Boyko A, Centonze D, Elovaara I, Giovannoni G, Havrdová E, Hommes O, Kesselring J, Kobelt G, Langdon D, LeLorier J, Morrow SA, Oreja-Guevara C, Schippling S, Thalheim C, Thompson H, Vermersch P. Achieving patient engagement in multiple sclerosis: A perspective from the multiple sclerosis in the 21st Century Steering Group. Mult Scler Relat Disord 2015; 4:202-18. [DOI: 10.1016/j.msard.2015.02.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/30/2015] [Accepted: 02/21/2015] [Indexed: 11/29/2022]
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