Quality of life in multiple sclerosis

Pöllmann, W.; Busch, Claudia; Voltz, Raymond

doi:10.1007/s00115-004-1790-8

Cited by 16 publications

(6 citation statements)

References 111 publications

(69 reference statements)

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“…In the present study, quantitative analysis using effect sizes revealed the greatest differences in the dimensions anxiety, physical functioning, role-physical functioning and general health. This finding underscores the importance of psychological, 3 social and impairment-related aspects, 8 , 10 and their interrelation in patients with MS. 7 , 23 , 24 With respect to a few HRQoL dimensions, our data confirm results from other countries, but also deliver a specific pattern of impaired HRQoL. In detail, mental health was the only dimension that was not affected in our cohort of MS patients.…”

Section: Discussionsupporting

confidence: 57%

“… 8 Health-related quality of life (HRQoL) can be considered as a multidimensional index of well-being that involves the individual patient's perspective. 8 – 10 Previous studies have assessed HRQoL in MS patients in comparison to the general population, which have resulted in inconsistent reports. For example, one study found worse scores for physical functioning, vitality and general health in a cohort of 185 MS patients in the US, but also domains that were similar to the general population.…”

Section: Introductionmentioning

confidence: 99%

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Anxiety, depression and impaired health-related quality of life are therapeutic challenges in patients with multiple sclerosis

et al. 2010

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Anxiety, depression and impaired health-related quality of life (HRQoL) are commonly reported in patients with multiple sclerosis (MS) and are of great interest for therapeutic approaches. Based on regional differences a quantitative assessment of these factors in comparison to the general population, and the consideration of demographic cofactors, would be useful when designing specific interventions. We adopted such an approach in a German cohort of MS patients. Anxiety, depression (HADS) and HRQoL (SF-36) were measured in 49 consecutive outpatients with MS and compared to age- and gender-adjusted control groups (n=1330 for HADS; n=5087 for SF-36) extracted from German National Health Surveys. Patients with MS showed significantly increased levels of anxiety and depression as well as decreased HRQoL with the exception of mental health; the effect sizes ranged from 0.39 (depression) to 1.06 (physical functioning). As could be expected, MS patients with relapsing-remitting clinical course had better physical functioning than patients with secondary progressive MS. There were strong relations between anxiety and depression (r=0.54; P<0.01), and between neurological impairment (EDSS) and physical functioning (r=−0.80; P<0.001) as well as depression (r=0.48; P<0.05). This investigation of MS patients confirms the prevalence and impact of anxiety, depression and most of the HRQoL dimensions in MS patients and provides evidence for the usefulness of a quantitative comparison to a region-specific general population as a starting point for therapeutic approaches.

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Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Anxiety, depression and impaired health-related quality of life are therapeutic challenges in patients with multiple sclerosis

et al. 2010

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“…The SEIQoL-DW index is obtained from the satisfaction with and weighting for each area, and ranges from 0 (worst possible score) to 100 (best possible score). SEIQoL-DW has been used in neurological diseases [ 27 - 30 ], and was the primary outcome measure of the Ne-Pal trial [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Home-based palliative approach for people with severe multiple sclerosis and their carers: study protocol for a randomized controlled trial

Solari¹,

Giordano²,

Grasso

et al. 2015

Trials

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BackgroundPreliminary evidence suggests that palliative care may be useful for people with severe multiple sclerosis (MS). The aim of this study is to determine the effectiveness of a home-based palliative approach (HPA) for people with severe MS and their carers.Methods/designThis is a single-blind randomized controlled trial with a nested qualitative study. Seventy-five severe MS-carer dyads are being randomized (at three centers, one in each area of Italy) to HPA or usual care (UC) in a 2:1 ratio. Each center has a specially trained team consisting of four professionals (physician, nurse, psychologist, social worker). The team makes a comprehensive assessment of the needs of the dyads. HPA content is then agreed on, discussed with the patient’s caring physician, and delivered over six months. The intervention is not intended to replace existing services. At later visits, the team checks the HPA delivery and reviews/modifies it as necessary.HPA and UC dyads are assessed at home by a blind examiner at baseline, and three and six months later; they also receive monthly telephone interviews. Dyads assigned to UC receive the examiner’s visits and telephone interviews, but not the team visits.Primary outcome measures are changes in symptoms (Palliative care Outcome Scale-Symptoms-MS, POS-S-MS), and quality of life (the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), not assessed in patients with severe cognitive compromise) at three and six months. Other outcomes are changes in patient functional status and mood; changes in carer quality of life, mood and caregiving burden; costs; incorporation with standard care; unplanned hospital admissions; referrals to hospice; and deaths.The experience of participants will be evaluated qualitatively by individual semi-structured interviews (HPA patients and carers) and focus group meetings (HPA patients’ caring physicians).DiscussionThe results of our study will show whether the HPA is feasible and beneficial to people with severe MS and their carers living in the three Italian geographic areas. The nested qualitative study will add to the understanding of the strengths and limitations of the intervention.Trial registrationThe trial was registered with Current Controlled Trials (identifier: ISRCTN73082124) on 19 June 2014.

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“…CBTs treatments showed a positive short-term effect on fatigue, even if the proposals, the outcomes and the results are still very heterogeneous [ 17 , 32 , 33 ]. We did not find a consistent change of QoL in pwMS, probably due to the high variability of the sample, the dissociation between the two scores [ 34 , 35 ] or because IID could not help enough to cope with MS. PwINS reported a significant improvement on cognitive fatigue, the highest at baseline. A durable benefit was noticed on sleep as well as on psychological stress and QoL.…”

Section: Discussionmentioning

confidence: 71%

Integrated Imaginative Distention Therapy to Cope with Fatigue. DIMMI SI Study: The First Randomized Controlled Trial in Multiple Sclerosis

et al. 2017

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IntroductionFatigue is a frequent, disabling, and difficult to treat symptom in neurological disease and in other stress-related conditions; Integrated Imaginative Distention (IID) is a therapy combining muscular and imaginative relaxation, feasible also in disabled subjects; the DIMMI SI trial was planned to evaluate IID efficacy on fatigue.MethodsThe design was a parallel, randomised 1:1 (intervention:waiting list), controlled, open-label trial. Participants were persons with multiple sclerosis (pwMS), persons with insomnia (pwINS), and health professionals (HP) as conditions related to fatigue and stress. The primary outcome was the post-intervention change of fatigue; secondary outcomes were changes in insomnia, stress, and quality of life (QoL). Eight IID weekly training group sessions were delivered by a skilled psychotherapist. The study lasted 12 months.ResultsOne hundred and forty-four subjects were enrolled, 48 for each condition. The mean change in Modified Fatigue Impact Scale (MFIS) score among exposed was 7.7 [95% CI 1.1, 14.4] (P = 0.023) in pwMS; 7.1 [1.9, 12.3] (P = 0.007) among pwINS, and 11.3 [4.3, 18.2] among HP (P = 0.002). At the last follow-up, the benefit was confirmed on physical fatigue for pwMS, on total fatigue for pwINS and HP.ConclusionsDIMMI SI is the first randomized controlled trial evaluating the efficacy of IID on fatigue. IID resulted a complementary intervention to reduce fatigue in stress-related conditions, in both health and disease status. NCT02290990ClinicalTrials.gov.Electronic supplementary materialThe online version of this article (doi:10.1007/s40120-017-0081-9) contains supplementary material, which is available to authorized users.

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Quality of life in multiple sclerosis

Cited by 16 publications

References 111 publications

Anxiety, depression and impaired health-related quality of life are therapeutic challenges in patients with multiple sclerosis

Anxiety, depression and impaired health-related quality of life are therapeutic challenges in patients with multiple sclerosis

Home-based palliative approach for people with severe multiple sclerosis and their carers: study protocol for a randomized controlled trial

Integrated Imaginative Distention Therapy to Cope with Fatigue. DIMMI SI Study: The First Randomized Controlled Trial in Multiple Sclerosis

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