Adherence to Therapy, Physical and Mental Quality of Life in Patients with Multiple Sclerosis.

Alessandra Buja,Carlo Pinato,Alessia Tognetto,Simona F Mafrici,Guendalina Graffigna,Tatjana Baldovin,Umberto Bolzonella,Gianfranco Damiani,Serena Barello

doi:10.3390/jpm11070672

Abstract

Ensuring multiple sclerosis (MS) patients’ adherence to therapy is often challenging, but it is crucial to their survival and health-related quality of life (HRQoL). The aim of the present study was to outline connections between adherence, physical and mental HRQoL, levels of psychological readiness to engage in a treatment, levels of social support, anthropometric, socio-demographic and clinical factors in patients suffering from MS. This cross-sectional study involved a sample of 237 Italian MS patients. A survey was conducted with a structured self-administered online questionnaire using validated measures of quality of life, adherence to therapy and anthropometric, socio-demographic, psychological and clinical variables. A path analysis was used to test the overall structure of the associations between the variables. The pathway indicates a positive association between mental health index and a stronger degree of engagement and being or having been in a long-term relationship. Physical health index was positively associated with age, having an occupation, and having a specific form of MS. Having had relapses in the previous year raised the odds of better adherence to therapy, while an increase in Body Mass Index (BMI) reduced them. Our findings could help in the management of MS patients, promoting behavioral interventions that take the psychological and socio-demographic peculiarities of each patient into account with a view to improving their adherence to therapy.

Highlights

The aim of the present study was to outline associations between adherence to therapy, physical and mental health-related quality of life (HRQoL) and levels of psychological readiness to engage in a treatment, levels of social support, anthropometric, socio-demographic and clinical factors in patients suffering from multiple sclerosis (MS)
The main contribution of our analysis concerns the complex connections it identifies between adherence and physical and mental HRQoL of MS patients with anthropometric, socio-demographic and psychological factors that influence their engagement in their health
The study revealed an association between adherence to therapy and Body Mass Index (BMI) and relapses in the previous year, between MCS and Patient Health Engagement (PHE)-s® and between PCS and age, having an occupation and having a specific form of MS

Summary

Introduction

Quality of life (QoL) and health-related quality of life (HRQoL) are key parameters in assessing cases of MS [2]. Mitchell [3] reported that QoL is influenced more by psychosocial factors, such as coping, mood tone, autonomy and perceived social support, than by biological variables, such as the extent of lesions evident on magnetic resonance imaging (MRI). In decreasing order of frequency, patients experience anxiety, depression, cognitive decay and anger management problems [4], and higher rates of psychiatric comorbidities have been found among patients with lower incomes [5]. More than half the patients report needs unrelated to their pharmacological therapy that are not identified and managed adequately. These issues generally relate to their personal and professional well-being

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