title: Medication use in a large international sample of people with multiple sclerosis: associations with quality of life, relapse rate and disability.
abstract: OBJECTIVE
  To examine associations between medication use and health-related quality of life (HRQOL), relapse rate and disability in an international cohort of people with multiple sclerosis (PwMS).
  
  
  METHODS
  Using Web 2.0 platforms, the authors recruited PwMS who completed survey items on demographics, medication use, HRQOL, relapse rate and disability.
  
  
  RESULTS
  Of 2276 respondents from 56 countries, approximately half were taking a disease-modifying drug (DMD), most commonly glatiramer acetate or an interferon. Use of DMDs was not consistently associated with HRQOL. Individually, glatiramer acetate was associated with better HRQOL when compared with other DMDs or no DMD use. Overall, DMD use was neither associated with disability nor lower relapse rate, although those taking a DMD >12 months had 23.9% fewer relapses than those not taking a DMD. Polypharmacy, defined as those taking five or more over the counter, prescription or herbal medications, irrespective of DMD use, was associated with markedly worse HRQOL across all domains.
  
  
  CONCLUSIONS
  There was no consistent association of DMD use with better health outcomes in this large international \sample of PwMS, although relapse rate appears lower for those taking a DMD for >12 months. Glatiramer acetate had associations with better HRQOL compared with other DMDs.
authors.forename: George A
authors.initials: GA
authors.lastname: Jelinek
authors.forename: Tracey J
authors.initials: TJ
authors.lastname: Weiland
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Hadgkiss
authors.forename: Claudia H
authors.initials: CH
authors.lastname: Marck
authors.forename: Naresh
authors.initials: N
authors.lastname: Pereira
authors.forename: Dania M
authors.initials: DM
authors.lastname: van der Meer
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D000068717:Glatiramer Acetate / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007372:Interferons / Q000627:therapeutic use; D038622:Internationality; D020407:Internet; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D019338:Polypharmacy; D011788:Quality of Life; D012008:Recurrence; D057566:Self Report; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007155:Immunologic Factors; D000068717:Glatiramer Acetate; D007372:Interferons
keywords: Disability; Disease-modifying drugs,; Health-related quality of life,; Medications,; Multiple sclerosis,; Relapse rate,