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Sainz de la Maza S, Maurino J, Castillo-Triviño T, Borges M, Sebastián Torres B, Sotoca J, Alonso Torres AM, Caminero AB, Borrega L, Sánchez-Menoyo JL, Barrero-Hernández FJ, Calles C, Brieva L, Blasco MR, Dotor García-Soto J, Rodríguez-Regal A, Navarro-Cantó L, Agüera-Morales E, Garcés M, Carmona O, Gabaldón-Torres L, Forero L, Hervás M, Gómez-Ballesteros R. Hopelessness in Patients with Early-Stage Relapsing-Remitting Multiple Sclerosis. Patient Prefer Adherence 2023; 17:1431-1439. [PMID: 37337517 PMCID: PMC10277026 DOI: 10.2147/ppa.s411069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/25/2023] [Indexed: 06/21/2023] Open
Abstract
Background Hopelessness is a risk factor for depression and suicide. There is little information on this phenomenon among patients with relapsing-remitting multiple sclerosis (RRMS), one of the most common causes of disability and loss of autonomy in young adults. The aim of this study was to assess state hopelessness and its associated factors in early-stage RRMS. Methods A multicenter, non-interventional study was conducted. Adult patients with a diagnosis of RRMS, a disease duration ≤ 3 years, and an Expanded Disability Status Scale (EDSS) score of 0-5.5 were included. The State-Trait Hopelessness Scale (STHS) was used to measure patients´ hopelessness. A battery of patient-reported and clinician-rated measurements was used to assess clinical status. A multivariate logistic regression analysis was conducted to determine the association between patients' characteristics and state hopelessness. Results A total of 189 patients were included. Mean age (standard deviation-SD) was 36.1 (9.4) years and 71.4% were female. Median disease duration (interquartile range-IQR) was 1.4 (0.7, 2.1) years. Symptom severity and disability were low with a median EDSS (IQR) score of 1.0 (0, 2.0). A proportion of 65.6% (n=124) of patients reported moderate-to-severe hopelessness. Hopelessness was associated with older age (p=0.035), depressive symptoms (p=<0.001), a threatening illness perception (p=0.001), and psychological and cognitive barriers to workplace performance (p=0.029) in the multivariate analysis after adjustment for confounders. Conclusion Hopelessness was a common phenomenon in early-stage RRMS, even in a population with low physical disability. Identifying factors associated with hopelessness may be critical for implementing preventive strategies helping patients to adapt to the new situation and cope with the disease in the long term.
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Affiliation(s)
| | | | | | - Mónica Borges
- Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Javier Sotoca
- Department of Neurology, Hospital Universitari Vall d´Hebrón, Barcelona, Spain
| | | | - Ana B Caminero
- Department of Neurology, Complejo Asistencial de Ávila, Ávila, Spain
| | - Laura Borrega
- Department of Neurology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | | | | | - Carmen Calles
- Department of Neurology, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Luis Brieva
- Department of Neurology, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | | | | | - Ana Rodríguez-Regal
- Department of Neurology, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - Laura Navarro-Cantó
- Department of Neurology, Hospital General Universitario de Elche, Elche, Spain
| | | | - Moisés Garcés
- Department of Neurology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Olga Carmona
- Department of Neurology, Fundació Salut Empordà, Figueres, Spain
| | | | - Lucía Forero
- Department of Neurology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Mariona Hervás
- Department of Neurology, Consorci Corporació Sanitària Parc Taulí, Sabadell, Spain
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Sainz de la Maza S, Gómez-Ballesteros R, Borges M, Martín-Martínez J, Sotoca J, Alonso A, Caminero AB, Borrega L, Sánchez-Menoyo JL, Barrero-Hernández FJ, Calles C, Brieva L, Blasco-Quílez MR, Dotor García-Soto J, del Campo-Amigo M, Navarro-Cantó L, Agüera E, Garcés-Redondo M, Carmona O, Gabaldón-Torres L, Forero L, Hervàs M, Medrano N, Maurino J, Castillo-Triviño T. Detecting disability using self-reported and clinical assessments in early-stage relapsing-remitting multiple sclerosis: Looking for a complementary approach. Mult Scler J Exp Transl Clin 2023; 9:20552173231169475. [PMID: 37187856 PMCID: PMC10176560 DOI: 10.1177/20552173231169475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/23/2023] [Indexed: 05/17/2023] Open
Abstract
Disability accrual is mainly driven by progression independent of relapse activity, which is present even in early stages of relapsing-remitting multiple sclerosis (RRMS) and sometimes overlooked. This multicenter, non-interventional study evaluated whether patient-reported outcomes measures (PROMs) could capture disability in 189 early-stage RRMS patients (mean age: 36.1 ± 9.4 years, 71.4% female, mean disease duration: 1.4 ± 0.8 years, median EDSS: 1.0). The 9-Hole Peg Test (9-HPT), NeuroQoL Upper Extremity (NeuroQoL-UE), Timed 25-Foot Walk (T25-FW), Multiple Sclerosis Walking Scale (MSWS-12), Symbol Digit Modalities Test (SDMT), and Perceived Deficits Questionnaire (PDQ-5) were used to assess hand function, gait, and cognition, respectively. These functions were at least mildly affected in this early-stage population, finding significant correlations between PROMs and clinical assessments. PROMs could enable early-stage RRMS patients to communicate their perceived disability in different domains, assisting clinicians in disease monitoring and decision making.
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Affiliation(s)
- Susana Sainz de la Maza
- Department of Neurology, Hospital Universitario
Ramón y Cajal, IRyCIS, Universidad de Alcalá, Madrid, Spain
| | | | - Mónica Borges
- Department of Neurology, Hospital Universitario Virgen
Macarena, Sevilla, Spain
| | | | - Javier Sotoca
- Department of Neurology, Hospital Universitari Mútua
Terrassa, Terrassa, Spain
| | - Ana Alonso
- Department of Neurology, Hospital Regional
Universitario de Málaga, Málaga, Spain
| | - Ana B Caminero
- Department of Neurology, Complejo Asistencial de
Ávila, Ávila, Spain
| | - Laura Borrega
- Department of Neurology, Hospital Universitario Fundación
Alcorcón, Alcorcón, Spain
| | | | | | - Carmen Calles
- Department of Neurology, Hospital Universitari
Son Espases, Palma de Mallorca, Spain
| | - Luis Brieva
- Department of Neurology, Hospital Universitari Arnau de
Vilanova, Lleida, Spain
| | | | | | - María del Campo-Amigo
- Department of Neurology, Complexo Hospitalario
Universitario de Pontevedra, Pontevedra, Spain
| | - Laura Navarro-Cantó
- Department of Neurology, Hospital General Universitario de
Elche, Elche, Spain
| | - Eduardo Agüera
- Department of Neurology, Hospital
Universitario Reina Sofía, Córdoba, Spain
| | - Moisés Garcés-Redondo
- Department of Neurology, Hospital Clínico Universitario
Lozano Blesa, Zaragoza, Spain
| | - Olga Carmona
- Department of Neurology, Fundació Salut
Empordà, Figueres, Spain
| | | | - Lucía Forero
- Department of Neurology, Hospital
Universitario Puerta del Mar, Cádiz, Spain
| | - Mariona Hervàs
- Department of Neurology, Consorci Corporació Sanitària
Parc Taulí, Sabadell, Spain
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Sainz de la Maza S, Maurino J, Borges M, Martín-Martínez J, Sotoca J, Alonso A, Caminero AB, Borrega L, Sánchez-Menoyo JL, Barrero-Hernández FJ, Calles C, Brieva L, Blasco MR, García-Soto JD, Campo-Amigo MD, Navarro-Cantó L, Agüera E, Garcés M, Carmona O, Gabaldón-Torres L, Forero L, Hervás M, de Alda LR, Gómez-Ballesteros R, Castillo-Triviño T. Measuring productivity loss in early relapsing-remitting multiple sclerosis. Mult Scler Relat Disord 2022; 58:103398. [PMID: 35216781 DOI: 10.1016/j.msard.2021.103398] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/08/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Multiple sclerosis is one of the most common causes of neurological disability in young adults with major consequences for their autonomy and capacity to maintain employment. OBJECTIVE The aim of this study was to assess the impact on work productivity in early-stage relapsing-remitting multiple sclerosis (RRMS). METHODS A multicenter, non-interventional study was conducted. Adult patients with a diagnosis of RRMS, a disease duration ≤ 3 years, and an Expanded Disability Status Scale (EDSS) score of 0-5.5 were included. Absenteeism, presenteeism, and unpaid work loss due to RRMS were measured using the Valuation of Lost Productivity (VOLP) questionnaire. The EDSS, SymptoMScreen, 5-item Modified Fatigue Impact Scale, Hospital Anxiety and Depression Scale, Symbol Digit Modalities Test, and Multiple Sclerosis Work Difficulties Questionnaire were used to gather information on disability, patients' perception of symptom severity, fatigue, mood/anxiety, cognition, and problems in the workplace, respectively. Associations between the VOLP and clinical and work outcomes were analyzed using Spearman's rank correlations. RESULTS A total of 189 patients were included. Mean age (SD) was 36.1 ± 9.4 years and 71.4% were female. Mean disease duration was 1.2 ± 0.8 years. Median EDSS score was 1.0 (IQR 0, 2.0). One hundred thirty patients (68.8%) were working for pay or self-employed. Fifty-three patients (40.8%) reported absence from work in the past 3 months with an average of 14.3 absent workdays. Their health problems resulted in the loss of 3.4% of their actual work time in the past 7 days. Thirty patients got help (11.8 h) with their unpaid work activities in the past 7 days. Absenteeism was significantly correlated with anxiety and depression (rho=0.298 and 0.291, p<0.001), fatigue (rho=0.214, p = 0.014), and symptom severity (rho=0.213, p = 0.015). Presenteeism was significantly correlated with fatigue (rho=0.375, p<0.001), symptom severity (rho=0.373, p<0.001), depression (rho=0.263, p = 0.008), and disability (rho=0.215, p = 0.031). CONCLUSIONS Productivity loss even in a RRMS population with short disease duration stresses the need for more efficient treatment control of disease activity from earlier stages.
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Affiliation(s)
| | | | - Mónica Borges
- Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Javier Sotoca
- Department of Neurology, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Ana Alonso
- Department of Neurology, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Ana B Caminero
- Department of Neurology, Complejo Asistencial de Ávila, Ávila, Spain
| | - Laura Borrega
- Department of Neurology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | | | | | - Carmen Calles
- Department of Neurology, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Luis Brieva
- Department of Neurology, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Maria R Blasco
- Department of Neurology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | - María Del Campo-Amigo
- Department of Neurology, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - Laura Navarro-Cantó
- Department of Neurology, Hospital General Universitario de Elche, Elche, Spain
| | - Eduardo Agüera
- Department of Neurology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Moisés Garcés
- Department of Neurology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Olga Carmona
- Department of Neurology, Fundació Salut Empordà, Figueres, Spain
| | | | - Lucía Forero
- Department of Neurology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Mariona Hervás
- Department of Neurology, Consorci Corporació Sanitària Parc Taulí, Sabadell, Spain
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Gabaldón-Torres L, Jordan M, Osorio-Caicedo P, Badía-Picazo M, Salas-Felipe J. Autoimmune acute motor sensory axonal polyradiculoneuritis in a case of inflammatory bowel disease. Neurología (English Edition) 2015. [DOI: 10.1016/j.nrleng.2014.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gabaldón-Torres L, Jordan M, Osorio-Caicedo P, Badía-Picazo MC, Salas-Felipe J. Autoimmune acute motor sensory axonal polyradiculoneuritis in a case of inflammatory bowel disease. Neurologia 2014; 30:586-7. [PMID: 24953412 DOI: 10.1016/j.nrl.2014.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 01/02/2014] [Accepted: 04/05/2014] [Indexed: 11/27/2022] Open
Affiliation(s)
- L Gabaldón-Torres
- Unidad de Neurología-Neurofisiología, Servicio de Medicina Interna, Hospital de Denia, Denia, Alicante, España.
| | - M Jordan
- Unidad de Neurología-Neurofisiología, Servicio de Medicina Interna, Hospital de Denia, Denia, Alicante, España
| | - P Osorio-Caicedo
- Unidad de Neurología-Neurofisiología, Servicio de Medicina Interna, Hospital de Denia, Denia, Alicante, España
| | - M C Badía-Picazo
- Unidad de Neurología-Neurofisiología, Servicio de Medicina Interna, Hospital de Denia, Denia, Alicante, España
| | - J Salas-Felipe
- Unidad de Neurología-Neurofisiología, Servicio de Medicina Interna, Hospital de Denia, Denia, Alicante, España
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