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Van Hijfte L, Cambron M, Capron B, Dachy B, Decoo D, Dive D, Dubois B, Sankari SE, London F, Perrotta G, Popescu V, Van Pesch V, Van Wijmeersch B, Willekens B, Laureys G. Multiple Sclerosis Multidisciplinary Care: A National Survey and Lessons for the Global Community. Mult Scler Relat Disord 2024; 85:105540. [PMID: 38489948 DOI: 10.1016/j.msard.2024.105540] [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: 03/29/2023] [Revised: 01/31/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Access to, standardization and reimbursement of multidisciplinary care for people with MS (PwMS) is lacking in many countries. Therefore, this study aims to describe the current multidisciplinary care for people with MS (PwMS) in Belgium and identify benefits, needs and future perspectives METHODS: A survey for PwMS questioned various aspects of MS and viewpoints on care. For MS nurses (MSN) and neurologists, employment, education, job-content, care organization and perspectives were inquired. Descriptive and univariate statistics were performed RESULTS: The PwMS survey comprised 916 respondents with a mean age of 46±12.7 years and 75,4 % of the respondents being female. The majority of the participants had relapsing remitting MS (60.8 %) and the mean patient determined disease steps (PDDS) was 2.0 (IQR=3). 65.3 % and 60.4 % of the PwMS reported having access to a multidisciplinary team (MDT) or MSN. Access to an MSN was associated with more frequent disease modifying treatment (p=.015), spasticity (p=.042) and gait treatment (p=.035), but also more physiotherapy (p=.004), driver's license adjustment (p<.001) and a higher employment rate (p=.004). MDT access was associated with more frequent symptomatic bladder treatment (p=.047), higher physiotherapy rate (p<.001), higher work- (p=.002), insurance- (p<.001) and home support measures (p=.019). PwMS without an available MDT more often indicated that MS care needs improvement (p<.001). MSN's (n = 22) were mainly funded through various budgets, including hospital and neurology practice budgets. Finally, 69 % and 75 % neurologists (n = 62) working without an MSN or MDT stated a need of such support and 61 % agreed that MDT's should be organized at hospital-network level CONCLUSION: MDT and MSN availability may enhance medical and socio-economic support for PwMS. Guidelines, alignment and reimbursement are needed.
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Affiliation(s)
- Liesbeth Van Hijfte
- Ghent University Hospital, 4Brain Research Unit, Department of Neurology, Gent, Belgium.
| | - Melissa Cambron
- Sint-Jan Bruges Hospital, Department of Neurology, Brugge, Belgium
| | - Brigitte Capron
- CHU de Charleroi, Department of Neurology, Lodelinsart, Belgium
| | - Bernard Dachy
- Hôpital Brugmann, Université Libre de Bruxelles, Department of Neurology, Brussels, Belgium
| | - Danny Decoo
- AZ Alma, Department of Neurology, Eeklo, Belgium
| | | | - Bénédicte Dubois
- University Hospitals Leuven, Department of Neurology, Leuven, Belgium
| | - Souraya El Sankari
- Cliniques Universitaires Saint-Luc, UCLouvain, Department of Neurology, Brussels, Belgium
| | - Frederic London
- CHU UCL Namur, Université catholique de Louvain, Department of Neurology, Yvoir, Belgium
| | - Gaetano Perrotta
- Hôpital Erasme, Université Libre de Bruxelles, Department of Neurology, Brussels, Belgium
| | - Veronica Popescu
- University MS Centre (UMSC), Hasselt-Pelt, Belgium; Noorderhart Hospitals, Revalidation and MS, Pelt, Belgium
| | - Vincent Van Pesch
- Cliniques Universitaires Saint-Luc, UCLouvain, Department of Neurology, Brussels, Belgium
| | - Bart Van Wijmeersch
- University MS Centre (UMSC), Hasselt-Pelt, Belgium; Noorderhart Hospitals, Revalidation and MS, Pelt, Belgium
| | - Barbara Willekens
- Antwerp University Hospital, Department of Neurology and UNiCA (University Neuroimmunology Center Antwerp), Edegem, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Translational Neurosciences Research Group, Wilrijk, Belgium
| | - Guy Laureys
- Ghent University Hospital, 4Brain Research Unit, Department of Neurology, Gent, Belgium
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Natarajan J, Joseph MA, Al Asmi A, Matua GA, Al Khabouri J, Thanka AN, Al Balushi LD, Al Junaibi SM, Al Ismaili IS. Health-related Quality of Life of People with Multiple Sclerosis in Oman. Oman Med J 2021; 36:e318. [PMID: 34804600 PMCID: PMC8593230 DOI: 10.5001/omj.2021.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/10/2021] [Indexed: 11/03/2022] Open
Abstract
