Defining the prodromal phase of multiple sclerosis based on healthcare access in a Portuguese population - ProdMS study

Mult Scler Relat Disord. 2021 Oct:55:103154. doi: 10.1016/j.msard.2021.103154. Epub 2021 Jul 19.

Abstract

Background: Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system. Prodromal symptoms and higher healthcare use have been suggested in patients who later develop MS.

Objectives: Assess the healthcare utilization pattern of relapsing-remitting MS (RRMS) patients in the five years prior to MS diagnosis.

Methods: Retrospective, multicentric study. Demographic and clinical data, drug prescriptions and diagnostic tests were collected from electronic health records five-years previous to MS diagnosis and compared with national data.

Results: Included 168 patients, 112 (66.7%) female, median age 34±11 years. The mean number of healthcare use per patient per year was 3.14±2,69, most of them in primary healthcare (47%). Most frequent symptoms were musculoskeletal (22%), gastrointestinal (17%), sensitive (14%) and sensory organs (14%). Median number of diagnostic tests per patient was 6 (IQR 7), and drug prescriptions per patient was 6 (IQR 9). Most frequently prescribed drugs were analgesic/anti-inflammatories, antibiotics and anxiolytics and there was a high request rate of MRIs.

Conclusion: RRMS patients had a high frequency of healthcare utilization when compared to national data. This supports the current evidence showing a prodromal phase in MS.

Keywords: Healthcare use; Multiple sclerosis; Portuguese multicentric study; Prodromal phase; Prodromal symptoms.

MeSH terms

  • Adult
  • Female
  • Health Services Accessibility
  • Humans
  • Middle Aged
  • Multiple Sclerosis* / diagnosis
  • Multiple Sclerosis* / drug therapy
  • Multiple Sclerosis* / epidemiology
  • Multiple Sclerosis, Relapsing-Remitting*
  • Portugal / epidemiology
  • Retrospective Studies
  • Young Adult