Article Text
Abstract
Background Multiple sclerosis (MS), a neurological disorder, demands personalised drug treatment. Parenteral first-line treatment for MS include disease-modifying therapies: intramuscular (IM) interferon (IFN) beta-1a, subcutaneous (SC) IFN-beta 1-a, IFN-beta 1-b and glatiramer acetate. Patients may respond well, ‘look fine’ but have a reduced quality of life (QoL).
Purpose To assess the relationship between biological variables (age, EDSS, duration of drug use), QoL and neuropsychiatric complications, aware that the overall wellbeing of patients is not a simple manifestation of impairment or disability but also of many psychosocial and emotional factors.
Material and methods Retrospective study, January 2016 to September 2017,patients with chronic treatment for years.
Data collected from the patients’ medical records.
The instrument used was the Multiple Sclerosis Quality of Life-54 questionnaire with two major components: physical health and mental health.
An Excel database was designed to analyse the results.
Results Fifty-five patients, mean age 41.2 (24–64) with a median of MS-7 years.
Eleven with GA, 44 with INF.
forty-three (78%) were females.
The average number of patient’ visits to the Neurology Department during the last year was three.
We established two categories of patients:
The young group (24–35) years respond well to treatment, EDSS 0–1, free of significant physical symptoms, but QoL is seriously impaired. In these patients the scores from the questionnaire show that their physical health is much better than their mental health. Negative relationship between age, mental symptoms and QoL.
Over 35 years, with neurological dysfunction, EDSS>3.5, view their QoL in a positive light, continue to participate fully in life, mental health better than physical health, with positive correlations of QoL with age and mental symptoms despite their neurological disability.
There were significant differences in QoL based on age and duration of drug use.
Significant differences in mental and physical health occur at extreme ages of patients (24–64), young patients present with mental health affected by poor QoL, due to factors such as depression, anxiety and stress.
Conclusion Is important to assess QoL in MS patients, not common in every clinical practice, from the beginning, during the routine clinical visits to identify those patients most in need of pharmaceutical care. Physical and mental health aspects of lives should be screened for carefully. The role of healthcare clinicians should be in education and counselling to improve QoL.
No conflict of interest