Objectives Multiple sclerosis (MS) is a disabling neurological disorder with significant adverse effects on patients' quality of life (QoL). Despite the increased prevalence of MS in Arabian Gulf countries in recent years, no study has assessed the impact of MS on the health-related QoL (HRQoL) of Omani patients. Therefore, the objective of this study was to determine the impact of MS on HRQoL of Omani patients using the validated disease-specific self-administered MS International QoL (MusiQoL) instrument. Methods We conducted a descriptive cross-sectional survey between April and December 2019 on 177 Omani patients with MS attending Sultan Qaboos University Hospital and Khoula Hospital in Oman using the MusiQoL instrument. Results The majority (51.4%) of patients had poor HRQoL, and 48.6% had moderate HRQoL. We found that being > 30 years, female, married, separated, widowed, or divorced, and having visual and sleep problems resulted in poorer HRQoL scores. Among the different HRQoL components, relationships with the healthcare system and relationships with family and friends were the most affected by the disease process. Our results also showed that psychological wellbeing and coping domains of MusiQoL questionnaires are significantly reduced in females compared to males. Conclusions Understanding the HRQoL of Omanis with MS provides valuable knowledge that could help optimize the management of this disease.
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Affiliation(s)
- Jansirani Natarajan
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Mickael Antoine Joseph
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Abdullah Al Asmi
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Gerald Amandu Matua
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Anitha Nesa Thanka
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Suad Moosa Al Junaibi
- Adult Health Nursing Department, Nursing Program, Oman College of Health Sciences, Muscat, Oman
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Demirtepe-Saygılı D. Multiple sclerosis experiences of couples: Examination of patient and partner perspectives. J Health Psychol 2021; 27:2079-2090. [PMID: 34111986 DOI: 10.1177/13591053211017192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study aims to investigate Multiple Sclerosis (MS) experiences of couples. Using a dyadic qualitative method, separate simultaneous interviews were conducted with 20 couples, including one partner with MS. The themes resulting from content analysis were examined in two categories: Convergent (anxiety about future, acceptance of MS and MS as an accelerator of the relationship) and divergent (sexual problems, the experience of MS symptoms, the priority of the problems and untold issues). The findings revealed shared and unique perspectives of partners in the illness process, having the potential to guide the psychosocial interventions for couples living with a chronic illness.
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Aburub AS, Khalil H, Al-Sharman A, El-Salem K. Measuring quality of life and identifying what is important to Jordanian living with multiple sclerosis using the Arabic version of the patient-generated index. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1893. [PMID: 33448540 DOI: 10.1002/pri.1893] [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] [Received: 03/06/2020] [Revised: 11/30/2020] [Accepted: 12/25/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Patient-generated index (PGI) is one of the individualized measures used to measure the quality of life (QOL) in people with different chronic conditions including multiple sclerosis (MS). However, the psychometric properties of the Arabic version of the PGI have not been fully established in Jordanian living with MS. Therefore, the objective of this study is to identify what matters to Jordanian living with MS and to contribute evidence toward the psychometric properties of the Arabic version of the PGI. METHODS A total of 75 participants with MS completed three QOL measures; PGI, the patient determined disease steps (PDDS), and EQ-5D. Generalized estimating equations were used to compare the total score of three QOL measures. Bland-Altman plot and Spearman's correlation coefficient were used to study the relationships and differences between the PGI and the other study measures (PDDS and EQ-5D). RESULTS Only 66 (88%) of the participants were able to complete the PGI. Overall, 36 areas of QOL concern were nominated by the participants using the PGI with the top three areas were emotional function (47%), involuntary movement reaction functions (45.5%), and walking (44 %). The average global score of the PGI was lower (34 ± 22) than the global score of the EQ-5D (69 ± 23), and the PDDS (68 ± 24). PGI had a moderate correlation with EQ-5D and PPDS. CONCLUSION The Arabic version of the PGI is a feasible, acceptable, and valid measure among Jordanians with MS. PGI also captures more important areas that contribute to QOL than EQ-5D and PDDS. PGI could improve the decision making and guide healthcare professionals to provide appropriate intervention programs to reduce the burdens from MS disease and improve QOL.
