Pain in patients with multiple sclerosis and its effect on selected aspects of the quality of life

Czech version

Authors: M. Miertová ¹; N. Juríčková ²; A. Ovšonková ¹
Authors‘ workplace: Ústav ošetrovateľstva, Jesseniova, lekárska fakulta v Martine, Univerzita, Komenského v Bratislave, Slovensko ¹; Oddelenie cievnej chirurgie, Univerzitná nemocnica Martin, Slovensko ²
Published in: Cesk Slov Neurol N 2024; 87(3): 208-212
Category: Original Paper
doi: https://doi.org/10.48095/cccsnn2024208

Overview

Aim: To determine the mean intensity of currently experienced pain, its impact on behavioral and functional domains of life according to the The Medical Outcomes Study (MOS) Pain Effects Scale (PES) and currently experienced overall quality of life according to the Multiple Sclerosis Quality of Life 54 (MSQoL-54) in MS. Patients and methods: The quantitative observational study had 108 MS patients. The questionnaire included the Visual Analogue Scale (VAS) to assess the intensity of current pain, MOS PES to determine the impact of pain on selected functional and behavioral areas of the quality of life, and subjective perception of the overall quality of life using the item of the MSQoL-54. Descriptive statistics was used to evaluate averages and Spearman’s correlation coefficient to detect any relationship. Results: Patients reported a mean moderate pain intensity according to the VAS (M = 3.8). Pharmacotherapy was used by 66.7% of patients with the effect of occasional and frequent pain minimization; most commonly used drugs were nonsteroidal antiphlogistics (N = 55). Non-pharmacological methods were used by 36 patients with intermittent and frequent pain minimization; most used method was exercise. MOS PES showed a moderate effect of pain on functional and behavioral quality of life domains. According to the MSQoL-54, overall quality of life was rated as satisfactory (M = 5.8), and was rated lower with increasing pain intensity. Increasing pain intensity according to the MOS PES negatively affected mood, walking ability, sleep, activities of daily living, and recreational activities. Conclusion: Objectification of pain and identification of its impact on quality of life will help to improve individualized MS treatment.

Keywords:

Pain – Quality of life – Neurology – Multiple sclerosis – patient

Sources

1. Šťastná D, Menkyová I, Horáková D. Progresivní roztroušená skleróza ve světle nejnovějčích poznatků. Cesk Slov Neurol N 2023; 86/ 119(1): 10– 17. doi: 10.48095/ cccsnn202310.

2. Vachová M. Bolest u roztroušené sklerózy. Neurol praxi 2020; 21(5): 369– 371. doi: 10.36290/ neu.2020.114.

3. Grau-López L, Sierra S, Martínez-Cáceres E et al. Analysis of the pain in multiple sclerosis patients. Neurologia 2011; 26(4): 208– 213. doi: 10.1016/ S2173-5808(11)70043-8.

4. Racke MK, Frohman EM, Frohman T. Pain in multiple sclerosis: understanding pathophysiology, diagnosis, and management through clinical vignettes. Front Neurol 2022; 12: 799698. doi: 10.3389/ fneur.2021.799698.

5. Donáth V. Liečba najčastejších symptómov sclerosis multiplex. Neurológia pre prax 2020; 21(6): 428– 432.

6. Taláb R, Talábová M. Glatiramer acetát – léčba roztroušené sklerózy monitorovaná v registru ReMus. Cesk
Slov Neurol N 2020; 85/ 116(4): 401– 407. doi: 10.14735/
amcsnn2020401.

7. Hradílek P. Adherence k léčbě u roztroušené sklerózy. Neurol praxi 2012; 13(3): 155– 158.

8. Kasap Z, Uğurlu H. Pain in patients with multiple sclerosis. Turk J Phys Med Rehab 2023; 69(1): 31– 39. doi: 10.5606/ tftrd.2022.10524.

9. Feketová S, Waczulíková I, Valkovič P et al. Central pain in patients with multiple sclerosis. J Mult Scler 2017; 4: 3. doi: 10.4172/ 2376-0389.1000208.

