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Research ArticleOriginal Article
Open Access

Quality of life assessment among multiple sclerosis patients in Saudi Arabia

Adel A. Alhazzani, Mohammed S. Alqahtani, Mohammed S. Alahmari, Muhannad A. Asiri, Noof M. Alamri, Leen A. Sarhan, Shahad S. Alkhashrami and Abdullmgeed A. Asiri
Neurosciences Journal April 2018, 23 (2) 140-147; DOI: https://doi.org/10.17712/nsj.2018.2.20170335
Adel A. Alhazzani
From the College of Medicine (Alhazzani, Alqahtani, Alahmari, Asiri M, Alamri, Sarhan, Alkhashrami, Asiri A), King Khalid University, Abha, Department of Neurology (Alhazzani), King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
MD, FAAN
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  • For correspondence: [email protected]
Mohammed S. Alqahtani
From the College of Medicine (Alhazzani, Alqahtani, Alahmari, Asiri M, Alamri, Sarhan, Alkhashrami, Asiri A), King Khalid University, Abha, Department of Neurology (Alhazzani), King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Mohammed S. Alahmari
From the College of Medicine (Alhazzani, Alqahtani, Alahmari, Asiri M, Alamri, Sarhan, Alkhashrami, Asiri A), King Khalid University, Abha, Department of Neurology (Alhazzani), King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Muhannad A. Asiri
From the College of Medicine (Alhazzani, Alqahtani, Alahmari, Asiri M, Alamri, Sarhan, Alkhashrami, Asiri A), King Khalid University, Abha, Department of Neurology (Alhazzani), King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Noof M. Alamri
From the College of Medicine (Alhazzani, Alqahtani, Alahmari, Asiri M, Alamri, Sarhan, Alkhashrami, Asiri A), King Khalid University, Abha, Department of Neurology (Alhazzani), King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Leen A. Sarhan
From the College of Medicine (Alhazzani, Alqahtani, Alahmari, Asiri M, Alamri, Sarhan, Alkhashrami, Asiri A), King Khalid University, Abha, Department of Neurology (Alhazzani), King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Shahad S. Alkhashrami
From the College of Medicine (Alhazzani, Alqahtani, Alahmari, Asiri M, Alamri, Sarhan, Alkhashrami, Asiri A), King Khalid University, Abha, Department of Neurology (Alhazzani), King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Abdullmgeed A. Asiri
From the College of Medicine (Alhazzani, Alqahtani, Alahmari, Asiri M, Alamri, Sarhan, Alkhashrami, Asiri A), King Khalid University, Abha, Department of Neurology (Alhazzani), King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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  • Figure 1
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    Figure 1

    Shows the SF-36 domain scores for male and female multiple sclerosis patients.

Tables

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    Table 1

    Clinical characteristics of study patients with multiple sclerosis (N=598).

    Variablesn(%)
    Gender
     Male214(35.8)
     Female384(64.2)
    Marital status
     Single250(41.8)
     Married310(51.8)
     Divorced36(6)
     Widower2(0.4)
    Education level
     Illiterate4(0.7)
     Primary12(2)
     Intermediate28(4.7)
     Secondary140(23.4)
     University378(63.2)
     Postgraduate36(6)
    Regions
     Southern170(28.4)
     Middle150(25.1)
     East114(19.1)
     North28(4.7)
     West136(22.7)
    Age (years), mean±SD [range]32.4±8.4[15-60]
    At disease onset, mean±SD [range]26.9±7.6[13-56]
    Disease duration (years), mean±SD6.5±4.7
    Number of admission, mean±SD1.4±1.7
    Number of attacks during last 2 years), mean±SD [range]1.4±1.9[0-14]
    Drug used now (n=558)
    Interferon beta-1b (Betaferon)146(26.2)
    Interferon beta-1a (Rebif)114(20.5)
    Interferon beta-1a (Avonex)100(17.9)
    Teriflunomide (Aubagio)20(3.6)
    Dimethyl fumarate (Tecfidera)18(3.2)
    Fingolimod (Gilenya)108(19.3)
    Natalizumab (Tysabri)46(8.2)
    Rituximab (Rituxan)4(0.7)
    Alemtuzumab (Lemetrada)2(0.5)
    • View popup
    Table 2

    Frequency of comorbid conditions in multiple sclerosis patients.

    Chronic diseasesFrequencyPercent (%)
    No comorbidity444(74.2)
    Associated chronic diseases154(25.8)
     Diabetes mellitus39(6.5)
     Hypertension32(5.3)
     Asthma28(4.7)
     Headache / migraine27(4.5)
     Depression26(4.3)
     Thyroid disease18(3.0)
     Anti-phospholipid syndrome6(1.0)
     Systemic lupus erythematosus5(0.8)
     Sjogren syndrome2(0.3)
    • View popup
    Table 3

    Spearmen correlation between PDDS and QOL subscales

    PFRPREEFEWSFBPGH
    Mean58.645.042.645.646.261.965.755.4
    SD28.841.243.320.218.225.824.717.3
    R-0.640-0.505-0.253-0.501-0.244-0.523-0.475-0.518
    P-value0.0000.0000.0000.0000.0000.0000.0000.000
    • PF - Physical functioning, RP - Role limitations due to physical health, RE - Role limitations due to emotional problems, EF - Energy/fatigue, EW - Emotional well-being, SF - Social functioning, BP - Body pain, GH - General health, PDDS -Patient Determined Disease Steps, QOL - quality of life.

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    Table 4

    Differences in SF-36 subscale scores by marital status.

    SubscalesSingleMarriedDivorcedP-value
    MeanSDMeanSDMeanSD
    Males
     PF64.331.157.829.451.727.00.001
     RP56.540.744.041.333.334.20.001
     RE46.442.247.744.477.834.40.000
     EF51.721.347.919.541.711.30.116
     EW49.017.450.815.445.314.90.231
     SF67.925.262.325.754.217.10.119
     BP78.720.766.222.678.320.20.002
     GH57.518.952.615.943.318.10.089
    Females
     PF63.426.854.028.150.628.70.000
     RP50.638.535.841.345.346.00.004
     RE42.242.536.442.745.847.70.123
     EF48.218.340.720.836.917.40.282
     EW46.418.943.018.840.018.70.186
     SF63.324.558.226.455.529.80.008
     BP64.422.160.626.858.828.60.003
     GH58.917.053.216.957.218.40.002
    Total
     PF63.828.455.428.649.428.30.000
     RP52.839.338.941.443.145.40.000
     RE43.742.440.643.65048.20.464
     EF49.519.543.420.638.116.90.000
     EW47.418.445.91840.918.60.187
     SF65.224.86026.155.128.70.014
     BP69.822.662.925.462.428.80.006
     GH58.417.75316.554.419.20.004
    • PF - Physical functioning, RP - Role limitations due to physical health, RE - Role limitations due to emotional problems, EF - Energy/fatigue, EW - Emotional well-being, SF - Social functioning, BP - Body pain, GH - General health.

    • View popup
    Table 5

    Differences in SF-36 subscale scores by educational level.

    Education levelPFRPREEFEWSFBPGH
    Males
     IntermediateMean26.312.58.341.343.059.458.855.0
    SD21.223.115.416.620.428.99.421.0
     SecondaryMean67.144.147.144.147.562.568.452.4
    SD26.242.243.520.515.726.819.621.1
     UniversityMean59.349.447.150.350.263.971.853.9
    SD30.840.843.220.316.325.223.316.6
     PostgraduateMean80.083.388.957.556.781.392.966.7
    SD14.528.926.016.412.918.18.610.3
    P-value0.0010.0010.0000.1160.2310.1190.0020.089
    Females
     IlliterateMean37.512.50.047.532.062.538.850.0
    SD26.014.40.026.013.914.421.711.5
     PrimaryMean49.237.538.940.042.052.156.348.3
    SD31.847.146.835.319.024.334.022.1
     IntermediateMean33.032.550.039.052.450.051.051.0
    SD29.136.446.516.215.038.031.916.0
     SecondaryMean54.034.432.740.642.055.057.552.2
    SD26.839.139.318.917.924.322.714.5
     UniversityMean62.245.941.944.944.962.665.057.7
    SD25.840.443.518.919.124.923.116.8
     PostgraduateMean59.266.747.248.343.071.971.065.0
    SD36.348.249.125.022.927.635.225.1
    P-value0.0000.0040.1230.2820.1860.0080.0030.002
    Total
     IlliterateMean37.512.50.047.532.062.538.850.0
    SD26.014.40.026.013.914.421.711.5
     PrimaryMean49.237.538.940.042.052.156.348.3
    SD31.847.146.835.319.024.334.022.1
     IntermediateMean31.126.838.139.649.752.953.352.1
    SD26.934.044.216.016.835.427.517.3
     SecondaryMean57.136.836.241.443.357.060.352.2
    SD27.139.940.719.317.525.022.416.3
     UniversityMean61.047.444.147.247.263.468.056.1
    SD28.040.543.419.618.124.923.416.8
     PostgraduateMean66.172.261.151.447.675.278.465.6
    SD32.143.046.822.721.024.930.721.2
    P-value0.0000.0000.0210.0160.1270.0010.0000.002
    • PF - Physical functioning, RP - Role limitations due to physical health, RE - Role limitations due to emotional problems, EF - Energy/fatigue, EW - Emotional well-being, SF - Social functioning, BP - Body pain, GH - General health, SD - standard deviation.

    • View popup
    Table 6

    Differences in SF-36 subscale scores by associated comorbidity.

    Associated comorbidityPFRPREEFEWSFBPGH
    Males
     Absent (n=176)Mean62.150.647.750.049.364.973.455.4
    SD29.041.944.220.616.026.121.618.0
     Present (n=38)Mean52.642.149.146.652.662.564.950.0
    SD34.437.740.117.917.122.125.614.2
     P-value0.1210.2240.8490.3440.2480.5960.0330.084
    Females
     Absent (n=268)Mean59.749.144.045.746.363.565.758.2
    SD28.942.042.919.317.524.724.616.8
     Present (n=116)Mean52.628.029.338.239.252.253.550.7
    SD25.234.941.720.521.027.224.417.2
     P-value0.015<0.0010.0020.0010.002<0.001<0.001<0.001
    Total
     Absent (n=444)Mean60.749.645.347.447.463.968.657.0
    SD28.941.943.319.917.025.323.817.4
     Present (n=154)Mean52.631.534.240.242.454.556.050.5
    SD27.636.042.120.320.926.625.416.6
     P-value0.002<0.0010.005<0.0010.008<0.001<0.001<0.001
    • PF - Physical functioning, RP - Role limitations due to physical health, RE - Role limitations due to emotional problems, EF - Energy/fatigue, EW - Emotional well-being, SF - Social functioning, BP - Body pain, GH - General health.

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Quality of life assessment among multiple sclerosis patients in Saudi Arabia
Adel A. Alhazzani, Mohammed S. Alqahtani, Mohammed S. Alahmari, Muhannad A. Asiri, Noof M. Alamri, Leen A. Sarhan, Shahad S. Alkhashrami, Abdullmgeed A. Asiri
Neurosciences Journal Apr 2018, 23 (2) 140-147; DOI: 10.17712/nsj.2018.2.20170335

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Quality of life assessment among multiple sclerosis patients in Saudi Arabia
Adel A. Alhazzani, Mohammed S. Alqahtani, Mohammed S. Alahmari, Muhannad A. Asiri, Noof M. Alamri, Leen A. Sarhan, Shahad S. Alkhashrami, Abdullmgeed A. Asiri
Neurosciences Journal Apr 2018, 23 (2) 140-147; DOI: 10.17712/nsj.2018.2.20170335
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