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Affiliation(s)
- Ala' S Aburub
- Physical Therapy, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan
| | - Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alham Al-Sharman
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid El-Salem
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Conroy SK, Brownlowe KB, McAllister TW. Depression Comorbid With Stroke, Traumatic Brain Injury, Parkinson's Disease, and Multiple Sclerosis: Diagnosis and Treatment. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2020; 18:150-161. [PMID: 33162852 DOI: 10.1176/appi.focus.20200004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Depression is common among patients with neurologic disorders, and it has long been considered more difficult to treat than depression in the general population. In this review, the authors consider challenges in the diagnosis and treatment of depression among patients with stroke, traumatic brain injury, Parkinson's disease, and multiple sclerosis. For each disorder, the authors discuss the epidemiology and time course of depression as well as review the physiologic and psychological etiologies of depression. In addition, for each disorder, they review screening tools and diagnostic considerations, including differential diagnosis; discuss etiological factors, both neurobiological and psychological; and assess evidence for various depression treatments, including pharmacologic, psychosocial, and neuromodulatory therapies. The evidence suggests that depression is common among patients with neurologic disorders and that it is crucial for general psychiatrists to provide treatment for this population.
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Affiliation(s)
- Susan K Conroy
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Conroy, McAllister); Department of Psychiatry, Wexner Medical Center, Ohio State University, Columbus (Brownlowe)
| | - Katherine B Brownlowe
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Conroy, McAllister); Department of Psychiatry, Wexner Medical Center, Ohio State University, Columbus (Brownlowe)
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Conroy, McAllister); Department of Psychiatry, Wexner Medical Center, Ohio State University, Columbus (Brownlowe)
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Messinis L, Kosmidis MH, Nasios G, Konitsiotis S, Ntoskou A, Bakirtzis C, Grigoriadis N, Patrikelis P, Panagiotopoulos E, Gourzis P, Malefaki S, Papathanasopoulos P. Do Secondary Progressive Multiple Sclerosis patients benefit from Computer- based cognitive neurorehabilitation? A randomized sham controlled trial. Mult Scler Relat Disord 2020; 39:101932. [PMID: 31927200 DOI: 10.1016/j.msard.2020.101932] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/21/2019] [Accepted: 01/02/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cognitive impairment is common in multiple sclerosis (MS), but deficits tend to be more pronounced in progressive MS, negatively impacting daily functional capacity. Despite this, most cognitive rehabilitation (CR) interventions to date have focused on relapsing-remitting MS (RRMS). Moreover, information on the efficacy of CR in progressive MS is limited and controversial. The present study investigated the efficacy of a home based, computer assisted cognitive rehabilitation (HBCACR) intervention (RehaComTM software) exclusively in a Secondary Progressive Multiple Sclerosis (SPMS) sample. METHODS This was a randomized, multi site, sham controlled trial. Thirty six (36) individuals with SPMS, naïve to the RehaCom software, with cognitive deficits were randomized to the treatment (IG; n= 19) or control group condition (CG; n=17). Treatment with the RehaCom modules consisted of 24 domain and task specific, 45 minute session's over an 8-week period, three sessions per week, applied by each patient at home. The CG completed non specific computer based activities at home with the same frequency and duration. Primary cognitive outcome measures included the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery, and secondary outcome measures for depression (BDI-FS), fatigue (MFIS), and quality of life (EuroQol EQ-5D) visual analogue scale (VAS). RESULTS The two groups were well matched on demographic and clinical characteristics, cognitive reserve and severity of cognitive deficits at baseline assessment. At post treatment assessment the IG group showed significant improvements with large effect sizes; in verbal learning [z = -4.759, p <.0005, g = 2.898], visuospatial memory [z = -3.940, p <.0005, g = 1.699] and information processing speed [z= -4.792, p <.0005, g = 2.980], compared with the sham control group. We also found significant between group differences on physical [z=-3.308, p = .001, g= -.604], cognitive [z = -4.011, p <.0005, g = -1.654], psychosocial [z= 3.308, p = .010, g = -.940], and general fatigue impact [z= -2.623, p = .008, g = -.519], depression severity [z = -2.730, p = .006, g = -.519], and quality of life [z= -4.239, p <.0005, g = -1.885] in favor of the treated group. CONCLUSION These data provide the first evidence supporting the efficacy of computer based restorative cognitive rehabilitation applied at home exclusively in SPMS patients, suggesting that adaptive neuroplasticity may occur after functional cognitive training in progressive MS. Improved cognitive functioning in combination with mood augmentation appear to have ameliorated fatigue, which impacted daily functioning activity and culminated in improved health related quality of life.
