There is a need for better diagnosis and treatment management of comorbidities — simultaneously occurring disorders — in people with multiple sclerosis (MS), as shown by the impact these additional health issues have on patients’ health-related quality of life, according to a new report.
The data was presented by Lara Marie Lo, from the University of Tasmania, Australia, on Feb. 28 in a poster session at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2019.
The poster was titled “Effects of Comorbidities on the Health Related Quality of Life in People with Multiple Sclerosis.” ACTRIMS 2019 was held in Dallas, Texas, from Feb. 29 to March 2, 2019.
MS patients report lower health-related quality of life compared to the general population. They, like others, become even more affected by the presence of other health issues, referred to as comorbidities.
Despite this, there is little research examining how comorbidities impact MS patients’ quality of life, pertaining to overall, physical, and mental health.
Therefore, a team at University of Tasmania examined nearly 1,000 participants from the Australian Multiple Sclerosis Longitudinal Study — a survey-based research study, running since 2001, designed to provide data of practical use for improving the lives of Australians with MS.
The team assessed 902 MS patients who had comorbidities and available clinical data about their overall health and quality of life. Quality of life was assessed through the Assessment of Quality of Life-8 Dimensions (AQoL-8D) questionnaire, with scores ranging from 0 (meaning death) to 1 (perfect health).
Results showed that the presence of comorbidities in MS patients were associated with a lower health-related quality of life; the greater the number of comorbidities, the lower the patient’s health-related quality of life score.
Overall, comorbidities were found to account for 18.09% of the variance seen in quality of life in the MS cohort analyzed.
The team observed that the three most important comorbidity categories affecting overall health-related quality of life in MS patients were: mental and behavioral problems, diseases of the musculoskeletal system, and endocrine and metabolic disorders.
When looking at specific disorders, they found that systemic lupus erythematosus, (less 0.16 score in AQoL-8D) depression (less 0.15 score), hyperthyroidism (less 0.12), and anxiety (less 0.11) were the comorbidities with the largest impact on MS patients’ overall health-related quality of life.
Researchers then analyzed the mental and physical components of health separately.
Depression (less 0.14 score in AQoL-8D) and anxiety (less 0.10) were found to have the largest impact on the psychosocial component of quality of life. In turn, lupus (less 0.18), rheumatoid arthritis and hyperthyroidism (less 0.11) had the largest impact on the physical component.
Based on the results, the team suggested that “the identified impact of comorbidities on health-related quality of life, and their magnitude of effect, emphasizes the need for recognition and appropriate management of comorbidities in people with MS.”