MEASUREMENT OF HEALTH-RELATED QUALITY-OF-LIFE IN MULTIPLE-SCLEROSIS PATIENTS

Background: Patient outcomes in multiple sclerosis (MS) have generally been measured by their neurological impairment using specific scales such as the Kurtzke Expanded Disability Status Scale (EDSS), However, this scale does not measure the multiple dimensions of health-related quality of life (HRQOL) such as functional status and general well-bei ng, which are also important outcomes along with disease-specific meas urements, Methods: HRQOL was measured in a group of 97 MS patients usi ng the RAND 36-item Health Survey 1.0. The EDSS score was assigned by the clinic neurologist. Additional data were collected from the clinic al record for each patient, Results: MS patients scored poorly in a nu mber of HRQOL domains such as physical and role functioning and energy or vitality, Disability as quantified by the EDSS correlated only wit h the physical functioning domain, Regression models were developed to measure the relationship between patient characteristics (independent variables) and HRQOL domains (dependent variables). Discussion: A num ber of patient characteristics were associated with higher or lower sc ores on the HRQOL domains. Of particular interest is the finding that a family history of MS was associated with poorer physical and social functioning as well as more pain and less vitality, The occurrence of seizures had a negative impact on role functioning, social functioning and general health perceptions, HRQOL gives caregivers a broader meas ure of disease burden than the EDSS alone, and should be useful in pla nning and monitoring interventions.