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Affiliation(s)
- Lambros Messinis
- Neuropsychology Section, Departments of Neurology and Psychiatry, University Hospital of Patras and University of Patras Medical School.
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina
| | | | - Aikaterini Ntoskou
- Rehabilitation Unit for patients with Spinal Cord Injury, "Demetrios and Vera Sfikas" Department of Medicine, University of Patras Medical School
| | - Christos Bakirtzis
- B'Department of Neurology and the MS Center, AHEPA University Hospital, Central Macedonia, Thessaloniki, Greece
| | - Nikolaos Grigoriadis
- B'Department of Neurology and the MS Center, AHEPA University Hospital, Central Macedonia, Thessaloniki, Greece
| | - Panayiotis Patrikelis
- First Department of Neurosurgery, Medical School, National and Kapodistrian University of Athens, Greece
| | - Elias Panagiotopoulos
- Rehabilitation Unit for patients with Spinal Cord Injury, "Demetrios and Vera Sfikas" Department of Medicine, University of Patras Medical School
| | | | - Sonia Malefaki
- Department of Mechanical Engineering & Aeronautics, University of Patras (statistics)
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Abstract
Multiple sclerosis (MS) is a chronic, progressive, autoimmune, neurodegenerative disorder that can interfere with physical and psychological functioning, negatively affecting health-related quality of life (HRQoL). Fostering mindfulness may mitigate the negative consequences of MS on HRQoL. The relationship between mindfulness, mood and MS-related quality of life was investigated. In total, 52 individuals with MS completed questionnaires to examine the relationship between trait mindfulness and wellness. Higher levels of trait mindfulness were associated with better HRQoL, lower depression and anxiety, lower fatigue impact and fewer perceived cognitive deficits. Mindfulness interventions have the potential to enhance wellness in those living with MS.
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Nozari E, Ghavamzadeh S, Razazian N. The Effect of Vitamin B12 and Folic Acid Supplementation on Serum Homocysteine, Anemia Status and Quality of Life of Patients with Multiple Sclerosis. Clin Nutr Res 2019; 8:36-45. [PMID: 30746346 PMCID: PMC6355946 DOI: 10.7762/cnr.2019.8.1.36] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 01/11/2019] [Accepted: 01/15/2019] [Indexed: 11/24/2022] Open
Abstract
Plasma homocysteine level and megaloblastic anemia status are two factors that can affect the quality of life of patients with multiple sclerosis (MS). We conducted this study to determine the effect of vitamin B12 and folic acid supplementation on serum homocysteine, megaloblastic anemia status and quality of life of patients with MS. A total of 50 patients with relapsing remitting multiple sclerosis (RRMS) included in this study which divided into 2 groups. The vitamin group received 5 mg folic acid tablet daily and 3 doses of vitamin B12 (1,000 mcg) injection and the other group received placebo and normal saline injection (same doses). The quality of life was measured by using Multiple Sclerosis Quality of Life-54 questionnaire (MSQOL-54). Fully automated fluorescence polarization immunoassay was used to measure serum homocysteine, vitamin B12 and folate. Complete blood count blood test was conducted to determine the anemia status. The mean homocysteine level reduced by 2.49 ± 0.39 µmol/L (p = 0.001), hemoglobin increased from 11.24 ± 1.54 to 13.12 ± 1.05 g/dL (p = 0.001), and mean corpuscular volume decreased from 95.50 ± 6.65 to 89.64 ± 4.24 in the vitamin group (p = 0.001). There was a significant improvement in the mental field of life quality in the placebo group (37.46 ± 19.01 to 50.98 ± 21.64; p = 0.001), whereas both physical and mental fields of quality of life were improved significantly in the vitamin group (40.38 ± 15.07 to 59.21 ± 12.32 and 29.58 ± 15.99 to 51.68 ± 18.22, respectively; p = 0.001). Serum homocysteine level decrease and anemia status improvement with vitamin B12 and folic acid supplementation reveal the potential role of these two vitamins in improving the life quality of MS patients.
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Affiliation(s)
- Ehsan Nozari
- Department of Nutrition, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Saied Ghavamzadeh
- Department of Nutrition, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Nazanin Razazian
- Department of Neurology, Medicine Faculty, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Sadeghi Bahmani D, Kesselring J, Papadimitriou M, Bansi J, Pühse U, Gerber M, Shaygannejad V, Holsboer-Trachsler E, Brand S. In Patients With Multiple Sclerosis, Both Objective and Subjective Sleep, Depression, Fatigue, and Paresthesia Improved After 3 Weeks of Regular Exercise. Front Psychiatry 2019; 10:265. [PMID: 31130879 PMCID: PMC6510171 DOI: 10.3389/fpsyt.2019.00265] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/08/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Multiple sclerosis (MS) patients suffer from various difficulties including sleep complaints, symptoms of depression and fatigue, paresthesia, and cognitive impairments. There is growing evidence that regular physical activity has a positive effect on both sleep and psychological functioning, though there is limited evidence of this kind for MS patients. The aim of the present study was therefore to investigate the impact on this patient group of a regular exercise program with respect to subjective and objective sleep, depression, paresthesia, fatigue, and cognitive performance. Methods: A total of 46 patients [mean age: 50.74 years; Expanded Disability Status Scale (EDSS): mean: 5.3, 78.4% females] completed this 3-week intervention study. At baseline and 3 weeks later, they answered questionnaires covering sociodemographic information, subjective sleep, depression, fatigue, paresthesia, and subjective physical activity. Objective sleep [sleep electroencephalogram (EEG) recordings] and cognitive performance were also assessed at both time points. Patients participated in a regular exercise activity every weekday for about 60 min. Results: Compared to the baseline, by the end of the study, objective sleep had significantly improved (sleep efficiency, sleep onset latency, and wake time after sleep onset), and symptoms of sleep complaints, depression, fatigue, and paresthesia were significantly reduced. Subjective physical activity (moderate and vigorous) and cognitive performance also increased over the course of the intervention. Conclusions: In patients with MS, participation in regular exercise impacted positively on their objective and subjective sleep, depression, paresthesia, fatigue, and cognitive performance.
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Affiliation(s)
- Dena Sadeghi Bahmani
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | | | - Uwe Pühse
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Vahid Shaygannejad
- Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Sport Science Section, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Haapamäki J, Heikkinen E, Sipponen T, Roine RP, Arkkila P. The impact of an adaptation course on health-related quality of life and functional capacity of patients with inflammatory bowel disease. Scand J Gastroenterol 2018; 53:1074-1078. [PMID: 30175636 DOI: 10.1080/00365521.2018.1500639] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) has a substantial impact on patients health-related quality of life (HRQoL). In this study, we examined the impact of adaptation courses on HRQoL, psychological well-being, depression and number of sick-leave days of IBD patients. METHODS The study recruited 142 IBD patients attending an adaptation course of 5-12 days. The courses were specially designed for IBD patients and included multidisciplinary information about IBD, peer support, group activities and encouragement for adequate physical exercise. The participants completed the study questionnaire at the beginning and the end of the course and after six and 12 months of follow-up. HRQoL was assessed with the generic 15-dimensional (15D) tool and depression with Beck's Depression Inventory (BDI). Utilization of health care services and work absenteeism was also assessed. Visual analog scales were used for assessing psychological functioning. RESULTS 15D, BDI scores and scores describing psychological well-being were significantly better at the end of the course when compared to baseline (15D 0.82 vs. 0.84, p < .001; BDI 11.8 vs. 8.5, p < .001). Positive results were maintained during follow up. The percentage of patients receiving peer support rose from 32 to 70% and those with peer support had better HRQoL at the 12-month follow-up (p = .01). No significant change in health care utilization or number of sick-leave days was observed. CONCLUSION Adaptation training appears to have a positive impact on the psychological well-being of IBD patients. Peer support appears to be an important factor.
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Affiliation(s)
- Johanna Haapamäki
- a Helsinki University Hospital , Helsinki University , Helsinki , Finland
| | - Erjastiina Heikkinen
- b Kaisankoti Rehabilitation centre , Espoo , Finland.,c Social and Health Services, City of Helsinki , Helsinki , Finland
| | - Taina Sipponen
- a Helsinki University Hospital , Helsinki University , Helsinki , Finland
| | - Risto P Roine
- d Faculty of Health Sciences, University of Eastern Finland , Kuopio , Finland
| | - Perttu Arkkila
- a Helsinki University Hospital , Helsinki University , Helsinki , Finland
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Schreiber K, Kant M, Pfleger C, Jensen HB, Oesterberg O, Hald AR, Nielsen FK, Rubak S. High treatment adherence, satisfaction, motivation, and health-related quality of life with fingolimod in patients with relapsing-remitting multiple sclerosis - results from a 24-month, multicenter, open-label Danish study. Patient Prefer Adherence 2018; 12:1139-1150. [PMID: 29988735 PMCID: PMC6029605 DOI: 10.2147/ppa.s166278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Treatment adherence is a prerequisite for treatment success and therefore an important consideration to assure that therapeutic goals are achieved both from a patient point of view and for optimal health care resource utilization. Published data on treatment adherence with fingolimod (Gilenya®) are limited. Therefore, this study investigated treatment adherence in patients with relapsing-remitting multiple sclerosis (RRMS) treated with fingolimod in Denmark. PATIENTS AND METHODS This was a 24-month, multicenter, open-label study, investigating treatment adherence, satisfaction, motivation, and health-related quality of life (QoL) in RRMS patients treated with fingolimod. In addition, the effect of a motivational interview support program on these measures was evaluated. Treatment adherence was assessed by pill count. Treatment satisfaction, motivation, and QoL were assessed by patient-reported outcomes (PROs). RESULTS A total of 195 patients were enrolled in the study. A very high treatment adherence was observed during the entire study with no statistically significant difference between study visits before (99%) and after (97%) the motivational interview. In accordance, a high level of treatment satisfaction was found in the Treatment Satisfaction Questionnaire for Medication 9, which was scored high throughout the study with the highest scores seen for the convenience domain (ranging from 94.51 to 95.78). Furthermore, additional PROs demonstrated a high health-related QoL, a self-determined form of motivation for taking medication, and a patient perception of an autonomy supportive approach provided by the health care provider, at all study visits. CONCLUSION High levels of treatment adherence, satisfaction, motivation, and QoL were observed in Danish RRMS patients treated with fingolimod. As these positive measures were observed at all study visits and throughout the study, no effect of the motivational interview support program was found.
