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Value of health-related quality of life to predict disability course in multiple sclerosis

From the Departments of Medical Psychology (Drs. Klein, E. van der Ploeg, Collette, and H.M. van der Ploeg, M.A.J. Visschedijk), Neurology (Drs. Uitdehaag, Hoogervorst, and Polman), and Clinical Epidemiology and Biostatistics (Dr. Uitdehaag), Amsterdam, and Section for Diagnostics, Monitoring, and Research (Dr. Pfennings), Flevo Future Clinic, Utrecht, the Netherlands; and National Multiple Sclerosis Center (Dr. Vleugels), Melsbroek, Belgium.

Address correspondence and reprint requests to M.A.J. Visschedijk, Department of Medical Psychology, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; e-mail: maj.visschedijk{at}vumc.nl

Objective: To determine the value of health-related quality of life (HRQoL) to predict change in disability status in patients with multiple sclerosis (MS).

Methods: Over a 5-year period, data were collected on HRQoL (Medical Outcomes Study Short Form-36 Health Survey) and disability status (Expanded Disability Status Scale) from a heterogeneous group of 81 Dutch-speaking patients with MS.

Results: Multivariate logistic regression analysis showed that HRQoL in the domains of Physical Functioning and Role-Physical Functioning is a significant predictor of change in disability status.

Conclusions: A patient’s subjectively perceived health-related quality of life may not be only a clinically and psychosocially meaningful outcome per se but may also be a predictor of objective outcomes such as change in disability status over a substantial period of time.

Received April 9, 2004. Accepted in final form August 16, 2004.

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