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Relapse Prevalence, Symptoms, and Healthcare Engagement: Insights from Patients with Multiple Sclerosis from the Multiple Sclerosis in America 2017 Survey
ECTRIMS Online Library. Nazareth T. Oct 26, 2017; 200460
Tara Nazareth
Tara Nazareth
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Abstract: P805

Type: Poster

Abstract Category: Therapy - symptomatic - 33 Treatment of specific symptoms

Background: Underestimation of the frequency and severity of relapse in multiple sclerosis (MS) is detrimental to the patient, provider (HCP), and the healthcare system. We sought direct insight into relapse prevalence, symptoms and healthcare engagement from patients with MS via the annual MS in America survey (MSIA).
Methods: The MSIA was fielded by Health Union in Q1'2017 to patients with MS and caregivers via online sources including MultipleSclerosis.net. Survey questions included patient demographics, health coverage, symptoms, disability, relapse experience and related HCP interactions. Descriptive analyses were conducted.
Results: 5,311 patients responded (84.3% female, 87.6% Caucasian, mean age 51.4 years); 35.1% were employed, 40.1% were on disability, and 97.9% had health coverage. Patients reported number of relapses over the past 2 years, (annualized) as < 1/year (44.1%), 1-2/year (35.5%), >2/year (20.4%). Patients with relapses (n=3,882) cited an average relapse duration of < 1 month (62.5%), 1-2 months (10.9%), and ≥3 months (13.7%); 12.9% were unsure/didn't recall. 2/3 of patients reported relapse symptoms of fatigue, numbness/tingling/altered sensations, and walking/balance/coordination. During a relapse, 46.9% said they 'often'/'always' engage their HCPs. The top reasons for not 'always' doing so were 'relapses are not always severe enough to warrant it' and 'I prefer to manage my relapses on my own'. Patients who engage their HCPs during a relapse said relapse-related symptoms/severity, prescription medications/treatments, and treatment effectiveness (resolution) are most discussed. Frequency of HCP engagement during a relapse was positively related to breadth of topics discussed (relapse-related, MS-related) and negatively related to number of relapses. 35.0% of patients reported HCP follow-up within 1 month of communication of relapse, 50.3% said at a next office visit, and 14.7% said there usually is no follow-up.
Conclusions: Our study highlights a subset of patients with >2 relapses/year, relapse duration ≥1 month, and relapse symptoms that interfere with functioning. Yet >50% do not engage with their HCPs regularly during relapse. When patient do engage with their HCPs, many report untimely or no follow-up at all. Given a positive relationship with breadth of discussion and a negative relationship with relapse frequency, HCP-patient engagement during and after relapse to ensure appropriate resolution and treatment should be prioritized.
Disclosure:
Tara Nazareth is an employee and stockholder of MNK Pharmaceuticals
Jackie Polyakov is an employee and stockholder of MNK Pharmaceuticals
Edward Banfe is an employee and stockholder of MNK Pharmaceuticals
Royce Waltrip is an employee and stockholder of MNK Pharmaceuticals
Kristine Zerkowski is an employee of Health Union
Leslie Beth Herbert is an employee of Health Union

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