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The impact of a recent relapse on patient-reported outcomes in subjects with multiple sclerosis

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Abstract

Purpose

In this study, we estimate the impact of a recent relapse on physical and mental health in subjects with relapsing-remitting multiple sclerosis (RRMS) using validated patient-reported outcome (PRO) measures.

Methods

Subjects enrolled in the Comprehensive Longitudinal Investigation of MS at the Brigham and Women’s Hospital with RRMS were eligible for enrollment. Subjects with a clinical visit within 45 days of a relapse were identified and divided into groups based on whether the relapse occurred before (recent relapse) (n = 59) or after the visit (pre-relapse) (n = 31). A group of subjects with no relapses was also identified (remission) (n = 336). PRO measures in these three groups were compared. All outcomes were compared using a t test and linear regression controlling for age, disease duration, sex, and EDSS.

Results

Subjects with a recent relapse had significantly worse functioning on several physical and mental health scales compared to subjects in remission even after adjusting for potential confounders. Subjects with a recent relapse also showed significant deterioration on PRO measures over 1 year compared to subjects in remission (P < 0.05 for each comparison). Subjects in the pre-relapse group were not significantly different than subjects in remission.

Conclusions

Clinical relapses have a measurable effect on PRO in subjects with RRMS.

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References

  1. Hemmett, L., Holmes, J., Barnes, M., & Russell, N. (2004). What drives quality of life in multiple sclerosis? QJM, 97(10), 671–676.

    Article  PubMed  CAS  Google Scholar 

  2. Nortvedt, M. W., Riise, T., Myhr, K. M., & Nyland, H. I. (1999). Quality of life in multiple sclerosis: measuring the disease effects more broadly. Neurology, 53(5), 1098–1103.

    Article  PubMed  CAS  Google Scholar 

  3. Hermann, B. P., Vickrey, B., Hays, R. D., Cramer, J., Devinsky, O., Meador, K., et al. (1996). A comparison of health-related quality of life in patients with epilepsy, diabetes and multiple sclerosis. Epilepsy Research, 25(2), 113–118.

    Article  PubMed  CAS  Google Scholar 

  4. Hviid, L. E., Healy, B. C., Rintell, D. J., Chitnis, T., Weiner, H. L., & Glanz, B. I. (2011). Patient reported outcomes in benign multiple sclerosis. Multiple Sclerosis, 17(7), 876–884.

    Article  PubMed  Google Scholar 

  5. Ford, H. L., Gerry, E., Johnson, M. H., & Tennant, A. (2001). Health status and quality of life of people with multiple sclerosis. Disability and Rehabilitation, 23(12), 516–521.

    Article  PubMed  CAS  Google Scholar 

  6. Pittock, S. J., Mayr, W. T., McClelland, R. L., Jorgensen, N. W., Weigand, S. D., Noseworthy, J. H., et al. (2004). Quality of life is favorable for most patients with multiple sclerosis: A population-based cohort study. Archives of Neurology, 61(5), 679–686.

    Article  PubMed  Google Scholar 

  7. Pfennings, L., Cohen, L., Ader, H., Polman, C., Lankhorst, G., Smits, R., et al. (1999). Exploring differences between subgroups of multiple sclerosis patients in health-related quality of life. Journal of Neurology, 246(7), 587–591.

    Article  PubMed  CAS  Google Scholar 

  8. Rudick, R. A., Miller, D., Hass, S., Hutchinson, M., Calabresi, P. A., Confavreux, C., et al. (2007). Health-related quality of life in multiple sclerosis: Effects of natalizumab. Annals of Neurology, 62(4), 335–346.

    Article  PubMed  CAS  Google Scholar 

  9. Lublin, F. D., Baier, M., & Cutter, G. (2003). Effect of relapses on development of residual deficit in multiple sclerosis. Neurology, 61(11), 1528–1532.

    Article  PubMed  Google Scholar 

  10. Kalb, R. (2007). The emotional and psychological impact of multiple sclerosis relapses. Journal of the Neurological Sciences, 256(Suppl 1), S29–S33.

    Article  PubMed  Google Scholar 

  11. Halper, J. (2007). The psychosocial effect of multiple sclerosis: The impact of relapses. Journal of the Neurological Sciences, 256(Suppl 1), S34–S38.

