title: Quality of life in multiple sclerosis: determinants, measurement, and use in clinical practice.
abstract: Multiple sclerosis (MS) is a complex demyelinating disease with a relatively unpredictable course. It is well established that MS has a significant impact on health-related quality of life (HRQL) for individuals at all stages of the disease. It is argued that clinicians offer treatment to their patients for three reasons: 1) to increase longevity, 2) to prevent future morbidity, and 3) to make patients feel better. To assess how well they are accomplishing the third of these goals, clinicians have come to depend on the direct measurement of patients' HRQL. We review the many physical and emotional symptoms and other consequences of MS that negatively influence HRQL, how HRQL is measured, the unique information these measures provide compared with clinical parameters, the benefit of treatment interventions, and how to include HRQL assessment and data from other sources in clinical encounters and suggest measures to consider for clinical use.
authors.affiliation: Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, U-10, 9500 Euclid Avenue, Cleveland, OH 44195, USA. millerd@ccf.org
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Miller
authors.forename: Rebecca
authors.initials: R
authors.lastname: Allen
mesh_terms: D002986:Clinical Trials as Topic; D006304:Health Status; D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome