Quality of life for veterans with multiple sclerosis on disease-modifying agents: Relationship to disability

Our objective was to compare self-reported health-related quality of life (HRQOL) for U.S. veterans with multiple sclerosis (MS) on disease-modifying agents with provider reports of HRQOL from standard disability measures. We conducted a 3-year prospective observational study of 204 subjects who used interferon beta or glatiramer acetate and compared subjects' responses on the Veterans Short-Form 36 (VSF-36) (36-item short-form functional status assessment for veterans) with the Kurtzke Expanded Disability Status Scale (EDSS) and the Functional System (FS) scales, which are standard MS disability scales. EDSS and FS scores were significantly correlated with some VSF-36 domains (physical function [r = -0.57], role physical [r = -0.37], and physical component summary [r = -0.40]) and weakly correlated with other domains. HRQOL scores did not predict disability or compliance with therapy. We observed decrements in HRQOL at relatively low disability levels. HRQOL measures directly associated with physical function were correlated with standard MS disability scales. Researchers need to clarify the role of HRQOL in clinical outcomes assessment, as shown by the lack of outcome sensitivity and predictive value of the VSF-36.