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Affiliation(s)
- Karen Schreiber
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Matthias Kant
- Department of Neurology, Hospital of Southern Jutland, Soenderborg, Denmark
| | - Claudia Pfleger
- Department of Neurology, Aalborg University Hospital, Denmark
| | | | | | | | | | - Sune Rubak
- Department of Child and Adolescent Health, Aarhus University Hospital Skejby, Aarhus Denmark
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Barzegar M, Badihian S, Mirmosayyeb O, Ashtari F, Jamadi M, Emami S, Jahani L, Safavi A, Shaygannejad V. Comparative study of quality of life, anxiety, depression, and fatigue among patients with neuromyelitis optica spectrum disorder and multiple sclerosis: The first report from Iran. Mult Scler Relat Disord 2018; 22:161-165. [PMID: 29775851 DOI: 10.1016/j.msard.2018.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/07/2018] [Accepted: 04/13/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are associated with reduced Health Related Quality of Life (HRQOL). To the best of our knowledge, change of HRQOL in patients with NMOSD has not been yet measure in Iran. The objective of this study was to assess HRQOL in NMOSD and MS patients and identify related factors METHODS: A cross sectional study of 41 patients with NMOSD and 136 age and sex-match MS patients was performed. A series of questionnaires including Persian validated questionnaires on HRQOL (SF-36), fatigue (MFIS), depression (BDI-II), anxiety (HAM-A) and sleep quality (PSQI) were record. All demographic variables, socioeconomic status and clinical data were also obtained. Student's T test and Mann-Whitney U test used to compare variables between groups and multivariate regression analysis applied to assay predictor factors. RESULTS The mean scores of mental (MCS) and physical (PCS) components of QOL were statistically lower in patients with NMOSD compare with MS patients (β = -4.49, P = 0.004; β = -3.52, P = 0.015). Multivariate analysis indicated fatigue, depression and anxiety were independent, significant predictor of MCS (β = -0.229, P = 0.002; β = -0.229, P = 0.002; β = -0.258, P = 0.020 respectively). However, PCS was significantly predicted by fatigue (β = -0.258 P < 0.001), solely. CONCLUSION These findings indicate NMOSD patients have lower HRQOL in compare to patients with MS. Also, screening and treatment of fatigue as the most important predictor for HRQOL is necessary.
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Affiliation(s)
- Mahdi Barzegar
- Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Student Research Committee, School of medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shervin Badihian
- Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Student Research Committee, School of medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Mirmosayyeb
- Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Student Research Committee, School of medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshteh Ashtari
- Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Jamadi
- Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Student Research Committee, School of medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shohreh Emami
- Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Jahani
- Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Armaghan Safavi
- Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Shaygannejad
- Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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Al-Sharman A, Khalil H, Nazzal M, Al-Sheyab N, Alghwiri A, El-Salem K, AlDughmi M. Living with multiple sclerosis: A Jordanian perspective. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018. [DOI: 10.1002/pri.1709] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Alham Al-Sharman
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences; Jordan University of Science and Technology; Irbid Jordan
| | - Hanan Khalil
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences; Jordan University of Science and Technology; Irbid Jordan
| | - Mohammad Nazzal
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences; Jordan University of Science and Technology; Irbid Jordan
| | - Nihaya Al-Sheyab
- Faculty of Nursing, Department of Maternal and Child Nursing-Faculty member; Jordan University of Science and Technology; Irbid Jordan
| | - Alia Alghwiri
- School of Rehabilitation Sciences; The University of Jordan; Amman Jordan
| | - Khalid El-Salem
- Faculty of Medicine; Jordan University of Science and Technology; Irbid Jordan
| | - Mais AlDughmi
- School of Rehabilitation Sciences; The University of Jordan; Amman Jordan
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Cook KF, Victorson DE, Cella D, Schalet BD, Miller D. Creating meaningful cut-scores for Neuro-QOL measures of fatigue, physical functioning, and sleep disturbance using standard setting with patients and providers. Qual Life Res 2014; 24:575-89. [PMID: 25148759 DOI: 10.1007/s11136-014-0790-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE To establish clinically relevant classifications of health outcome scores for four Neuro-QOL measures (lower extremity function, upper extremity function, fatigue, and sleep disturbance). METHODS We employed a modified educational standard-setting methodology to identify cut-scores for symptom severity. Clinical vignettes were developed to represent graduated levels of symptom severity. A clinician panel and a panel of persons with multiple sclerosis (PwMS) were recruited, and, in separate, 1-day meetings, the panelists identified adjacent vignettes they judged to represent the threshold between two levels of severity for a given domain (e.g., threshold between a vignette that indicated "no problems" with sleep and the adjacent one that represented "mild problems" with sleep). Working independently, each panel (PwMS and clinicians) reached consensus on its recommended thresholds for each of the four targeted measures. Cut-scores were defined as the mean location for each pair of threshold vignettes. RESULTS PwMS and clinician panels derived identical thresholds for severity levels of lower extremity function and sleep disturbance, but slightly different ones for upper extremity function and fatigue. In every case of divergence, PwMS set higher thresholds for more severe classifications of symptoms (by 0.5 SDs) than did clinicians. CONCLUSIONS The modified bookmarking method is effective for defining thresholds for symptom severity based on self-reported outcome scores and consensus judgments. Derived cut-scores and severity levels provide an interpretative context for Neuro-QOL scores. Future studies should explore whether these findings can be replicated and evaluate the validity of the classifications compared to external criteria.
