Comparison of disease progression and impact of symptoms among Black Caribbean and White British participants severely affected by MS.

(i) Palliative Care Outcome Scale (POS) & POS-S symptoms: comprises 10 items on anxiety, PwMS and informal caregiver concerns, practical needs and 18 questions specifically relating to MS symptoms. (ii) Multiple Sclerosis Impact Scale (MSIS): 29 questions on a variety of MS-related impacts of the illness. (iii) Modified Fatigue Impact Scale (MFIS): Examines perceptions of functional limitations that fatigue. (iv) Blessed Orientation Memory Concentration Test (BOMCT): Examines presence of cognitive impairment and thereby diminished capacity. (v) Hospital Anxiety and Depression Scale (HADS): Assesses psychological distress, with two sub-scales of anxiety and depression, used widely among people with physical illnesses. *The analysis of covariance (ANCOVA) was adjusted for the probability of participating in the study (propensity score).