#MSblog: Lifestyle modifications in MS: does it improve quality of life or not?
Hadgkiss et al. Health-related quality of life outcomes at 1 and 5 years after a residential retreat promoting lifestyle modification for people with multiple sclerosis. Neurol Sci. 2013 Feb;34(2):187-95. doi: 10.1007/s10072-012-0982-4.
Background: There is a strong body of evidence that supports the use of non-drug therapies in the management of people with multiple sclerosis (MS). A 5-day residential retreat for people with MS in Victoria, Australia, promotes lifestyle modification within a patient-centred model of care.
Objective & methods: Analysis of the health-related quality of life (HRQOL) of the retreat participants was undertaken using the MSQOL-54, prior to attendance, 1 and 5 years after the retreat.
Results: 274 retreat participants (71%) completed baseline questionnaires. Despite the usually progressive nature of MS, the cohort demonstrated clinically and statistically significant improvements in HRQOL. One year after attending the retreat, median improvements of 11.3% were observed in the overall quality of life domain (p < 0.001); 18.6% in the physical health composite (p < 0.001); and 11.8% in the mental health composite (p < 0.001). In the subset of 165 who had reached the 5-year time-point, there was a 19.5% median improvement in overall quality of life (p < 0.001); 17.8% in the physical health composite (p < 0.001) and 22.8% in the mental health composite (p < 0.001), compared to baseline.
Conclusions: Attendance at a retreat promoting lifestyle modification for the integrated management of MS appears to have positive effects on short and medium-term HRQOL. Non-drug therapies should be considered as part of any comprehensive treatment plan for people with MS.
“My problem with this study is that it is observational and descriptive. MSers volunteering for a residential retreat, or could afford to spend a week at the retreat, may be very different to the average MSers who aren’t prepared to volunteer for such a service. This is why we do randomised controlled trials to get rid of any biases that could explain these results. Therefore it is impossible to assess the utility of this service. The NHS and NICE would simple dismiss this study as meaningless if we tried to make a business case using this data for setting-up or using a similar service for MSers in the UK.”
“The main lesson from this study is that if you want people to adopt your findings you need to well designed randomised controlled trials.”
“This raises ethical issues about what type of research should or shouldn’t be done.”