    Article  PubMed  Google Scholar 

  12. Orme, M., Kerrigan, J., Tyas, D., Russell, N., & Nixon, R. (2007). The effect of disease, functional status, and relapses on the utility of people with multiple sclerosis in the UK. Value in Health, 10(1), 54–60.

    Article  PubMed  Google Scholar 

  13. Parkin, D., Jacoby, A., McNamee, P., Miller, P., Thomas, S., & Bates, D. (2000). Treatment of multiple sclerosis with interferon beta: An appraisal of cost-effectiveness and quality of life. Journal of Neurology, Neurosurgery and Psychiatry, 68(2), 144–149.

    Article  CAS  Google Scholar 

  14. Bethoux, F., Miller, D. M., & Kinkel, R. P. (2001). Recovery following acute exacerbations of multiple sclerosis: From impairment to quality of life. Multiple Sclerosis, 7(2), 137–142.

    PubMed  CAS  Google Scholar 

  15. Nortvedt, M. W., Riise, T., Myhr, K. M., & Nyland, H. I. (2000). Quality of life as a predictor for change in disability in MS. Neurology, 55(1), 51–54.

    Article  PubMed  CAS  Google Scholar 

  16. Gauthier, S. A., Glanz, B. I., Mandel, M., & Weiner, H. L. (2006). A model for the comprehensive investigation of a chronic autoimmune disease: The multiple sclerosis CLIMB study. Autoimmunity Reviews, 5(8), 532–536.

    Article  PubMed  CAS  Google Scholar 

  17. Gorman, M. P., Healy, B. C., Polgar-Turcsanyi, M., & Chitnis, T. (2009). Increased relapse rate in pediatric-onset compared with adult-onset multiple sclerosis. Archives of Neurology, 66(1), 54–59.

    Article  PubMed  Google Scholar 

  18. Ware, J. E., Jr, & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.

    Article  PubMed  Google Scholar 

  19. Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.

    Article  Google Scholar 

  20. Fisk, J. D., Pontefract, A., Ritvo, P. G., Archibald, C. J., & Murray, T. J. (1994). The impact of fatigue on patients with multiple sclerosis. Canadian Journal of Neurological Sciences, 21(1), 9–14.

    PubMed  CAS  Google Scholar 

  21. Ritvo, P., Fischer, J., Miller, D., Paty, D., & LaRocca, N. (1997). Multiple sclerosis quality of life inventory: A user’s manual. New York, NY: National Multiple Sclerosis Society.

    Google Scholar 

  22. Efron, B., & Tibshirani, R. (1993). An introduction to the bootstrap. New York, NY: Chapman & Hall.

    Google Scholar 

  23. Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2003). Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Medical Care, 41(5), 582–592.

    PubMed  Google Scholar 

  24. Freedman, M. S., Patry, D. G., Grand’Maison, F., Myles, M. L., Paty, D. W., & Selchen, D. H. (2004). Treatment optimization in multiple sclerosis. Canadian Journal of Neurological Sciences, 31(2), 157–168.

    PubMed  Google Scholar 

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Acknowledgments

The CLIMB study is funded in part by the Nancy Davis Foundation and Merck Serono.

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Authors and Affiliations

  1. Partners Multiple Sclerosis Center, Brigham and Women’s Hospital, 6th Floor, 1 Brookline Place, Brookline, MA, 02445, USA

    Brian C. Healy, Irene R. Degano, Ana Schreck, David Rintell, Howard Weiner, Tanuja Chitnis & Bonnie I. Glanz

  2. Department of Neurology, Harvard Medical School, Brookline, MA, USA

    Brian C. Healy, David Rintell, Howard Weiner, Tanuja Chitnis & Bonnie I. Glanz

  3. Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA

    Brian C. Healy

Authors
  1. Brian C. Healy
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  2. Irene R. Degano
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  3. Ana Schreck
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  4. David Rintell
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  5. Howard Weiner
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  6. Tanuja Chitnis
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  7. Bonnie I. Glanz
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Corresponding author

Correspondence to Brian C. Healy.

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Healy, B.C., Degano, I.R., Schreck, A. et al. The impact of a recent relapse on patient-reported outcomes in subjects with multiple sclerosis. Qual Life Res 21, 1677–1684 (2012). https://doi.org/10.1007/s11136-011-0108-0

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  • DOI: https://doi.org/10.1007/s11136-011-0108-0

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