Quality of life in multiple sclerosis. Comparison with inflammatory bowel disease and rheumatoid arthritis

R. A. Rudick, D. Miller, J. D. Clough, L. A. Gragg and R. G. Farmer
Department of Neurology, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic Foundation, OH 44195.

Multiple sclerosis (MS) and other chronic illnesses can drastically decrease quality of life (QOL), but there has been little systematic study of QOL in patients with chronic medical diseases. We analyzed QOL in 68 patients with MS, 164 patients with inflammatory bowel disease, and 75 patients with rheumatoid arthritis. The previously validated test instrument was a standardized interview consisting of 41 questions clustered in four subscales: functional and economic scale, social and recreational scale, affect and life in general scale, and medical problems scale. Patients were included in the study if they had a definite medical diagnosis and disease duration of 10 years or longer. In the patients with MS, Kurtzke's Expanded Disability Status Scale correlated strongly only with the medical problems score. Of Kurtzke's Functional System Scales, only the visual Functional System Scores was correlated with total QOL and subscale scores, suggesting that vision is strongly related to QOL. Duration of MS was unrelated to QOL scores. There were significant differences between patients with MS, inflammatory bowel disease, and rheumatoid arthritis on the subscale and total QOL scores. Results suggested that QOL was best in the inflammatory bowel disease group and worst in the MS group. Numerous statistically significant differences on individual questions were evident, suggesting that unique clinical profiles differentially characterize these diseases. Assessments of QOL are a meaningful addition to impairment scales, such as Kurtzke's Expanded Disability Status Scale. Furthermore, QOL scores may meaningfully measure the impact of a chronic medical disease, such as MS, compare the impacts of different diseases, and assess the effects of therapeutic intervention.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

'Restricting choices and limiting independence': social and economic impact of multiple sclerosis upon households by level of disability
Green and Todd
Chronic Illness 2008;4:160-172.
ABSTRACT  

Long-term benefits of exercising on quality of life and fatigue in multiple sclerosis patients with mild disability: a pilot study
McCullagh et al.
Clin Rehabil 2008;22:206-214.
ABSTRACT  

Effect of exercise training on quality of life in multiple sclerosis: a meta-analysis
Motl and Gosney
Mult Scler 2008;14:129-135.
ABSTRACT  

Deterioration in the health-related quality of life of persons with multiple sclerosis: the possible warning signs
Turpin et al.
Mult Scler 2007;13:1038-1045.
ABSTRACT  

Health-related quality of life in secondary progressive multiple sclerosis
Beiske et al.
Mult Scler 2007;13:386-392.
ABSTRACT  

Coping and quality of life in one hundred and thirty five subjects with multiple sclerosis
Montel and Bungener
Mult Scler 2007;13:393-401.
ABSTRACT  

Worries and concerns of patients with multiple sclerosis: development of an assessment scale
Thornton et al.
Mult Scler 2006;12:196-203.
ABSTRACT  

The Effects of Economic Disadvantage on Psychological Well-being and Quality of Life among People with Multiple Sclerosis
McCabew and De Judicibus
J Health Psychol 2005;10:163-173.
ABSTRACT  

Quality of life measures for the palliative care of people severely affected by multiple sclerosis: a systematic review
Gruenewald et al.
Mult Scler 2004;10:690-725.
ABSTRACT  

A systematic approach to analyse health-related quality of life in multiple sclerosis: the GEDMA study
Morales-Gonzales et al.
Mult Scler 2004;10:47-54.
ABSTRACT  

Validity and reliability of the MSQ LI in cognitively impaired patients with multiple sclerosis
Marrie et al.
Mult Scler 2003;9:621-626.
ABSTRACT  

Contrast letter acuity as a visual component for the Multiple Sclerosis Functional Composite
Balcer et al.
Neurology 2003;61:1367-1373.
ABSTRACT | FULL TEXT  

"Sticking Jewels in Your Life": Exploring Women's Strategies for Negotiating an Acceptable Quality of Life with Multiple Sclerosis
Reynolds and Prior
Qual Health Res 2003;13:1225-1251.
ABSTRACT  

Patient and community preferences for treatments and health states in multiple sclerosis
Prosser et al.
Mult Scler 2003;9:311-319.
ABSTRACT  

The use of quality of life measures in multiple sclerosis research
Nortvedt and Riise
Mult Scler 2003;9:63-72.
ABSTRACT  

Symptom Management and Adjustment of Patients with Multiple Sclerosis: A 4-Year Longitudinal Intervention Study
Wassem and Dudley
Clin Nurs Res 2003;12:102-117.
ABSTRACT  

Benefit of interferon {beta}-1a on MSFC progression in secondary progressive MS
Cohen et al.
Neurology 2002;59:679-687.
ABSTRACT | FULL TEXT  

Self-reported visual dysfunction in multiple sclerosis: results from the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25)
Balcer et al.
Mult Scler 2000;6:382-385.
ABSTRACT  

New low-contrast vision charts: reliability and test characteristics in patients with multiple sclerosis
Balcer et al.
Mult Scler 2000;6:163-171.
ABSTRACT  

Recent developments in the assessment of quality of life in Multiple Sclerosis (MS)
Fischer et al.
Mult Scler 1999;5:251-259.
ABSTRACT  

Reliability and validity of two self-report measures of impairment and disability for MS
Schwartz et al.
Neurology 1999;52:63-63.
ABSTRACT | FULL TEXT  

Quality of life in multiple sclerosis in France, Germany, and the United Kingdom
Murphy et al.
J. Neurol. Neurosurg. Psychiatry 1998;65:460-466.
ABSTRACT | FULL TEXT  

Health-Related Quality of Life in People with Multiple Sclerosis Undergoing Inpatient Rehabilitation
Freeman et al.
Neurorehabil Neural Repair 1996;10:185-194.
ABSTRACT