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Predictors of prescriptions for management of fatigue among veterans with multiple sclerosis
Michael Hatzakis1, Aaron P Turner, Rhonda M Williams
1Department of Veterans Affairs, Puget Sound Health Care System, Seattle, WA 98108, USA. michael.hatzakis@med.va.gov
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.
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