Predictors of prescriptions for management of fatigue among veterans with multiple sclerosis.
|Title||Predictors of prescriptions for management of fatigue among veterans with multiple sclerosis.|
|Publication Type||Journal Article|
|Authors||Hatzakis M, Turner AP, Williams RM, Bowen JD, Rodriquez AA, Haselkorn JK|
|Journal||Archives of Physical Medicine and Rehabilitation|
|Date Published||2005 Jul|
|Adult, Age Factors, Aged, Aged, 80 and over, Central Nervous System Stimulants, Cohort Studies, Cross-Sectional Studies, Dopamine Agents, Drug Prescriptions, Fatigue, Female, Hospitals, Veterans, Humans, Logistic Models, Male, Middle Aged, Multiple Sclerosis, Northwestern United States, Questionnaires, Veterans|
OBJECTIVE: To determine predictors of fatigue-modifying medication use. DESIGN: Cross-sectional cohort. SETTING: Veterans Health Administration (VHA) facilities. PARTICIPANTS: Veterans with multiple sclerosis (MS) in the VHA in the northwestern United States from 1995 to 2000. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A self-administered survey distributed by mail sought information from veterans with MS about demographics, symptoms, barriers to care, and disease characteristics. The variables were compared with prescriptions for fatigue-modifying medications during the study period. RESULTS: Of 1032 patients, 451 (44%) completed the survey, and 306 (68%) reported moderate or high fatigue levels. Only 40% of the 306 were prescribed fatigue-modifying medications. Those using specialized fatigue services or who received care at tertiary centers were more likely to receive fatigue treatments. Patient-perceived barriers to accessing care and other patient characteristics were not associated with prescription rates. CONCLUSIONS: Fatigue is undertreated among veterans with MS. However, there is considerable variability in the provision of fatigue care. Interventions to improve the quality and uniformity of fatigue care are warranted.