Predictors of prescriptions for management of fatigue among veterans with multiple sclerosis.
OBJECTIVE
To determine predictors of fatigue-modifying medication use.


METHODS
Cross-sectional cohort.


METHODS
Veterans Health Administration (VHA) facilities.


METHODS
Veterans with multiple sclerosis (MS) in the VHA in the northwestern United States from 1995 to 2000.


METHODS
Not applicable.


METHODS
A self-administered survey distributed by mail sought information from veterans with MS about demographics, symptoms, barriers to care, and disease characteristics. The variables were compared with prescriptions for fatigue-modifying medications during the study period.


RESULTS
Of 1032 patients, 451 (44%) completed the survey, and 306 (68%) reported moderate or high fatigue levels. Only 40% of the 306 were prescribed fatigue-modifying medications. Those using specialized fatigue services or who received care at tertiary centers were more likely to receive fatigue treatments. Patient-perceived barriers to accessing care and other patient characteristics were not associated with prescription rates.


CONCLUSIONS
Fatigue is undertreated among veterans with MS. However, there is considerable variability in the provision of fatigue care. Interventions to improve the quality and uniformity of fatigue care are warranted.
Department of Veterans Affairs, Puget Sound Health Care System, Seattle, WA 98108, USA. michael.hatzakis@med.va.gov
Michael
M
Hatzakis
Aaron P
AP
Turner
Rhonda M
RM
Williams
James D
JD
Bowen
Arthur A
AA
Rodriquez
Jodie K
JK
Haselkorn
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D015259:Dopamine Agents / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005221:Fatigue / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D015205:Northwestern United States / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014728:Veterans
D000697:Central Nervous System Stimulants; D015259:Dopamine Agents