Multiple sclerosis and related disorders · 2025
The impact of multidisciplinary care on the health-related quality of life in people with multiple sclerosis: a systematic review.
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Van Hijfte Liesbeth, Jonkers Caroline, Van Kerkhove Yinthe, Willekens Hebe, Laureys Guy, Willekens Barbara
Аннотация
OBJECTIVE: To summarize the evidence regarding the impact of multidisciplinary care on health-related quality of life (HRQoL) in people with multiple sclerosis (pwMS).
METHODS: Medline, Web of Science and clinical trials.gov were searched using 'multiple sclerosis', 'multidisciplinary care' and 'Quality of Life'. Interventional, cross-sectional or observational studies, published between January 2000 and September 2023 and using at least one HRQoL outcome measure were retained. Demographics, MS- and study specific data were extracted and the risk of bias was evaluated.
RESULTS: The search yielded sixteen articles. Study designs consisted of fourteen randomized controlled trials, one observational and one non-randomized intervention. Researchers reported inpatient, outpatient or home-based interventions. Two publications included cost-effectiveness analyses. Disease specific and generic HRQoL questionnaires were used, supplementing physical, cognitive and psychosocial outcome measures. Multidisciplinary teams (MDTs) usually consisted of physiotherapists, nurses, psychologists and neurologists. Most studies focused on pwMS with high disability. No studies demonstrated an overall sustained total HRQoL improvement, although positive changes were found within subscales focusing on psychosocial well-being. Comparable positive trends were seen for physical, cognitive and self-efficacy outcomes, and cost-effectiveness.
CONCLUSION: Methodological heterogeneity may have led to inconclusive evidence regarding MDTs impact on HRQoL in MS. Future challenges entail to (i) optimize the MDT composition, (ii) standardize outcome measures, including HRQoL, to assess the efficacy of multidisciplinary care in MS, and considering MS subpopulations and/or symptom clusters, and (iii) to demonstrate the cost-effectiveness of MDTs in comparison to the standard of care in MS.
METHODS: Medline, Web of Science and clinical trials.gov were searched using 'multiple sclerosis', 'multidisciplinary care' and 'Quality of Life'. Interventional, cross-sectional or observational studies, published between January 2000 and September 2023 and using at least one HRQoL outcome measure were retained. Demographics, MS- and study specific data were extracted and the risk of bias was evaluated.
RESULTS: The search yielded sixteen articles. Study designs consisted of fourteen randomized controlled trials, one observational and one non-randomized intervention. Researchers reported inpatient, outpatient or home-based interventions. Two publications included cost-effectiveness analyses. Disease specific and generic HRQoL questionnaires were used, supplementing physical, cognitive and psychosocial outcome measures. Multidisciplinary teams (MDTs) usually consisted of physiotherapists, nurses, psychologists and neurologists. Most studies focused on pwMS with high disability. No studies demonstrated an overall sustained total HRQoL improvement, although positive changes were found within subscales focusing on psychosocial well-being. Comparable positive trends were seen for physical, cognitive and self-efficacy outcomes, and cost-effectiveness.
CONCLUSION: Methodological heterogeneity may have led to inconclusive evidence regarding MDTs impact on HRQoL in MS. Future challenges entail to (i) optimize the MDT composition, (ii) standardize outcome measures, including HRQoL, to assess the efficacy of multidisciplinary care in MS, and considering MS subpopulations and/or symptom clusters, and (iii) to demonstrate the cost-effectiveness of MDTs in comparison to the standard of care in MS.