While the physical disability aspect of multiple sclerosis (MS) is of great importance, quality of life (QoL) measurements are being considered increasingly important with regard to evaluating disease progression, treatment, and the management of care provided to MS patients. Despite the acknowledged need to consider QoL issues, QoL assessment remains underutilized in clinical practice. These issues should be explored and understood to promote the use of measuring QoL in MS clinical practice. We explore the difficulties for clinicians: choosing and determining the most appropriate QoL measure and how to best integrate QoL measurements into clinical practice. This paper discusses several avenues to provide to clinicians arguments of the clinical relevance and accuracy of QoL instruments and ultimately to enhance the use of QoL measures in clinical practice for MS patients. 1. Introduction While the physical disability aspect of multiple sclerosis (MS), the most common demyelinating disease of the central nervous system in young adults, is of great importance, it is now well recognized that it does not reflect all of the facets that patients consider important in their life. Fatigue, depression, and physical disability are only one aspect of a person’s experience with MS; it is well documented that cognitive, emotional, and psychological functions contribute to their quality of life (QoL) [1]. The QoL measurements are being considered increasingly important with regard to evaluating disease progression, treatment and the management of care provided to MS patients [2, 3]. The US Food and Drug Administration (FDA) and the European Medicines Agency encourage the use of QoL assessment in patients with chronic illnesses [4, 5], and several groups have published detailed recommendations for QoL assessment [6, 7]. In MS research, 118 studies that have reported QoL as an outcome were performed with MS patients in the Clinical Trials registry (ClinicalTrials.gov, December 31, 2012). Despite the acknowledged need to consider QoL issues, QoL assessment remains under-utilized in MS clinical practice [8]. QoL assessment may be considered to be an “unfulfilled promise” [9–11]. Therefore, these issues should be explored and understood to promote both the use and usefulness of measuring QoL in MS clinical practice. Here, we explore the difficulties for clinicians to choose and determine the most appropriate QoL measure, to be convinced by the clinical utility of the QoL assessment implementation in clinical practice and to interpret QoL scores. 2. Difficulties for MS
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