10. Labuz-Roszak B, Niewiadomska E, Kubicka-Baczyk K et al. Prevalence of pain in patients with multiple sclerosis and its association with anxiety, depressive symptoms and quality of life. Psychatr Pol 2019; 53(2): 475– 486. doi: 10.12740/ PP/ 94469.

11. Akpinar Z, Serhat Tokgöz O, Gümüş H. The relationship between pain and clinical features in multiple sclerosis. TJN 2014; 3: 2014. doi:10.4274/ tnd.60437.

12. Gürkan MA, Tuzcu Gürkan, F. Measurement of pain in multiple sclerosis. Noro Psikiyatr Ars 2018; 55 (Suppl 1): S58– S62. doi: 10.29399/ npa.23336.

13. Herbert LB, Zerkowski K, O’Brien S et al. Impact on interpersonal relationships among patients with multiple sclerosis ad their partners. Neurodegener Dis Manag 2019; 9(3): 173– 189. doi: 10.2217/ nmt-2018-0045.

14. Mountford S, Kahn M, Balakrishnan P et al. Correlation and differences of patient-reported outcomes vs. Likert-Rating of MS symptoms in a real-world cohort using a digital patient app. Digital Health 2023; 9: 20552076231173520. doi: 10.1177/ 20552076231173520.

15. Vitková M. Kvalita života pacientov so sclerosis multiplex. Via pract 2016; 13(6): 248– 250.

16. Gil-González I, Martín-Rodríguez A, Conrad R et al. Quality of life in adults with multiple sclerosis: a systematic review. BMJ Open 2020; 10(11): e041249. doi: 10.1136/ bmjopen-2020-041249.

17. Ritvo PG, Ficher JS, Miller DM et al. MSQLI – Multiple Sclerosis Quality of Life Inventory: a user’s manual. [online]. New York: National Multiple Sclerosis Society, 1997. Available from URL: https:/ / nms2cdn.azureedge.net/ cmssite/ nationalmssociety/ media/ msna tionalfiles/ brochures/ msqli_-a-user-s-manual.pdf.

18. Vickrey BG. Multiple Sclerosis Quality of Life (MSQOL)-54 Instrument. [online]. Los Angeles, University of California, 1995. Available from URL: https:/ / www.nationalms society.org/ NationalMSSociety/ media/ MSNationalFiles/ Brochures/ MSQOL54_995.pdf.

19. Dušek L, Pavlík T, Jarkovský J et al. Analýza dat v neurologii. LXXIV. Neparametrický Spearmanův koeficient korelace. Cesk Slov Neurol N 2019; 85/ 115(2): 236– 239.

20. Agoklu H. User’s guide to correlation coefficients. Turk J Emerg Med 2018; 18(3): 91– 93. doi: 10.1016/ j.tjem.2018.08.001.

21. Michalski D, Liebig S, Thomae E et al. Pain in patients with multiple sclerosis: a complex assessment including quantitative and qualitative measurements provides for a disease-related biopsychosocial model. J Pain Res 2011; 4: 219– 225. doi: 10.2147/ JPR.S20309.

22. Marck CH, De Livera AM, Weiland TJ et al. Pain in people with multiple sclerosis: associations with modifiable lifestyle factors, fatigue, depression, anxiety, and mental health quality of life. Front Neurol 2017; 8: 461. doi: 10.3389/ fneur.2017.00461.

23. Janqueira AF, Farraposo S, Cruz AR et al. Pain prevalence in multiple sclerosis in a Lisbon Tertiary Hospital: a cross-sectional study. Cureus 2022; 14(2): e22213. doi: 10.7759/ cureus.22213.

24. Truini A, Barbanti P, Pozzilli C, Gruccu G. A mechanism-based classification of pain in multiple sclerosis. J Neurol 2013; 260: 351– 367. doi: 10.1007/ s00415-012-6579-2.

25. Aboud T, Schuster NM. Pain management in multiple sclerosis: a review of available treatment options. Cur Treat Options Neurol 2019; 21(12): 62. doi: 10.1007/ s11940-019-0601-2.