Less than a third of patients with multiple sclerosis (MS) have been offered a treatment for fatigue as part of their routine care, despite it being a symptom reported by 90% of patients, a recent UK study has shown.
MS is a disabling, unpredictable disease in which the immune system attacks the protective myelin sheath that covers the nerves and disrupts communication between the brain and the rest of the body. The disease affects approximately 100,000 people in the UK and 2.3 million globally.
Fatigue is one of the most prevalent symptoms of MS and is associated with disability, disease progression and quality of life, which in turn are associated with increased health care costs.
The study used the UK MS Register, which currently has over 17,000 members who are asked to regularly update the information on their treatments. The data on fatigue treatments offered was collected using an online questionnaire.
Of the 4,367 patients who completed the survey, 90.3% reported experiencing fatigue, in line with previous prevalence estimates. Of this, only 30.8% reported having been offered at least one type of treatment for fatigue, in spite of 83.5% reportedly wanting better provision of fatigue treatments.
Pharmacological treatments, particularly amantadine, were the most commonly offered at 22.4%, compared to non-pharmacological treatments at 12.6%.
Notably, of those reporting being offered any treatment for fatigue, at least some level of improvement following medications, exercise or behavioural treatments was reported among 59% to 62%.
Those younger, those with a longer duration of MS, those not in regular employment and those with higher levels of fatigue were more likely to have been offered some form of fatigue treatment in the multivariate regression model.
The findings complement previous evidence on the unmet need for supportive therapies more generally in MS, the researchers concluded, though to date, no study has specifically examined the range of treatments routinely offered for fatigue and factors that are associated with being offered treatment.
The team outlined that research focus now needs to be ‘redirected to understanding and acknowledging the context of delivery in intervention development and on the implementation of evidence based approaches to treat fatigue’ in order to lead to lasting patient benefit.