Increased age and the burden of comorbidities are associated with an increased consumption of MS treatments

Clinicians of various specialties who care for people with multiple sclerosis (PwMS), according to the study, have a wide range of annual consultations with patients of older age and higher levels of comorbidity, who are associated with the highest care requirements in patients with multiple sclerosis (MS) results in multiple Sclerosis Journal published.

This study included an assessment of linked health administrative and clinical data from British Columbia, Canada. The data consisted of doctor visits, hospital admissions, and prescriptions issued by outpatient and public pharmacies.

Using this data, the study researchers developed 2 cohorts: cases of MS incidence (n = 1048) and cases of MS prevalence (n = 3180). Multi-channel sequence analysis (MCSA) was applied to this analysis to quantify and compare PwMS treatment pathways, taking into account hospital stays and doctor visits for all reasons. The doctor’s visits were divided into 5 specialist areas, including neurologists, psychiatrists, general practitioners, specialists in internal medicine and “others” (physical medicine and rehabilitation specialists, ophthalmologists and urologists).

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The investigators of the study used demographic and clinical characteristics in the MCSA to identify and characterize 12 and 6 different care frequency clusters among incidents and predominant MS cases, respectively. The median follow-up time was 9.6 and 13.0 years for incidence and prevalence, respectively.

In incidents and widespread MS cases, the average number of annual consultations showed a wide range between clusters. The median number of annual consultations for general practitioners was 5.6 to 21.3 versus 1.2 to 4.6 for neurologists, 0 to 5.3 for psychiatrists, 0 to 0.9 for internal medicine specialists, and 0.3 to 1.8 for other key specialists.

Cluster 3 of the incidence cohort and clusters A and E of the prevalence cohort showed a high number of comorbidities. In all cohorts, clusters with a higher comorbidity burden and higher age at the onset of MS symptoms were associated with higher care requirements in all disciplines.

This study lacked data on the lifestyle and environmental pressures that influence care consumption in PwMS, including obesity, diet, smoking, level of education, or physical activity.

The study researchers concluded that the identified “profiles and methodologies could help in the planning of health services and provide a novel outcome in health research or economic evaluation” at PwMS.

Disclosure: Several study authors stated links with the pharmaceutical industry. For a full list of the author’s disclosures, see the original reference.

reference

J. Roux, E. Kingwell, F. Zhu, H. Tremlett, E. Leray; BeAMS study group. Care Consumption by People with Multiple Sclerosis: A Multi-Channel Sequence Analysis in a Population-Based Setting in British Columbia, Canada. Published online May 28, 2021. Mult Scler. doi: 10.1177 / 13524585211016726