The impact of the episodic nature of chronic illness: A comparison of fibromyalgia, multiple sclerosis and human immunodeficiency virus

The purpose of this narrative review was to describe and compare the characteristics and episodic nature of disability among three chronic illnesses: multiple sclerosis (MS), HIV and fibromyalgia (FM). Searches were performed in electronic databases using a combination of keywords including episodic, relapse, remission, and fluctuation. We included articles published between 2004–2014 that described health challenges and the episodic nature of the illness. Data were extracted from selected articles, including the authors, date of publication, study population, the aims of the study, outcome measures and main study findings, and then were charted and collated to the dimensions of disability in the episodic disability framework. The descriptive words Saipriya Vajravelu1, Kelly K O’Brien2, Sandra Moll3, Patricia Solomon4 Affiliations: 1MSc, McMaster University – PhD Candidate, School of Rehabilitation Science, Hamilton, Ontario, Canada; 2PhD, University of Toronto – Assistant Professor, Department of Physical Therapy, Rehabilitation Sciences Institute (RSI), Institute of Health Policy, Management and Evaluation (IHPME), Toronto, Ontario, Canada; 3PhD, McMaster University – Assistant Professor, School of Rehabilitation Science, Hamilton, Ontario, Canada; 4PhD, McMaster UniversityAssociate Dean, Director and Professor, School of Rehabilitation Science, Hamilton, Ontario, Canada. Corresponding Author: Saipriya Vajravelu, M.Sc., PhD Candidate, School of Rehabilitation Science, Institute of Applied Health Sciences, Room 308, McMaster University, 1400 Main Street West, Hamilton, Ontario, Canada, L8S 1C7, Email: vajravs@mcmaster.ca Received: 01 April 2016 Accepted: 07 May 2016 Published: 28 May 2016 about symptoms/impairments, difficulty in day to day functioning, challenges to social inclusion and uncertainty were compared across illnesses to identify similarities and differences. We reported findings as a narrative summation. Forty-seven articles were included in this review. The comparison of the three chronic illnesses demonstrated that some of the symptoms/impairments such as pain, fatigue, sleep disturbance, depression, stress, and anxiety were reported commonly across illnesses. Similarly, difficulty with day to day functioning, challenges to social inclusion and uncertainty were reported across illnesses. On the other hand, factors influencing the symptoms, difficulties in daily functioning, challenges to social inclusion and uncertainty were found to be different. The episodic nature of the illness was identified among the three chronic conditions. People living with FM or MS or HIV, experience some common dimensions of disability that may be similarly experienced as episodic in nature. These similarities may not be exclusive to these three chronic illnesses, but could apply to individuals living with other chronic and episodic illnesses. Pursuing ways to enhance rehabilitation services among the conditions that experience similar episodic disability may help collectively to address disability and improve the overall health of people living with chronic illnesses.