2021 CMSC Annual Meeting

Multiple Sclerosis, Patient Reported Meaning and Purpose: The Relationship of Physical Ability to Patient Reported Quality of Life


Background: Multiple Sclerosis (MS) is an autoimmune disease characterized by relapses, progression, physical disability and MRI changes. Increasing disease impact is associated with physical disability, cognitive impairment, psychological impact and impaired social functioning. Traditional approach to patient care in MS focuses on identifying and treating the physical symptoms of MS with Disease Modifying Therapies (DMT), however the relationship of this to the overall patient experience remains uncertain. Patient reported outcomes (PROs) evaluating psychological and social functioning may provide value added information to identify critical patient-centric aspects that impact quality of life (QoL) and allow unrecognized opportunities to enhance outcomes and satisfaction. Objectives: To explores the impact of psychological, social and physical functioning on meaning and purpose in people with Multiple Sclerosis (PwMS). Methods: Retrospective chart review of data collected through routine care of PwMS that completed PROs including: PROMIS Meaning and Purpose- Short Form 4a (MP), Patient Determined Disease Steps (PDDS), Neuro-QoL Ability to Participate in Social Roles and Activities – Short Form (SR), and Hospital Anxiety and Depression Scale (HADS). Results: 345 PwMS, 73% female, average age 50.6 +/- 11.7 years. Significant correlations were determined by regression analysis with p<.01: MP&PDDS (r2=0.07), MP&HADS-A (r2=0.17), MP&HADS-D (r2=0.40), and MP&SR (r2=0.26). Conclusions: Meaning and purpose in PwMS is more closely correlated to psychological or social factors, rather than the physical disability. PRO physical disability (PDDS) demonstrated subtle negative correlation with MP, but SR and HADS both had large effect on MP, indicating that social and psychological function in PwMS may be a large contributor to patient QoL than previously anticipated. Enhanced understanding of such impact, identifying those with such impact and addressing these needs might provide unique opportunities to improve care, outcomes and satisfaction.