open access

Vol 17, No 2 (2023)
Research paper
Published online: 2023-01-25
Get Citation

Health-related quality of life of relapsing or remitting multiple sclerosis patients: a case-control study

Haniya Noun1, Rami Atat2, Georges Hatem13, Roula Ajrouche1, Sara Nahas4, Maya El-Hajj1, Salam Zein1, Sanaa Awada1
·
Palliat Med Pract 2023;17(2):73-83.
Affiliations
  1. Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
  2. Zahraa Hospital, University Medical Center, Beirut, Lebanon
  3. Faculty of Medicine, University of Porto, Porto, Portugal
  4. Nutrition-Wellness Center, Beirut, Lebanon

open access

Vol 17, No 2 (2023)
Research paper
Published online: 2023-01-25

Abstract

Background: Patients with multiple sclerosis (MS) report lower health-related quality of life (HRQoL) than other chronic disease populations. This study aims to identify risk factors of relapsing or remitting multiple sclerosis (RRMS) and assess its impact on HRQoL in Lebanese MS patients.

Patients and methods: A three-month case-control study was performed among 75 RRMS case patients recruited from two clinics in Beirut and 225 controls from the general population.

Results: Heavy cigarette smoking, moderate and heavy water pipe smoking, vitamin D deficiency, cardiovascular disease, and psychological disorders were significantly associated with RRMS. Linear regression showed that the multiple sclerosis international quality of life global index significantly decreased with the number of relapses, the incomplete recovery between relapses, and the psychological disorder. Higher-income and physical activity had a positive effect on quality of life (QoL).

Conclusions: Findings of this study highlighted the risk factors of RRMS, which can be used for informed decision-making and targeted awareness campaigns. Other factors affecting the HRQoL of MS patients should be considered to improve their experience throughout and after treatment.

Abstract

Background: Patients with multiple sclerosis (MS) report lower health-related quality of life (HRQoL) than other chronic disease populations. This study aims to identify risk factors of relapsing or remitting multiple sclerosis (RRMS) and assess its impact on HRQoL in Lebanese MS patients.

Patients and methods: A three-month case-control study was performed among 75 RRMS case patients recruited from two clinics in Beirut and 225 controls from the general population.

Results: Heavy cigarette smoking, moderate and heavy water pipe smoking, vitamin D deficiency, cardiovascular disease, and psychological disorders were significantly associated with RRMS. Linear regression showed that the multiple sclerosis international quality of life global index significantly decreased with the number of relapses, the incomplete recovery between relapses, and the psychological disorder. Higher-income and physical activity had a positive effect on quality of life (QoL).

Conclusions: Findings of this study highlighted the risk factors of RRMS, which can be used for informed decision-making and targeted awareness campaigns. Other factors affecting the HRQoL of MS patients should be considered to improve their experience throughout and after treatment.

Get Citation

Keywords

multiple sclerosis, quality of life, relapsing/remitting, Lebanon, predictors

Supp./Additional Files (1)
Appendix
Download
100KB
About this article
Title

Health-related quality of life of relapsing or remitting multiple sclerosis patients: a case-control study

Journal

Palliative Medicine in Practice

Issue

Vol 17, No 2 (2023)

Article type

Research paper

Pages

73-83

Published online

2023-01-25

Page views

1353

Article views/downloads

352

DOI

10.5603/PMPI.a2023.0008

Bibliographic record

Palliat Med Pract 2023;17(2):73-83.

Keywords

multiple sclerosis
quality of life
relapsing/remitting
Lebanon
predictors

Authors

Haniya Noun
Rami Atat
Georges Hatem
Roula Ajrouche
Sara Nahas
Maya El-Hajj
Salam Zein
Sanaa Awada

