Author Of 1 Presentation
P1105 - Polypharmacy in MS: Correlations with pain, fatigue, and mood. (ID 823)
Abstract
Background
Pain, fatigue, and mood disorders are typical in multiple sclerosis (MS) and are associated with negative outcomes such as disability and health-related quality of life. Polypharmacy is linked to adverse effects in the aging population, but little is known about how polypharmacy contributes to pain, fatigue, and mood symptoms in MS.
Objectives
The objective of this study is to describe the interaction of pain, fatigue, mood, and polypharmacy in a sample of older individuals with and without MS.
Methods
We recruited 2 groups of subjects aged 55 and older, including 50 patients with MS (PwMS; RRMS=25, PPMS=14, and SPMS=11) and 55 persons without MS (PwoMS). We gathered validated assessments to evaluate pain (MOS Pain), fatigue (Modified Fatigue Impact Scale [MFIS]), and mood (Hospital Anxiety and Depression Scale [HADS]). Medication lists were reviewed with subjects to assess polypharmacy.
Results
PwMS reported more pain (p<.001) and fatigue (p<.001) than PwoMS. Total HADS score was higher in PwMS (p=.001), indicating more mood symptoms. Disparity in HADS score appears to be driven by differences in the depression subscale (p<.001), as there was no difference in the anxiety subscale (p=.4). PwMS reported more medications (p<.01). Use of anticholinergic (p<.001), antiepileptic (p<.01), and stimulant (p=.01) was more common in PwMS. In PwMS, number of medications was correlated with depression (p<.01), fatigue (p<.05), and pain (p<.05); no such relationship emerged in PwoMS. Most common medications reported by PwMS were muscle relaxants, vitamin D, anticonvulsants, antidepressants, and analgesics (excluding aspirin). Most common medications in PwoMS were statins, antihypertensives, aspirin, analgesics (excluding aspirin), and vitamin D.
Conclusions
Polypharmacy may be associated with pain, fatigue, and mood symptoms in MS. Clinicians should consider a careful medication review in MS patients reporting these symptoms. Additionally, researchers investigating fatigue, pain, and mood in MS should measure and control for the effects of polypharmacy.