Healthcare utilization increases in the year before MS diagnosis: Study

People with multiple sclerosis (MS) utilize more healthcare resources a year before their MS diagnosis, suggesting this may be a period of prodromal MS, when patients start having unspecific and mild MS symptoms.

These might include mild cognitive issues, skin problems, and anemia, when the body doesn’t have enough healthy red blood cells to transport oxygen throughout the body.

“Understanding different characteristics of possible MS prodromal periods will allow for an earlier workup/clinical diagnosis and starting disease-modifying treatment,” the researchers wrote in  “Increased healthcare utilization in the year before multiple sclerosis diagnosis,” which was published in Multiple Sclerosis and Related Disorders.

MS occurs when the immune system attacks the myelin sheath, a protective layer around nerve fibers that helps them send electrical signals efficiently. The loss of myelin leads to progressive nerve fiber degeneration and a range of symptoms.

Previous studies have suggested a prodromal phase could occur in both relapsing-remitting and primary progressive MS, based on non-routine healthcare utilization. There is no set timeline for this phase to occur, however, leading researchers at The Medical College of Wisconsin to use an informatics database of clinical data to analyze healthcare resource utilization by 108 newly diagnosed adults in the four years before their diagnosis.

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Utilizing healthcare resources before diagnosis

The patients’ mean age at diagnosis was 40.6 and most were women (64.8%) and white (71.3%). The utilization of healthcare resources before a diagnosis was significantly higher for older and unmarried patients.

There were no differences related to patients’ sex, ethnicity, employment status, area deprivation index (ADI), which is an indicator of socioeconomic disadvantage that considers income, education, employment, and housing quality, and between those living in rural or urban areas.

After adjusting for population variables, healthcare resource utilization was higher in the year before a MS diagnosis, compared to the period between two and four years before diagnosis.

“Those with less family obligations may have a more flexible schedule allowing for easier accessibility to care,” the researchers wrote.

Older patients demonstrated a significant correlation for healthcare utilization in the years two to four than a year before diagnosis. “Potentially, younger individuals may be demonstrating prodromal characteristics closer to a formal clinical diagnosis,” they said.

The study showed evidence of increased healthcare utilization in the year before a MS diagnosis, compared to previous years (between two and four), which may be when people start having MS-like symptoms.

The study’s retrospective nature, the small number of patients included, and the fact that no control population was used were identified as limitations. “Further studies are warranted for better elucidating prodromal [MS] characteristics,” the researchers wrote.