References (39)
  1. Huang WJ, Chen WW, Zhang X. Multiple sclerosis: pathology, diagnosis and treatments. Exp Ther Med. 2017; 13(6): 3163–3166.
  2. Wallin MT, Culpepper WJ, Nichols E. GBD 2016 Neurology Collaborators. Global, regional, and national burden of multiple sclerosis 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019; 18(3): 269–285.
  3. Dendrou CA, Fugger L, Friese MA. Immunopathology of multiple sclerosis. Nat Rev Immunol. 2015; 15(9): 545–558.
  4. Walton C, King R, Rechtman L, et al. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler. 2020; 26(14): 1816–1821.
  5. Zuvich RL, McCauley JL, Pericak-Vance MA, et al. Genetics and pathogenesis of multiple sclerosis. Semin Immunol. 2009; 21(6): 328–333.
  6. Nourbakhsh B, Mowry EM. Multiple sclerosis risk factors and pathogenesis. Continuum (Minneap Minn). 2019; 25(3): 596–610.
  7. Mokry LE, Ross S, Ahmad OS, et al. Vitamin d and risk of multiple sclerosis: a mendelian randomization study. PLoS Med. 2015; 12(8): e1001866.
  8. Hedström AK, Olsson T, Kockum I, et al. Low sun exposure increases multiple sclerosis risk both directly and indirectly. J Neurol. 2020; 267(4): 1045–1052.
  9. Salvetti M, Giovannoni G, Aloisi F. Epstein-Barr virus and multiple sclerosis. Curr Opin Neurol. 2009; 22(3): 201–206.
  10. Nielsen TR, Rostgaard K, Nielsen NM, et al. Multiple sclerosis after infectious mononucleosis. Arch Neurol. 2007; 64(1): 72–75.
  11. Handel AE, Williamson AJ, Disanto G, et al. An updated meta-analysis of risk of multiple sclerosis following infectious mononucleosis. PLoS One. 2010; 5(9): e16149.
  12. Mokry LE, Ross S, Timpson NJ, et al. Obesity and multiple sclerosis: a mendelian randomization study. PLoS Med. 2016; 13(6): e1002053.
  13. Zwibel HL, Smrtka J. Improving quality of life in multiple sclerosis: an unmet need. Am J Manag Care. 2011; 17 Suppl 5 Improving: S139–S145.
  14. Control CfD, Prevention. Measuring healthy days: Population assessment of health-related quality of life 2001.
  15. Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med. 1996; 334(13): 835–840.
  16. Lysandropoulos AP, Havrdova E. ParadigMS Group. 'Hidden' factors influencing quality of life in patients with multiple sclerosis. Eur J Neurol. 2015; 22 Suppl 2: 28–33.
  17. Freeman JA, Hobart JC, Thompson AJ. Does adding MS-specific items to a generic measure (the SF-36) improve measurement? Neurology. 2001; 57(1): 68–74.
  18. Baumstarck K, Boyer L, Boucekine M, et al. Measuring the quality of life in patients with multiple sclerosis in clinical practice: a necessary challenge. Mult Scler Int. 2013; 2013: 524894.
  19. Simeoni Mc, Auquier P, Fernandez O, et al. Validation of the multiple sclerosis international quality of life questionnaire. Mult Scler. 2008; 14(2): 219–230.
  20. Zeineddine M, Hajje A, Ayoubi N, et al. Prevalence and incidence rates of multiple sclerosis in lebanon. Mult Sclerosis Rel Disord. 2020; 37: 101608.
  21. Hatem G, Goossens MM. Health care system in Lebanon: a review addressing health inequalities and ethical dilemmas of frontline workers during COVID-19 pandemic. BAU J - Health Well-Being. 2022; 5(1).
  22. Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011; 69(2): 292–302.
  23. Farran N, Safieddine BR, Bayram M, et al. Factors affecting MS patients' health-related quality of life and measurement challenges in Lebanon and the MENA region. Mult Scler J Exp Transl Clin. 2020; 6(1): 2055217319848467.
  24. El-Muzaini H, Akhtar S, Alroughani R, et al. A matched case-control study of risk factors associated with multiple sclerosis in Kuwait. BMC Neurol. 2020; 20(1): 64.
  25. Hatem G, Zeidan J, Goossens M, et al. Normality testing methods and the importance of skewness and kurtosis in statistical analysis. BAU J - Sci Technology. 2022; 3(2).
  26. Mouhieddine TH, Darwish H, Fawaz L, et al. Risk factors for multiple sclerosis and associations with anti-EBV antibody titers. Clin Immunol. 2015; 158(1): 59–66.
  27. Al-Afasy HH, Al-Obaidan MA, Al-Ansari YA, et al. Risk factors for multiple sclerosis in Kuwait: a population-based case-control study. Neuroepidemiology. 2013; 40(1): 30–35.
  28. Hedström AK, Åkerstedt T, Olsson T, et al. Shift work influences multiple sclerosis risk. Mult Scler. 2015; 21(9): 1195–1199.
  29. Hedström AK, Lima Bomfim I, Barcellos L, et al. Interaction between adolescent obesity and HLA risk genes in the etiology of multiple sclerosis. Neurology. 2014; 82(10): 865–872.
  30. Oliveira SR, Simão AN, Kallaur AP, et al. Disability in patients with multiple sclerosis: influence of insulin resistance, adiposity, and oxidative stress. Nutrition. 2014; 30(3): 268–273.
  31. Stojanov A, Malobabic M, Milosevic V, et al. Psychological status of patients with relapsing-remitting multiple sclerosis during coronavirus disease-2019 outbreak. Mult Scler Relat Disord. 2020; 45: 102407.
  32. Jelinek GA, De Livera AM, Marck CH, et al. Lifestyle, medication and socio-demographic determinants of mental and physical health-related quality of life in people with multiple sclerosis. BMC Neurol. 2016; 16(1): 235.
  33. Berrigan LI, Fisk JD, Patten SB, et al. Health-related quality of life in multiple sclerosis: Direct and indirect effects of comorbidity. Neurology. 2016; 86(15): 1417–1424.
  34. Fernández O, Baumstarck-Barrau K, Simeoni MC, et al. MusiQoL study group. Patient characteristics and determinants of quality of life in an international population with multiple sclerosis: assessment using the MusiQoL and SF-36 questionnaires. Mult Scler. 2011; 17(10): 1238–1249.
  35. Carmel S. Health and well-being in late life: gender differences worldwide. Front Med (Lausanne). 2019; 6: 218.
  36. Peters M, Potter CM, Kelly L, et al. Self-efficacy and health-related quality of life: a cross-sectional study of primary care patients with multi-morbidity. Health Qual Life Outcomes. 2019; 17(1): 37.
  37. Achiron A, Aref H, Inshasi J, et al. Effectiveness, safety and health-related quality of life of multiple sclerosis patients treated with fingolimod: results from a 12-month, real-world, observational PERFORMS study in the Middle East. BMC Neurol. 2017; 17(1): 150.
  38. D'Alisa S, Miscio G, Baudo S, et al. Depression is the main determinant of quality of life in multiple sclerosis: a classification-regression (CART) study. Disabil Rehabil. 2006; 28(5): 307–314.
  39. Baumstarck K, Pelletier J, Boucekine M, et al. MusiQoL study group. Predictors of quality of life in patients with relapsing-remitting multiple sclerosis: a 2-year longitudinal study. Rev Neurol (Paris). 2015; 171(2): 173–180.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73 , 80–180 Gdańsk, Poland

phone:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl