Factors influencing quality of life in multiple sclerosis patients in Northwest Ethiopia: a multicentre cross-sectional study.

چکیده اصلی

BACKGROUND: Multiple sclerosis (MS) significantly affects patients' quality of life (QoL), particularly in resource-limited settings. This multicentre study aimed to identify factors influencing QoL among MS patients in Northwest Ethiopia, where data are scarce. METHODS: A cross-sectional study was conducted from January to June 2024 among 427 MS patients (≥18 years, diagnosed using McDonald criteria) attending three referral hospitals (University of Gondar, Debre Tabor, Felege Hiwot). Stratified sampling ensured representation across disease severity. Sociodemographic, clinical, psychological and behavioural data were collected. QoL was measured using the MSQOL-54 questionnaire. Multiple regression identified predictors of QoL, expressed as β coefficients and p values. Treatment adherence was assessed only among patients receiving disease-modifying therapy (DMT) (n = 310), and this subgroup was used for adherence-related analyses. RESULTS: The mean age of participants was 43 years, and 58.3% were female. Disease severity was classified as mild in 50.4%, moderate in 34.7%, and severe in 15.0% of participants. Low physical and mental QoL were reported in 34.9% and 31.6%, respectively. Lower QoL was significantly associated with greater disease severity (β = -0.85, p = 0.001), illness duration >10 years (β = -0.35, p = 0.002), fatigue (β = -1.10, p < 0.001), anxiety (β = -1.00, p < 0.001), depression (β = -1.20, p < 0.001), cognitive impairment and treatment non-adherence (evaluated only among DMT-treated patients). Moderate-to-high physical activity (β = 0.60, p = 0.001) and strong social support (β = 0.70, p = 0.001) were associated with higher QoL. CONCLUSIONS: QoL among MS patients was strongly influenced by disease severity, treatment adherence (among patients receiving DMT), fatigue, psychological distress, cognitive function, physical activity and social support. Interventions targeting these modifiable factors may improve patient outcomes. This study provides important evidence from Ethiopia and helps address a significant knowledge gap regarding MS care in resource-limited settings.

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