title: Health-related quality of life and disease-modifying treatment behaviour in relapsing-remitting multiple sclerosis--a multicentre cohort study.
abstract: OBJECTIVE
  To assess the overall health-related quality of life (HRQoL) in a population-based cohort of patients recently diagnosed with multiple sclerosis (MS) compared with the general Norwegian population, to compare HRQoL among MS patients continuing, switching, stopping or not starting disease-modifying treatment (DMT) and to assess the motivation for DMT according to HRQoL.
  
  
  METHODS
  A multicentre retrospective survey completed by patients recently diagnosed with relapsing-remitting MS (relapsing-remitting multiple sclerosis, RRMS) during 2001-2007 at four university clinics in Norway was performed. HRQoL was measured by the SF-36 version 2 Health Survey and standardized according to the general population with a mean of 50 and a standard deviation of 10. Motivation for DMT was assessed using Visual Analogue Scale (VAS).
  
  
  RESULTS
  The mean age at diagnosis was 37 years. Patients had reduced mean scores for all eight dimensions of the SF-36 with lowest scores on social functioning (mean = 31.1), mental health (mean = 32.7), general health (mean = 39.7) and vitality (mean = 40.9) compared with the general population. Continuers scored higher on mental summary scale (mean = 37.9) and lower on physical summary scale (mean = 43.8) compared with non-starters. Non-starters scored highest on physical summary scale (mean = 45.2, P = 0.007) and lowest on mental summary scale (36.1, P = 0.01) compared with continuers, stoppers and switchers. Patients with high SF-36 physical health summary score and low SF-36 mental health summary score were less motivated for using DMT.
  
  
  CONCLUSIONS
  The association of HRQoL and motivation to DMT emphasizes the need for health care personnel to inform and motivate patients to DMT, especially among patients with low mental health and otherwise high physical health and functioning.
authors.affiliation: Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway. nina.grytten@helse-bergen.no
authors.forename: N
authors.initials: N
authors.lastname: Grytten
authors.forename: J H
authors.initials: JH
authors.lastname: Aarseth
authors.forename: K
authors.initials: K
authors.lastname: Espeset
authors.forename: G
authors.initials: G
authors.lastname: Berg Johnsen
authors.forename: R
authors.initials: R
authors.lastname: Wehus
authors.forename: C
authors.initials: C
authors.lastname: Lund
authors.forename: T
authors.initials: T
authors.lastname: Riise
authors.forename: R
authors.initials: R
authors.lastname: Haugstad
mesh_terms: D000328:Adult; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000453:epidemiology / Q000628:therapy*; D009664:Norway / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires