Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia/Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, Australia.
Mult Scler. 2021 Jul;27(8):1262-1275. doi: 10.1177/1352458520958369. Epub 2020 Sep 14.
The symptoms that have the largest impact on health-related quality of life (HRQoL) in people with multiple sclerosis (MS) may vary by MS phenotype (relapsing-remitting MS (RRMS), secondary progressive MS (SPMS) and primary progressive MS (PPMS)). Knowing these symptoms assists in symptom management.
To examine the associations between 13 common MS symptoms and HRQoL in the total sample and stratified by MS phenotype.
The study included 1985 participants. HRQoL was measured with two multi-attribute utility instruments: assessment of quality of life with eight dimensions (AQoL-8D) and European quality of life with five dimensions and five levels for each dimension (EQ-5D-5L). Multivariable linear regression was used to identify the symptoms that had the largest impact on the HRQoLs.
Feelings of depression, pain, fatigue, and feelings of anxiety were most strongly associated with AQoL-8D and EQ-5D-5L. Walking difficulties additionally contributed to reduced EQ-5D-5L. The strongest single predictors in the multivariable analyses were feelings of depression or pain for AQoL-8D and walking difficulties for EQ-5D-5L, irrespective of MS phenotype.
The strongest single predictors for the AQoL-8D and EQ-5D-5L were feelings of depression, pain and walking difficulties, irrespective of MS phenotype. Reducing these symptoms may have the largest impact on improving HRQoL in all MS phenotypes of people with MS.
多发性硬化症(MS)患者中对健康相关生活质量(HRQoL)影响最大的症状可能因 MS 表型(复发缓解型 MS(RRMS)、继发进展型 MS(SPMS)和原发进展型 MS(PPMS))而异。了解这些症状有助于进行症状管理。
在总样本和按 MS 表型分层的情况下,检查 13 种常见 MS 症状与 HRQoL 之间的关联。
该研究纳入了 1985 名参与者。HRQoL 通过两种多属性效用工具进行测量:八个维度的生活质量评估(AQoL-8D)和每个维度五个等级的欧洲生活质量(EQ-5D-5L)。使用多变量线性回归来确定对 HRQoL 影响最大的症状。
抑郁感、疼痛、疲劳和焦虑感与 AQoL-8D 和 EQ-5D-5L 相关性最强。行走困难也会导致 EQ-5D-5L 降低。在多变量分析中,抑郁感或疼痛对 AQoL-8D 以及行走困难对 EQ-5D-5L 的影响最大,与 MS 表型无关。
对于 AQoL-8D 和 EQ-5D-5L,抑郁感、疼痛和行走困难是最强的单一预测因子,与 MS 表型无关。减轻这些症状可能会对改善所有 MS 表型的 MS 患者的 HRQoL 产生最大影响。