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Affiliation(s)
- Karon F Cook
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,
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15
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Tompkins SA, Roeder JA, Thomas JJ, Koch KK. Effectiveness of a relationship enrichment program for couples living with multiple sclerosis. Int J MS Care 2014; 15:27-34. [PMID: 24453760 DOI: 10.7224/1537-2073.2012-002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Living with a chronic illness such as multiple sclerosis (MS) has significant psychosocial ramifications. In particular, the patient's relationship with a spouse or significant other is often negatively affected. Programs are needed to address the psychosocial challenges of the illness and help improve outcomes for both the person with MS and his or her romantic support partner. Relationship Matters (RM) is a relationship enrichment program that integrates information and resources of the National Multiple Sclerosis Society with empirically based marriage education. The purpose of this study was to examine the effectiveness of the RM program in increasing relationship satisfaction and aspects of health-related quality of life in couples living with MS over a 3-month follow-up period. Couples were given 8 hours of programming via in-person workshops disseminated across the country or teleconferences. A control group consisting of members of MS couples who did not receive the intervention was used for comparison. The results indicate that RM significantly improved relationship satisfaction over time compared with no intervention (P < .05). Additional findings include significant improvements in mental health-related quality of life as well as reported improvements in communication, conflict resolution, and ability to handle MS-specific relationship issues. Overall, these findings show that RM results in improved couple functioning and additional psychological health benefits for individuals with MS and their romantic support partners.
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Affiliation(s)
- Sara Anne Tompkins
- Madipen Consulting, LLC, Fort Collins, CO, USA (SAT); National Multiple Sclerosis Society, Denver, CO, USA (JAR, KKK); and Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA (JJT)
| | - Jessica Ann Roeder
- Madipen Consulting, LLC, Fort Collins, CO, USA (SAT); National Multiple Sclerosis Society, Denver, CO, USA (JAR, KKK); and Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA (JJT)
| | - Jenifer J Thomas
- Madipen Consulting, LLC, Fort Collins, CO, USA (SAT); National Multiple Sclerosis Society, Denver, CO, USA (JAR, KKK); and Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA (JJT)
| | - Kimberly K Koch
- Madipen Consulting, LLC, Fort Collins, CO, USA (SAT); National Multiple Sclerosis Society, Denver, CO, USA (JAR, KKK); and Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA (JJT)
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Skokou M, Soubasi E, Gourzis P. Depression in multiple sclerosis: a review of assessment and treatment approaches in adult and pediatric populations. ISRN NEUROLOGY 2012; 2012:427102. [PMID: 23097716 PMCID: PMC3477767 DOI: 10.5402/2012/427102] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 09/17/2012] [Indexed: 12/18/2022]
Abstract
Multiple sclerosis is a chronic demyelinating disease affecting one million people worldwide, with a significant burden of psychiatric comorbidity. Depression is the commonest psychiatric manifestation but still remains largely underdiagnosed and undertreated. The present work reviews current knowledge on diagnosis, assessment, and somatic and psychotherapeutic treatment interventions for depression in adult and pediatric populations of patients with multiple sclerosis.
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Affiliation(s)
- Maria Skokou
- Department of Psychiatry, School of Medicine and University Hospital of Patras, University of Patras, Rio, 26504 Patras, Greece
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Abstract
Major depressive disorder is a common illness, particularly in patients with medical and neurologic conditions. This article summarizes current data on the epidemiology, diagnosis, and treatment of major depression, with special emphasis on the diagnosis and treatment of depression in medical and neurologic patients. We reviewed the role of pharmacotherapies, psychotherapies, somatic treatments, and alternative remedies and we included practical advice for clinician regarding the timing and sequence of these treatments, the role of standardized depression scales, and the criteria for referrals to specialty consultants.
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