Predictors of prescriptions for management of fatigue among veterans with multiple sclerosis.

Abstract

To determine predictors of fatigue-modifying medication use. Cross-sectional cohort. Veterans Health Administration (VHA) facilities. Veterans with multiple sclerosis (MS) in the VHA in the northwestern United States from 1995 to 2000. Not applicable. 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. 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. 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.