Need for symptomatic management in advanced multiple sclerosis
Multiple sclerosis (MS) is the most common cause of progressive disability in young adults in developed countries.1 In the early stages, patients are provided disease modifying treatment in addition to symptomatic treatment.2 As disability progresses and immunotherapy is terminated, there is usually an increasing need of symptomatic therapy.4 Common symptoms in advanced disease are spasticity, pain, bladder dysfunction, fatigue and emotional disturbances.6 These treatable symptoms may have an unnecessary large influence on function and quality of life. Impairment, disability, perception of treatment control, and symptoms interact and may complicate pharmacological symptomatic treatment particularly in advanced stages of the disease.7 Although MS is studied intensively, the information on use of symptomatic therapy in patients with advanced MS is rare. Some studies have shown unmet need of treatment in advanced MS, and others have reported a very poor continuity of care between specialists and the primary health care.9
To examine this further, we conducted a study based on a cohort of patients with advanced MS admitted to a specialist MS rehabilitation clinic to assess the prevalence of inadequate symptomatic treatment.